Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial
Keywords:
Child, Tooth, Deciduous, Pulpotomy, PainAbstract
Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.
References
Nematollahi H, Noorollahian H, Bagherian A, Yarbakht M, Nematollahi S. Mineral trioxide aggregate partial pulpotomy versus formocresol pulpotomy: a randomized, split-mouth, controlled clinical trial with 24 months follow-up. Pediatr Dent 2018; 40(3):184-9.
Coll JA, Seale NS, Vargas K, Marghalani AA, SA Shamali, Graham L. Primary tooth vital pulp therapy: a systematic review and meta-analysis. Pediatr Dent 2017; 39(1):16-23.
Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, et al. Use of vital pulp therapies in primary teeth with deep caries lesions. Pediatr Dent 2017; 39(5):E146-E159.
Ounsi HF, Debaybo D, Salameh Z, Chebaro A, Bassam H. Endodontic considerations in pediatric dentistry: a clinical perspective. Int Dent SA 2009; 11(2):40-50.
American Academy of Pediatric Dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Reference manual 20012-13. Pediatr Dent 2016; 38(6):280-8.
Fuks AB. Vital pulp therapy with new materials for primary teeth: new directions and treatment perspectives. Pediatr Dent 2008; 30(3):211-9.
Al-Dlaigan YH. Pulpotomy medicaments used in deciduous dentition: an Update. J Contemp Dent Pract 2015; 16(6):486-503. https://doi.org/10.5005/jp-journals-10024-1711
Sunitha B, Puppala R, Kethineni B, Mallela MK, Peddi R, Tarasingh P. Clinical and radiographic evaluation of four different pulpotomy agents in primary molars: a longitudinal study. Int J Clin Pediatr Dent 2017; 10(3):240-4. https://doi.org/10.5005/jp-journals-10005-1443
Sajadi F, Poureslami HR, Madani F, Sharifi H. Clinical and radiographic findings after using formocresol and Elaeagnus angustifolia fruit powder for pulpotomy of primary molar teeth. Wulfenia J 2014; 21(10):262-78.
Ansari G, Morovati SP, Asgary S. Evaluation of four pulpotomy techniques in primary molars: a randomized controlled trial. Iran Endod J 2018; 13(1):7-12. https://doi.org/10.22037/iej.v13i1.18407
El-Meligy O, Abdalla M, El-Baraway S, El-Tekya M, Dean JA. Histological evaluation of electrosurgery and formocresol pulpotomy techniques in primary teeth in dogs. J Clin Pediatr Dent 2001; 26(1):81-5. https://doi.org/10.17796/jcpd.26.1.w2243176tj661n8p
Rolling I, Tylstrup A. A 3 years clinical follow up study of pulpotomized primary molars treated with the formocresol technique. ASDC J Dent Child 1993; 60(2):107-14.
Sirohi K, Marwaha M, Gupta A, Bansal K, Srivastava K. Comparison of clinical and radiographic success rates of pulpotomy in primary molars using ferric sulfate and bioactive tricalcium silicate cement: An in vivo study. Int J Clin Pediatr Dent 2017; 10(2):147-51. https://doi.org/10.5005/jp-journals-10005-1425
Gisoure EF. Comparison of three pulpotomy agents in primary molars: A randomised clinical trial. Iran Endod J 2011; 6(1):11-4.
Ayatollahi F, Zarebidoki F, Razavi SH, Tabrizizadeh M, Ayatollahi R, Heydarigujani M. Comparison of microleakage of CEM Cement apical plug in different powder/liquid ratio in immature teeth using fluid filtration technique. J Dent 2019; 20(1):37-41. https://doi.org/10.30476/DENTJODS.2019.44561
Asgary S, Ahmadyar M. Vital pulp therapy using calcium-enriched mixture: an evidence-based review. J Conserv Dent 2013; 16(2):92-8. https://doi.org/10.4103/0972-0707.108173
Hegde KM, R N, Srinivasan I, R MKD, Melwani A, Radhakrishna S. Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: a crossover split-mouth study. J Dent Anesth Pain Med 2019; 19(3):143-9. https://doi.org/10.17245/jdapm.2019.19.3.143
Ashkenazi M, Blumer S, Eli I. Post-operative pain and use of analgesic agents in children following intrasulcular anaesthesia and various operative procedures. Br Dent J 2007; 202(5):E13. https://doi.org/10.1038/bdj.2007.81
Staman NM, Townsend JA, Hagan JL. Observational study: discomfort following dental procedures for children. Pediatr Dent 2013; 35(1):52-4.
Olczak-Kowalczyk D, Samul M, Góra J, Gozdowski D, Turska-Szybka A. Ferric Sulfate and Formocresol pulpotomies in paediatric dental practice. A prospective-retrospective study. Eur J Paediatr Dent 2019; 20(1):27-32. https://doi.org/10.23804/ejpd.2019.20.01.06
Shafie L, Barghi H, Parirokh M, Ebrahimnejad H, Nakhae N, Esmaili S. Postoperative pain following pulpotomy of primary molars with two biomaterials: A Randomized Split Mouth Clinical Trial. Iran Endod J 2017; 12(1):10-4. https://doi.org/10.22037/iej.2017.02
Poureslami HR, Sajadi F, Madani F, Sharifi H, Hosseini A. The comparison of pain after using of formocrezol and Elaegnus Angustifolia Fruit Powder for pulpotomy of deciduous teeth. Int J Curr Res Aca Rev 2015; 3(6):490-7.
Memarpour M, Fijan S, Asgary S, Keikhaee M. Calcium-enriched mixture pulpotomy of primary molar teeth with irreversible pulpitis. A clinical study. Open Dent J 2016; 10: 43-9. https://doi.org/10.2174/1874210601610010043
Yildiz E, Tosun G. Evaluation of formocresol, calcium hydroxide, ferric sulfate and MTA primary molar pulpotomies. Eur J Dent 2014; 8(2):234-40. https://doi.org/10.4103/1305-7456.130616
Shirvani A, Asgary S. Mineral trioxide aggregate versus formocresol pulpotomy: a systematic review and meta-analysis of randomized clinical trials. Clin Oral Investig 2014; 18(4):1023-30. https://doi.org/10.1007/s00784-014-1189-2
Peng L, Ye L, Guo X, Tan H, Zhou X, Wang C, Li R. Evaluation of formocresol versus ferric sulfate primary molar pulpotomy: a systematic review and meta-analysis. Int Endod J 2007; 40(10):751-7. https://doi.org/10.1111/j.1365-2591.2007.01288.x
Fernandez CC, Martinez SS, Jimeno FG, Rodriguez AIL, Mercade M. Clinical and radiographic outcomes of the use of four dressing materials in pulpotomized primary molars: a randomized clinical trial with 2-year follow-up. Int J Paediatr Dent 2013; 23(6):400-7. https://doi.org/10.1111/ipd.12009
Fei AL, Udin RD, Johnson R. A clinical study of ferric sulfate as a pulpotomy agent in primary teeth. Pediatr Dent 1991; 13(6):327-32.
Ansari G, Ranjpour M. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2-year follow-up. Int Endod J 2010; 43(5):413-8. https://doi.org/10.1111/j.1365-2591.2010.01695.x
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 2010; 36(3):400-13. https://doi.org/10.1016/j.joen.2009.09.009
Lin PY, Chen HS, Wang YH, Tu YK. Primary molar pulpotomy: a systematic review and network meta-analysis. J Dent 2014; 42(9):1060-77. https://doi.org/10.1016/j.jdent.2014.02.001.
Mehrdad L, Malekafzali B, Shekarchi F, Safi Y, Asgary S. Histological and CBCT evaluation of a pulpotomised primary molar using calcium enriched mixture cement. Eur Arch Paediatr Dent 2013; 14(3):191-4. https://doi.org/10.1007/s40368-013-0038-3
Srinivasan D, Jayanthi M. Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth. Indian J Dent Res 2011; 22(3):385-90. https://doi.org/10.4103/0970-9290.87058
Junqueira MA, Cunha NNO, Caixeta FF, Marques NCT, Oliveira TM, Moretti ABS, et al. Clinical, radiographic and histological evaluation of primary teeth pulpotomy Using MTA And Ferric Sulfate. Braz Dent J 2018; 29(2):159-65. https://doi.org/10.1590/0103-6440201801659
Goes PSA, Watt R, Hardy RG, Sheiham A. The prevalence and severity of dental pain in 14-15 year old Brazilian schoolchildren. Community Dent Health 2007; 24(4):217-24.
Farokh-Gisour E, Parirokh M, Parizi MK, Nakhaee N, Aminizadeh M. Comparison of postoperative pain following one-visit and two-visit vital pulpectomy in primary teeth: a single-blind randomized clinical trial. Iran Endod J 2018; 13(1):13-9. https://doi.org/10.22037/iej.v13i1.18205
Keles S, Kocaturk O. Immediate postoperative pain and recovery time after pulpotomy performed under general anaesthesia in young children. Pain Res Manag 2017; 2017:9781501. https://doi.org/10.1155/2017/9781501
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