Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial

Fatemeh Sadat Sajadi,Farzaneh Jalali,Mehrnaz Khademi

doi:10.1590/pboci.2021.007

Abstract

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.

Highlights

The maintenance of primary dentition is essential for aesthetic enhancement and development of jaws in children
A pulpotomy is the removal of the inflamed coronal pulp tissue, and the vital radicular pulp tissue is covered with a suitable covering material [4]
In the radiographic assessment after third-month in the Ferric Sulfate (FS) group showed external root resorption and periapical radiolucency in a first primary molar and widening of periodontal ligament (PDL) in a second primary molar. Both of these cases considered as radiographic failure in FS group, while there was no radiographic failure related to teeth treated with Calcium-Enriched Mixture (CEM) cement

Summary

Introduction

The maintenance of primary dentition is essential for aesthetic enhancement and development of jaws in children. According to a recent systematic review and a new AAPD (The American Academy of Pediatric Dentistry) guideline for vital pulp therapy in primary teeth, indirect pulp therapy, direct pulp cap, and pulpotomy are introduced as suitable treatments of choice [2,3]. The pulpotomy is only indicated when there is a pulp exposure in the presence of caries tissue, in which selective caries removal is being conducted [5]. This method needs a bactericidal medicament that has no side effects, improves the healing process, and has no interference in physiologic root resorption [6]

Methods

Results

Discussion

Conclusion