Abstract
The long-term effect of Zinc oxide zinc sulfate (Coltosol®) dressing material on pulpotomy success and tooth survival has not yet been studied. This study compared the success rates of Zinc oxide zinc sulfate and zinc oxide eugenol as coronal dressing materials post radicular pulp amputation in primary teeth pulpotomies. This study included healthy two- to ten-year-old children who had pulpotomies on primary molars between 2012 and 2018 at the Pediatric Dentistry Clinic of the School of Dental Medicine. Data were analyzed at several follow-ups of up to 60 months. Kaplan-Meier survival curves were used to estimate survival probabilities of Zinc oxide zinc sulfate versus zinc oxide eugenol. In the 107 children included in this study, 54 teeth were filled with Zinc oxide zinc sulfate and 53 were filled with zinc oxide eugenol. Follow-up ranged from 12.2 to 73.3 months. Overall survival of Coltosol® vs. IRM filled teeth was 87.1% and 79.3%, respectively. Overall survival probabilities for Coltosol®-filled teeth at 15.5, 24 and 45 months were 95%, 89.8% and 79.7%, respectively, while for IRM they were 93.7%, 83% and 67.7%, respectively. Treatment failure rates and type of treated teeth did not differ between boys and girls (p-value = 0.77 and 0.87, respectively). Zinc oxide zinc sulfate and zinc oxide eugenol exhibited comparable high long-term success rates of up to five years (p = 0.16).
Highlights
The main objective of pulp therapy in primary teeth is to maintain the integrity and condition of the teeth and their supporting tissues [1]
The issue of placing an adequate sealer in the pulp chamber is of critical importance; an ideal endodontic sealer provides a complete microscopic seal and possesses antimicrobial activity without causing an inflammatory response or cytotoxicity [4], and the radicular pulp should remain asymptomatic without adverse clinical signs or symptoms such as sensitivity, pain, or swelling
The coronal pulp chamber is filled with a suitable base such as zinc oxide eugenol and the tooth is preferably restored with a stainless-steel crown [1,3]
Summary
The main objective of pulp therapy in primary teeth is to maintain the integrity and condition of the teeth and their supporting tissues [1]. When caries removal results in a pulp exposure in a tooth with a normal pulp or reversible pulpitis, a pulpotomy is performed providing there is no evidence of radicular pathology. When the coronal tissue is removed, it is mandatory to ensure that the remaining radicular tissue is vital without suppuration, purulence, necrosis, or excessive hemorrhage [2]. The coronal pulp is amputated up to the orifices of the root canals and the remaining vital radicular pulp tissue surface is treated with medicaments such as formocresol, ferric sulfate, sodium hypochlorite, or MTA. The coronal pulp chamber is filled with a suitable base such as zinc oxide eugenol and the tooth is preferably restored with a stainless-steel crown [1,3]
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