Pulp Therapy In Primary Teeth Research Articles

Silver Diamine Fluoride as a Medicament for the Indirect Pulp Therapy in Primary Teeth: A Review of the Literature.

Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as amedicament for indirect pulp therapy(IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT.A literature search was undertaken on electronic databases includingPubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries.However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.

3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials.

3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth. MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10. Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs. The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.

Knowledge, awareness and attitude of parents on pulp therapy of primary teeth: A questionnaire study

: Many of the parents are not aware that primary dentition should be maintained in the dental arch in a healthy state for the overall health of the child. They believe that the treatment of primary teeth is not necessary as they are replaced by permanent teeth.: This study aimed to evaluate the knowledge, awareness and attitude of parents towards primary tooth pulp therapy.: Pretested questionnaire which included the demographics like age, gender and education level with further investigative questions on the need for pulp therapy in primary teeth, knowledge about pulp treatment, importance of pulp treatment, reason of dental visit, restoration of carious tooth and preference of pulp therapy was offered to the participants. Data was collected and compiled using Excel software. Descriptive statistical analysis was performed to obtain the results.: A total of 78 parents participated in the study. Out of which, 69 were female and 9 were men. Based on the education level, parents who studied below 10 standard felt that dental treatment was not needed for primary teeth and 62.5% of them felt that pulp therapy of primary teeth is not needed. On the other hand, parents who completed postgraduation knew that primary teeth are important and dental treatment is required for primary teeth. There is significant lack of awareness among parents regarding treatment of primary teeth.This present study has strived to gather vital information on parents’ oral health awareness and attitudes towards their child’s decayed teeth. While some of the responses were valid, it was clear that parents are still unaware of some important aspects of their child's oral health.

Comparative Evaluation of Novel Calcium Hydroxide-hydrogel with Calcium Hydroxide-iodoform as Obturating Material: A Protocol for an In-vitro Study

Introduction: Pulpectomy is one of the extensively done procedures in clinical practice, in which the pulp is extirpated, and the canal is filled with an obturating material. Modalities of pulp therapy in primary teeth are subtly different from that of permanent teeth, and so are the obturating materials. Calcium hydroxide has an optimum antimicrobial effect on the root canal of teeth. The success rate for Ca(OH)2 -iodoform paste ranges from 84% to 100%. A mixture of calcium hydroxide with iodoform is conventionally used due to its strong antibacterial property, but, high resorptive activity leads to increased periapical radiolucency in the long term. Chitosan, a hydrogel, is antimicrobial, antioxidant and anti-inflammatory. Aim: To prepare, optimise and characterise novel calcium hydroxide-hydrogel as an obturating material and compare it with conventional calcium hydroxide-iodoform. Materials and Methods: The present in-vitro study will be carried out at Sharad Pawar Dental College, Wardha, Maharashtra, India. Chitosan-calcium hydroxide hydrogel will be formulated by soaking commercially available chitosan in 2% acetic acid solution. Calcium hydroxide will be added to this base in different concentrations for each sample and mixed in a magnetic stirrer. Twenty samples of calcium hydroxidehydrogel will be formulated and divided into three groups with concentration of 0.1, 0.55 and 1% w/v respectively and a control group with calcium hydroxide-iodoform will also be evaluated. Calcium ion release shall be checked through infrared spectroscopy techniques and pH through pH meter at 7, 14, 21, and 28 days. To evaluate, an Analysis of Variance (ANOVA) followed by post- a hog test will be used. Expected Results: Various composition of Calcium hydroxidehydrogel might prove to be better obturating material when compared to conventional Calcium hydroxide-iodoform paste. Conclusion: Within the scope of this study, Calcium hydroxidehydrogel can be a potential alternative to the available obturating materials for primary teeth.

Cone-Beam Computed Tomography (CBTC) Applied to the Study of Root Morphological Characteristics of Deciduous Teeth: An In Vitro Study.

Pulp therapy in primary teeth is a challenge for a dentist, therefore, a better understanding of the anatomical characteristics of this tissue is essential to remedy these deficiencies. The aim of this study was to determine the morphological peculiarities of the root canals of extracted deciduous molars by Cone-Beam computed tomography (CBCT). As such, healthy molars without physiological resorption were collected and sanitized. After analyzing descriptive and inferential statistics, the results show that 56% of lower molar roots have a Weine’s type III canal configuration; the upper and lower second molars are significantly larger compared to the first, with a mean of 8.318 (±1.313) mm and 7.757 (±1.286) mm, respectively. Additionally, the palatine canals exhibited greater volume than the others, with a mean of 3.687 mm3. There are multiple discrepancies in the molars that have been studied in other investigations. The presence of a supernumerary root in the mandibular molars, a smaller dimension of the root canals and a more evident apical angulation are more obvious. The discovery of great anatomical versatility in the posterior dental group is an aspect applicable to root therapy.

Clinical Outcome of Direct Pulp Therapy in Primary Teeth: A Systematic Review and Meta-analysis.

Direct pulp treatment is carried out when a healthy pulp gets mechanically/accidentally exposed during the operative procedures or trauma. To determine the effects of various direct pulp capping materials as measured by the clinical and radiographic analysis. Two reviewers performed a database search of the studies published between January 2005 and November 2020. The inclusion criteria were papers published in the English language; children aged 3-12 years having deep carious lesions in primary teeth. All potential studies were acknowledged by their title and abstract. The full-text analysis of potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. The database searching led to 57 articles, which were of direct pulp treatment in primary teeth, after the removal of duplicates, 55 records remained but did not meet all inclusion criteria. A high variability was observed among the papers. Further filtering with criteria led to nine articles, which met all inclusion criteria. Meta-analysis demonstrated the success rates of DPT in primary teeth (95% confidence interval -0.799-0.898); P < 0.001. Clinical assessments of various direct pulp capping materials suggested 84.9% of success irrespective of the material used. The nine studies were heterogeneous according to the random effect model (P < 0.001, I2 = 84.08%). Direct pulp treatment has the advantage of being a conservative vital pulp therapy reducing the need for a more invasive treatment.

Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial.

AimTo compare the efficacy of lignocaine and benzocaine when applied as a topical anesthetic before intraoral local anesthetic administration in children.Materials and methodsForty-four patients aged between 4 years and 10 years indicated for pulp therapy of primary teeth under inferior alveolar nerve block were selected for this study. The participants were randomly allocated into two groups of 22 each. Group I (lignocaine gel) and group II (benzocaine gel) were applied before inferior alveolar nerve block. The pain scale was assessed by a trained examiner using the visual analog scale (VAS) and sound eye motor scale.ResultsLignocaine when used as a topical anesthetic agent showed lower mean scores under both the pain scales when compared with benzocaine but the results were statistically insignificant.ConclusionLignocaine and benzocaine are equally effective when applied as a topical anesthetic agent. But lignocaine was more preferred in taste when compared with benzocaine.How to cite this articleKotian N, Mani G, Ramakrishnan M. Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(2):180–182.

Effect of MTA on two types of furcal perforation in primary molars : A prospective clinical trial.

Objective : Pulptomy and pulpectomy usually are the most common techniques used in pulp therapy for primary teeth and despite the relative ease of performing this techniques iatrogenic errors may. furcal perforation of common errors can be occurred during performing pulp therapy in primary molars. two types of furcal perforation were selected according to time factor elapsed since their occurrence ( recent and long standing) and these types of perforation treated with MTA. This study was directed to evaluate the ability of MTA to treat furacal perforation in primary molars regarding the time factor Subjects and Methods: thirty patients were selected 15 with accidently recently ( group A) furcally perforated molars and 15 with long standing old perforation (group B), and the two types sealed with MTA and then completed by conventional pulp therapy treatment either by pulptomy or pulpectomy for group A , and pulpectomy for group B, then they followed up clinically and radiographically for 12 months. Result: there was statistically significant difference in success incidence between the two groups (p=0.014); being higher in recent perforation. For long standing perforation; 10 patients out of 15 patients (66.7%) showed success; while in recent perforation; 15 patients (100%) showed success. Conclusion : recent type of perforation which repaired at the same visit has a higher success rate and better prognosis than old type or long standing in primary molars

LSTR AND ITS POTENTIAL ROLE IN CONSERVATIVE MANAGEMENT OF NON-VITAL PRIMARY MOLAR: A CASE REPORT.

Lesion sterilization and tissue repair (LSTR) treatment is very effective in disinfecting the root canal using triple antibiotic mixed in a suitable vehicle. This report is highlighting a case where LSTR therapy was done using triple antibiotic paste in primary molar showing peri-radicular pathosis and root resorption. On one-year follow-up, the tooth was asymptomatic with reduction in peri-radicular pathosis and root resorption. Thus, LSTR can be successful for nonvital pulp therapy in primary teeth with peri-radicular pathosis and root resorption. And also, LSTR therapy can be used as an alternative option to extraction in treating primary teeth with peri-radicular pathosis.

Comparison between MTA and Biodentine on treatment of accidently recent furcal perforation in primary molars : A prospective clinical trial

Objective : Pulptomy and pulpectomy usually are the most common techniques for pulp therapy for primary teeth and despite the relative ease of performing this techniques iatrogenic errors may occurs such as furcal perforation . MTA and biodentine were selected to test their ability to repair the furcal perforation in primary molars. Subjects and Methods : thirty patients with thirty accidently furcally perforated molars discovered at and sealed immediately at the same visit with either biodentine or MTA and then completed by conventional pulp therapy treatment either by pulptomy or pulpectomy then followed up clinically and radiographically for 12 months. Result: both materials showed highly success rate, the first group of MTA show 100% success. And group II Showed (93.3%) showed success with no significant difference (p= 1.000). Conclusion : MTA and biodentine can successfully used in treatment o f Iatrogenic recent furcal perforations that may occur during pulpotomy in primary molars.

Pulp repair response after the use of a dentin-pulp biostimulation membrane (BBio) in primary teeth: study protocol for a randomized clinical trial

BackgroundVital pulp therapy aims at maintaining the pulp tissue injured but vital. Thus, the use of capping materials that induce tissue regeneration is a great current trend. This study aims to evaluate clinically and radiographically the pulp repair after the use of dentin-pulp biostimulation membrane in primary teeth.MethodsFour hundred and sixty-eight teeth from children aged between 5 and 9 years old, both genders, with deep caries lesion with pulp involvement, but no furcal impairment and any sign of necrosis will be selected. The vital pulp therapy will be performed with mineral trioxide aggregate (control group) and dentin-pulp biostimulation chitosan membrane (BBio group). The clinical and radiographic outcomes will be assessed at 12 and 24 months after treatment. The thickness of the dentin barrier will be verified through Image J2 software. The Wilcoxon signed rank test and Mann-Whitney test will respectively compare the intra- and intergroup clinical and radiographic outcomes. Paired t test and independent t test will respectively compare the intra- and intergroup radiographic measurements. The logistic regression will be applied, and the degrees of this association will be measured using odds ratio (OR) and 95% confidence interval (95% CI).DiscussionTherefore, this study protocol aims at new perspectives of vital pulp therapy of primary teeth by employing new easy-handling, low-cost material to keep viable the pulp tissue capable of regenerating and maintain the physiological process of deciduous tooth exfoliation.Trial registrationBrazilian Registry of Clinical Trials RBR-6vr58b. Registered on 17 February 2019.

Assessment of Commonly used Irrigants During Pulpectomy in Primary Teeth in a Hospital Based Setting - A Retrospective Study

Pulpectomy is a procedure done for non-vital teeth which involves the extirpation of pulp from primary teeth and filling it with an inert substance. pulpectomy requires biomechanical preparation, but this biomechanical preparation alone is insufficient. Irrigants are used during this procedure for the purpose of lubrication, disinfection and washing away action. These irrigants penetrate the smaller accessory and lateral canals, thereby cleaning and disinfecting them. It is essential to eradicate the microorganisms and their by products from the root canal and pulp chamber. The aim of this study is to evaluate the most common irrigants used during pulp therapy in primary teeth by south indian dentists. Data was collected and tabulated. The collected data was further analyzed, recorded in Microsoft excel software and was subjected to statistical analysis using IBM SPSS statistics analyzer. The total sample size of the current study was 2400 cases. The most common age group of the patients who reported to the clinics were 0 to 5 years of age (69.1 %) (p &amp;lt; 0.05 - significant). The more common gender for using saline as an irrigant were male (57.7 %) (p &amp;lt; 0.05 - significant). We found that saline was the most commonly used irrigant (58.7 %), while sodium hypochlorite was the least commonly used (0.1 %). The most common visit for using saline as an irrigant were single visit (p &amp;lt; 0.05 - significant) followed by multi-visit. Within the limitations of the current study, saline was the most commonly used and sodium hypochlorite was the least commonly used for pulpectomy procedure in primary teeth. Saline was also commonly preferred for single visit in patients in the age group of 0 to 5 years.

Pulp therapy in primary teeth

Pulp therapy in primary teeth

Influence of ozone application in the stepwise excavation of primary molars: a randomized clinical trial.

The aim of this randomized, controlled, three-arm parallel-group, double-blinded clinical trial was to investigate the clinical and microbiological effects of the ozone application in stepwise excavation of primary molars. This study was conducted in in vivo conditions with 105 lower primary molars that had deep caries lesions. The teeth were randomly divided into three groups: (I) control group, conventional stepwise excavation with no disinfectants; (II) CHX (positive control) group, 2% chlorhexidine digluconate; and (III) experimental group, ozone application. Dentine samples were collected at 4 different time points (T0, at the first appointment, after partial removal of carious dentin; T1, at the first appointment, after applying disinfection procedure; T2, at the second appointment - at the end of the 4-month period - immediately after the removal of the temporary restoration; T3, at the second appointment, after the final excavation) for the microbiological analysis of mutans streptococci and lactobacilli and the total number of colony-forming units. Clinical changes including dentin color, humidity, and consistency were recorded. Data were analyzed using the Mann-Whitney U test, Friedman test, and chi-squared test (p= 0.05). The dentin became harder and drier after 4months in all the groups. There was a gradual reduction in the total number of microorganisms in all the three groups. Bacterial reduction was greater in the CHX group compared to the ozone group (p= 0.002) and was greater in the ozone group compared to the control group (p= 0.015) after 4months (control, 78%; CHX, 93%; ozone, 82%). Stepwise excavation of primary teeth provided successful outcomes in all the groups. Moreover, CHX, due to its practicality and cost-effectiveness, can be effectively used with one- or two-step indirect pulp therapies. Usage of cavity disinfectants in the stepwise excavation procedure contributes to the reduction of bacterial population in the cavity, which may allow the avoidance of the second step of the indirect pulp therapy for primary teeth.

A Survival Analysis of Different Pulp Therapies in Decayed Primary Teeth

Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 records of children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation . Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively) . Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.

Digital Radiographic Evaluation of the Quality of Different Root Canal Obturation Techniques in Deciduous Mandibular Molars after Preparation with Rotary Technique.

Statement of the Problem: Several factors affect the success of pulp therapy of primary teeth, including cleaning and shaping of the root canals and the quality of obturation as the most important steps. Purpose: The aim of the present study was to compare the quality of different root canal obturation techniques in deciduous mandibular molars subsequent to preparation of the root canals with the rotary technique, using the photo stimulated phosphor (PSP) digital radiographic technique. Materials and Method: In this in vitro study, 221 root canals were selected in 80 extracted deciduous mandibular second molars. The root canals were prepared with a modified protocol for ProTaper NiTi rotary files and with only two instruments (SX and S2) and obturated using a lentulo spiral, condensation technique, an anesthetic syringe, and tuberculin syringe techniques with ZOE paste. The quality of the root canal obturation (obturation length and the number and sizes of the voids) was evaluated using PSP radiographic technique. Data were analyzed with SPSS 21, using chi-squared, Kruskal-Wallis and Mann-Whitney tests. Results:There were no significant differences in the obturation length (p= 0.285) and the number of voids (p= 0.061) between the study groups; however, there were significant differences in void sizes between the study groups (p= 0.001). The condensation and tuberculin syringe groups exhibited the best and worst results considering the obturation length, respectively. Lentulo and anesthetic syringe techniques have also exhibited acceptable results. The condensation and anesthetic syringe groups exhibited the minimum and maximum number of voids, respectively. The condensation and lentulo groups exhibited the maximum and minimum void sizes, respectively. Conclusion:If implemented correctly, there will be no significant difference among the experienced root canal obturation techniques considering obturation length and the number of voids.

Evaluation of clinical efficacy and volumetric changes in pulpectomized primary molars: An invitro study

IntroductionPulpectomy is the intervention of choice for treating infected pulp tissue. Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Ni-Titanium instruments are available but are rarely used in primary teeth. Rotary instruments were introduced to pediatric endodontics by Barr et al in the year 2000. A new system Kedo S files has been introduced which has overcome the major disadvantages of using multifiles in pediatric population. Aims and objectivesTo compare canal preparation between manual and rotary systems using CBCT and to compare volumetric filling using CBCT. Materials and MethodsA total of 30 extracted human primary teeth were included in the study.Teeth were cleaned and scaled and stored in 0.5% hypochlorite. Access cavity was done, pulp extirpated and irrigated with saline. The teeth were randomly divided into three groups. Group A, Group B and Group C. After canal preparation, root canal filling was done with Calcium hydroxide. The samples were subjected to CBCT analysis. ResultsThere was a significant difference in the volume of root canal enlarged in all the groups. Rotary files showed significant increase in the volume compared to K files.Rotary instrumented root canals showed good obturated volume compared to K files, although voids were common in all the groups. ConclusionRotary root canal instrumentation may be indicated for utilization in primary teeth, for enhancing root canal preparation and good quality of root canal filling.

Clinical and Radiographic Characteristics of the Primary Teeth Indicated For Pulpectomy: A Cross-Sectional Analysis

Introduction- Although difficult to achieve but an accurate diagnosis of pulp status is important for the success of pulp therapy in primary teeth. Clinical signs and symptoms, as well as radiographic characteristics, are important in this regard. Material and methods- This cross-sectional analysis evaluated the clinical and radiographic characteristics in 60 decayed primary mandibular second molars from children aged 4-8 years indicated for single visit pulpectomy treatment based on their history, clinical examination and radiographic examination. Results- Pain was present in 60% of cases followed by tenderness on percussion (1.7%) and sinus tract (1.7%). Evaluation of duration of onset of pulpal involvement revealed 86.7% cases had chronic involvement whereas 13.3% cases showed an acute exacerbation of chronic involvement. Irreversible pulpitis was present in 68.3% cases followed by pulp necrosis in 28.3%. Only 7 out of 60 cases indicated for pulpectomy showed radiographic involvement in periapical or furcation areas. Conclusion- Pain was the most common symptom. Majority of cases had chronic involvement and irreversible pulpitis was the most common indication for pulpectomy followed by pulp necrosis. Only a few cases indicated for pulpectomy in the present study had radiographic involvement present.

The Effect of Triple Antibiotic Paste on Pulp Capping of Primary Teeth. (Clinical and Radiographic Study)

The use of 3Mix can play a significant role in the dental management of pulp therapy for primary teeth. Where caries has penetrated into the deeper dentinal tissue, triple antibiotic paste may have a role depending on its antimicrobial effect. This study compared between the clinical, radiographic and microbiological effects of two medicaments; (3Mix and formocresol) on the remaining pulp tissue of the pulpotomized teeth, comprised 4main groups. In the first and second groups, vital pulpotomy procedure was performed while the third and fourth groups, non-vital pulpotomy were done. The teeth were evaluated clinically and radiographically at different intervals (immediately post-operative, 6 weeks, and 3 months), the result show that antibiotic paste having promising clinical effect on primary teeth.

Clinical and Radiographic Assessment of Pulpotomy Materials in Primary Molars

Aim or purpose: Clinical and radiographic evaluation of four different materials utilized in vital pulpotomy in mandibular primary molarsMaterials and methods: one hundred and sixty mandibular primary molars in forty children were included as split mouth design. Patients were medically free with an age range from 4-6 years. Inclusion criteria: patients presented with deep carious lesions including the first and second primary molars bilaterally, no evidence of any clinical pathology, mobility and had no tenderness to percussion. Pre-operative radiographs showed no evidence of external or internal root resorption, absence of furcal, periapical radiolucency or widened periodontal ligament space and no more than one-third root resorption detected. The included molars undergone vital pulp therapy and bilaterally randomly divided into four equal groups, group (1) formocresol, group (2) ferric sulphate, group (3) MTA (mineral trioxide aggregate) and group (4) Metapex (calcium hydroxide &iodoform). All treated molars were evaluated both clinically and radiographically for 12 months evaluation period. Data were collected and analysed statistically.Results: It was shown that, at base line, there was no statistically significant difference between clinical as well as radiographic success rates among the four groups. After 3 as well as 6 months, there was a statistically significant difference between clinical and radiographic success rates among the four groups. FS, MTA and Metapex groups showed higher clinical and radiographic success rates than FC group.Conclusions: Ferric sulphate, mineral trioxide aggregate (MTA) and Calcium hydroxide and iodoform paste (Metapex) provide clinically acceptable alternative to formocresol in vital pulp therapy in primary teeth.