Outcomes of Vital Primary Incisor Ferric Sulfate Pulpotomy
and Root Canal Therapy
FULL TEXT
• Michael J. Casas, DDS, MSc, FRCD(C) •
• David J. Kenny, BSc, DDS, PhD, FRCD(C) •
• Douglas H. Johnston, BSc, DDS, MSc, FRCD(C) •
• Peter L. Judd, BSc, DDS, MSc, FRCD(C) •
• Michael A. Layug, BSc, DDS, FRCD(C) •
A b s t r a c t
Purpose: To compare ferric sulfate (FS) pulpotomy and primary tooth root canal therapy (RCT) in cariously exposed vital pulps of primary incisors.
Methods: A total of 133 incisors in 50 children were randomly selected to be treated by FS pulpotomy (64) or RCT (69).
Results: Two years after treatment, 77 incisors (41 FS pulpotomy, 36 RCT) were available for clinical and radiographic examination. There was no clinical evidence of pathosis in 78% of FS pulpotomy-treated and 100% of RCT-treated incisors. Two independent pediatric dentists evaluated periapical radiographs of the treated incisors. Incisors were classified into 1 of 4 treatment outcomes: N, normal treated incisor; H, nonpathologic radiographic change present; PO, pathologic change present, but not requiring immediate extraction; PX, pathologic change present, extract immediately. Survival analysis was applied. A moderate level of agreement between raters was found for incisors with outcome PX (K = 0.54). Intra-rater reliability was substantial for incisors with outcome PX (K = 0.61). No difference was demonstrated in the proportion of FS pulpotomy- and RCT-treated incisors rated PX at the 2-year recall (x² = 0.6). RCT incisors demonstrated a significantly higher survival rate than FS pulpotomy incisors at 2 years (p = 0.04).
Conclusions: Treatment outcomes for RCT incisors were not significantly different from FS pulpotomy-treated incisors at 2 years; however, at 2 years the survival rate of RCT incisors was statistically greater than that of FS pulpotomy-treated incisors.
MeSH Key Words: dental pulp exposure/therapy; pulpotomy/methods; root canal therapy
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