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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