Outcomes of vital primary incisor ferric sulfate pulpotomy and root canal therapy.
OBJECTIVE
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.
Casas
Michael J
MJ
The Hospital for Sick Children, Toronto, Ontario, Canada. mcasa@sympatico.ca
Kenny
David J
DJ
Johnston
Douglas H
DH
Judd
Peter L
PL
Layug
Michael A
MA
D002675:Child, Preschool; D003789:Dental Pulp Exposure / Q000628:therapy*; D019232:Dental Restoration Failure; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging; D008297:Male; D011672:Pulpotomy / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D012387:Root Canal Filling Materials; D012390:Root Canal Therapy / Q000009:adverse effects / Q000379:methods*; D012391:Root Resorption / Q000209:etiology; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014094:Tooth, Deciduous; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement
D005290:Ferric Compounds; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C024823:ferric sulfate