Objectives: Pulpotomy of primary incisors is a serious challenge due to the lack of a distinct boundary between the coronal and the radicular pulp and the inaccuracy of the clinical indication criteria. The aim of the present study is the clinical and radiographic evaluation of pulpotomy versus root canal therapy (RCT) of vital primary incisors.
Study design: A total of 100 incisors in 50 patients (female: 27, male: 23) aged 3-4 years were allocated to formocresol pulpotomy (45 teeth) and RCT (46 teeth) using zinc oxide-eugenol. The radiographic and clinical evaluation of treatment outcomes was performed at 12 and 24 months post-operatively. A history of spontaneous pain, missing restorations, recurrent caries, mobility and percussion sensitivity, parulis or fistula, erythema, and swelling were recorded. Data analysis was performed based on two sample proportional test.
Results: The clinical success rate was 86.9% for pulpotomy and 95.6% for RCT (P > 0.05). The radiographic assessment exhibited no pathologic signs in 76.08% of pulpotomy group and 91.3% of RCT group and the difference was statistically significant (P < 0.05). The most common pathologic finding was periodontal widening followed by external/internal root resorption. Periapical radiolucency and fistula in pulpotomized teeth was significantly higher than in RCT-treated teeth (P < 0.05)
Conclusions: It may be concluded that the root canal therapy of vital primary incisors may be efficiently substituted for the pulpotomy of these teeth.