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Two-year outcomes of primary molar ferric sulfate pulpotomy and root canal therapy
Michael J Casas1, Michael A Layug, David J Kenny
1The Hospital for Sick Children, and Faculty of Dentistry, University of Toronto, Toronto, Canada. mcasas@sympatico.ca
Purpose:
The objective of this outcome study was to compare ferric sulfate pulpotomy (FS) and primary tooth root canal therapy (RCT) on cariously exposed vital pulps of primary molars.
Methods:
A total of 291 molars were treated in 130 children--182 molars received FS and 109 received RCT by random selection.
Results:
At 2-year reassessment, 116 molars (73 FS, 43 RCT) were available for clinical and radiographic examination. There was no clinical evidence of pathosis in 96% of FS and 98% of RCT molars. Two independent pediatric dentists evaluated periapical radiographs of the treated molars. Molars were classified into 1 of 4 outcomes: (1) N--normal treated molar, (2) H--nonpathologic radiographic change present, (3) P(O)--pathologic change present, follow-up in 6 months, and (4) P(X)--pathologic change present, extract immediately. Survival analysis was applied. A good level of agreement between raters was found for molars with outcome P(X) (kappa=0.745). Intrarater reliability was good for molars with outcome P(X) (kappa=0.710). Significantly greater numbers of FS than RCT molars were rated P(X) at the 2-year recall (chi2=5.8; P=.02). No significant difference in survival between the 2 types of vital pulp treatments was detected in log rank tests (P=.22).
Conclusions:
Outcomes for FS were poorer than RCT outcomes at 2 years; however, at 2 years, the survival rates were not statistically different.