Radiographic success of ferric sulfate and formocresol pulpotomies in relation to early exfoliation

The purpose of this retrospective study was to evaluate the radiographic findings with formocresol and ferric sulfate pulpotomies in relation to early tooth loss.

Vital pulpotomies with either ferric sulfate or formocresol, performed by faculty members between 1992 and 2002 at The University of Iowa, were evaluated retrospectively. Radiographic criteria were established to assess success or failure of the treated tooth. This was then correlated with time of tooth loss and space management.

Eighty-five molars, followed between 6 to 61 months, met the inclusion criteria. Of these, 15 (43%) teeth treated with ferric sulfate, 23 (56%) treated with formocresol, and 5 (55%) treated with a combination of ferric sulfate and formocresol remained free of any radiographic pathology. Overall, 13% of the pulpotomized teeth were prematurely lost due to abscess formation and in need of space management. Regardless of the treatment type, internal root resorption was the most common cause of premature exfoliation.

Both ferric sulfate and formocresol pulpotomies can lead to premature exfoliation of primary teeth, with the subsequent need for orthodontic space maintenance. Therefore, radiographic criteria should be taken into consideration when evaluating pulpotomized teeth at recall visits.