Clinical and radiographic outcomes of four pulpotomy agents in primary molars: a prospective randomized controlled trial

This split-mouth randomized controlled clinical trial aimed to assess the 12-month clinical and radiographic outcomes of four different pulpotomy materials in primary molars. The materials evaluated were Mineral Trioxide Aggregate (MTA), Biodentine, Ferric Sulfate (FS), and Sodium Hypochlorite (NaOCl) gel. Healthy children aged 4-7 with four primary molars requiring pulpotomy were included. Coronal pulpotomy was performed, followed by application of one of the four materials, and restoration with stainless steel crowns. Clinical and radiographic assessments were conducted at 6 and 12 months. Success rates were compared using Fisher's Exact and Cochran's Q tests. A total of 22 children (88 teeth) completed the study. At 12 months, clinical success was 100% in the MTA, Ferric sulfate and NaOCl gel groups, and 95.5% in the Biodentine group. Radiographic success was 100% for MTA and NaOCl gel, 95.5% for Biodentine, and 81.8% for FS (p < 0.05). Most failures occurred in first primary molars. MTA and Biodentine demonstrated high clinical and radiographic success, with Biodentine offering a faster procedure. NaOCl gel showed promising outcomes comparable to MTA. However, FS had lower radiographic success, indicating limitations for long-term use.Trial registration number: NCT07120321. Data: 08 August 2025. Retrospectively registered.