Primary dentition is importance to the maintenance of overall health, and pulp therapy is recommended to maintain primary teeth. Several methods have been employed to perform pulpotomy which may become necessary to prevent the loss of primary teeth. These include ferric sulfate, formocresol, calcium hydroxide and formaldehyde. This paper reviews the literature on the use of these various therapies in pulpotomy of primary teeth.
Because of difficulties in evaluating the condition of the diseased pulp, complete removal of the damaged tissue is a common procedure in adult therapy (48). This treatment is impractical in primary teeth because of the complicated anatomy of the root canals, the proximity of the permanent tooth germ and difficulties in finding a root canal filling material which is compatible with physiological root resorption. For these reasons, pulpotomy and partial pulp treatment have become popular. Internal root resorption was found to be less dramatic and less frequent when formocresol was used than when calcium hydroxide or zinc oxide-eugenol were used as the wound dressing (48:153). This is due to the severe damage to the residual tissue and its capacity to resorb. The disadvantage of using formocresol is that a chronic inflammation is immediately carried down to deeper parts of the root canal. Calcium hydroxide produced the most prompt healing (48:154). The author concludes that symptomless exposure by caries should be treated by vital pulpotomy with calcium hydroxide as a wound dressing.
A survey sent to all Canadian pediatric dental specialists and to Heads of Departments of Pediatric Dentistry of selected dental schools worldwide showed that the preferred pulpotomy medicament of Canadian pediatric dental specialists was a one-in -five dilution of formocresol (3). The second most prevalent medicament was full strength formocresol. In pediatric dental departments in dental schools, full strength f...