Electrosurgical Pulpotomy The Journal of Clinical Pediatric Dentistry Volume 36, Number 2/2011 133 INTRODUCTION P ulpotomy is the most common primary tooth pulp treatment in children under 6 years of age. 1 Buckley’s formocresol was first introduced as a pulp medica- ment in 1904, and since 1930 has been the drug of choice for primary molar vital pulpotomies due to its ease of use and high clinical success rate (55-98%). 2,3,4 However, formocre- sol and formaldehyde (a formocresol constituent) are poten- tially mutagenic and carcinogenic according to some animal studies 5,6 and has been shown to be distributed systemically after pulpotomy. 7 In 2004, the IARC (International Agency for Research on Cancer) issued a press release classifying formaldehyde as carcinogenic to humans. 3 This information was circulated to all pediatric dentistry consultants, resulting in the with- drawal of Buckley’s formocresol and all paraformaldehyde containing devitalizing pastes from most teaching hospitals in the UK, 3 however, some researchers believe that formocresol, when used judiciously, is unlikely to be geno- toxic, immunotoxic, or carcinogenic in children when used in pulpotomy procedures. 8 To identify a biologically acceptable and effective alter- native to formocresol, other agents and techniques have been examined. After amputation of the inflamed coronal pulp, a non inflamed radicular pulp can be altered through devitalization (e.g., with formocresol or electrosurgery), preservation (e.g., with ferric sulfate), or regeneration (e.g., with bone morphogenetic proteins). 9,10 Electrosurgery is a nonpharmacological, hemostatic technique for pulpotomy prior to placing a lining material. It is a time-efficient method that is relatively free from postoperative complica- tions, with a high success rate similar to formocresol pulpo- tomy. 4, 11-15 Currents producing various amounts of heat are used to produce a surgical incision, coagulation, or electrofulgura- tion. The procedure carbonizes and denatures the pulp tis- sue, producing a layer of coagulative necrosis that protects the healthy radicular tissue beneath the lining base material. 1 Despite many positive results for electrosurgery, some studies indicate less radiographic success using this tech- nique compared to formocresol pulpotomy .4 Such failures may be related to the stimulating and harm- ful effects of eugenol. Therefore, the purpose of this study was to assess the clinical and radiographic success rate of electrosurgical pulpotomy of primary molars with zinc oxide eugenol (ZOE) or zinc polycarboxylate (ZPC) cements, to identify the most suitable pulp-capping material. MATERIALS AND METHOD Patients: Healthy and cooperative 110 boys and girls (mean Comparison of Electrosurgical Pulpotomy with Zinc Oxide Eugenol or Zinc Polycarboxylate Cements Sub-Base Nematollahi H * / Sahebnasagh M ** / Parisay I *** Purpose: The aim of this study was to compare the clinical and radiographic success rates of electrosurgi- cal pulpotomy of human primary molars with zinc oxide eugenol (ZOE) and zinc polycarboxylate (ZPC) cements. Methods: In this randomized clinical trial study, 120 primary second molar teeth were treated by electrosurgical pulpotomy. Teeth were randomly assigned to two groups according to whether ZOE or ZPC cement was used as a sub-base. Teeth were restored with stainless steel crowns and were evaluated clini- cally and radiographically after 3, 6, and 12 months by two independent examiners. Clinical treatment out- comes and radiographic findings were statistically analyzed using Fishers’ exact test with statistically sig- nificant differences defined for P < 0.05. Results: At 12 months, the clinical and radiographic success rates in the ZOE group were 98.2% and 84.2% and in the ZPC group were 96.2% and 75%, respectively (P > 0.05 for all). Conclusions: The outcomes of this study suggested that either ZPC or ZOE sub-base have sim- ilar clinical and radiographic success in electrosurgical pulpotomy. Keywords: Pulpotomy; Tooth; Molars; electrosurgical pulpotomy; Zinc Oxide Eugenol cement; zinc poly- carboxylate cement J Clin Pediatr Dent 36(2): 133–138, 2011 * Nematollahi H, MS, Associate Professor ** Sahebnasagh M, Post Graduate, DDS Student *** Parisay I, MS Assistant Professor Send all correspondence to: Sahebnasagh M, Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Iran. Tel: +989155867545 Email: Marzieh.saheb@gmail.com dr.imanparissay@yahoo.com