EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY • 3/2005 133 Evaluation of three pulpotomy medicaments in primary teeth D. MARKOVIC, V. ZIVOJINOVIC, M. VUCETIC ABSTRACT . Aim To examine the success of the one-appointment pulpotomy technique with three different medicaments on primary molar teeth. Methods The study was conducted on 104 primary molars in 104 children with an indication for pulpotomy treatment on at least one primary molar. Primary teeth were treated with either formocresol (FC) (34 teeth), calcium hydroxide (CA) (33 teeth) or ferric sulphate (FS) (37 teeth) using standardised criteria for the pulpotomy procedures. Teeth were clinically and radiographically evaluated during the examination period of 18 months. Results The clinical success rate at 18 months for the FC and FS groups was 90.9% and 89.2%, respectively. The CA showed an overall clinical success rate of 82.3%, with no statistical difference compared with either the FC or FS groups. The overall radiographic success for each technique was: FC 84.8%, CA 76.5%, and FS 81.1%. The presence of a dentine bridge above the pulp amputation site was observed radiographically for CA (47%), and FS (40.5%) pulpotomies without any statistical difference. Radiographic examination did not reveal the presence of a dentine bridge for any of the teeth treated with FC pulpotomy. Conclusion Favourable clinical and radiographic success rates of ferric sulphate pulpotomy, comparable to formocresol were obtained. Therefore, ferric sulphate can be recommended as a pulpotomy medicament. KEYWORDS:Primary teeth, Pulpotomy, Formocresol, Ferric sulphate. Clinic of Preventive and Pediatric Dentistry, School of Dentistry, University of Belgrade, Serbia and Montenegro In cases where no radiographic evidence exists for bony degeneration and no inflammatory reaction of radicular pulp tissue is present, the treatment of choice is a vital pulpotomy procedure [Hicks et al., 1986]. The purpose of pulpotomy is maintenance of radicular vital pulp tissue, which is not necessarily achieved with the commonly used medicaments [Rolling and Lambjerg-Hansen, 1978]. Since Buckley's formula was introduced in 1904, formocresol pulpotomy remains a popular procedure. Many medicaments and techniques, with varying success rates, have now been proposed for the pulpotomy of primary teeth, such as: calcium hydroxide, gluteraldehyde, devitalising (N2) paste (paraformaldehyde), zinc oxide eugenol (ZOE), kripaste, Ledermix ® , electrosurgery, ferric sulphate, bioceramic materials, mineral trioxide aggregate (MTA), growth factors, lasers etc. [Davis et al., 1982; Shulman et al., 1987; Fuks et al., 1997a; Eidelman et al., 2001]. The mechanisms by which medicaments, used for pulpotomy procedures, act are still not fully determined ['s-Gravenmade, 1975]. Formocresol, being the most commonly used medicament “should be regarded only as a means to keep primary teeth with pulp exposures functioning for a limited period of time” because pulpal changes have been evident in Introduction In orofacial development of the child, preservation of the primary dentition for as long as possible is of great importance. As primary teeth maintain arch length and preserve masticatory function, clinicians must be familiar with the pathology of the primary teeth [Koch and Poulsen, 2001]. Clinically, when considering the pulp pathology of primary and young permanent teeth, it is often impossible to determine the degree of inflammation when there are cariously exposed pulps. It is also difficult to differentiate between either partial or total chronic inflammation of the pulp, and to choose an adequate therapy procedure [Dummer et al., 1980; Koch and Poulsen, 2001]. Research has shown that only with histological analysis can the pathological status of the pulp be precisely evaluated. Poor correlations between the clinical and histological conditions of the pulp have been described [Dummer et al., 1980; Duggal et al., 2002] and a clinical evaluation is only able to give an indication of the probable state of the pulp [Dummer et al., 1980].