Effect of different base materials on clinical and radiographic success rates of vital pulpotomy of primary tooth with ferric sulfate

Recently, ferric sulfate has been introduced as an alternative to formocresol in primary teeth pulpotomies. The most common cause of failure in ferric sulfate pulpotomies is internal resorption, but the main reason for this side effect has not been elucidated. The aim of this study was to compare the clinical and radiographic success rates with the use of different base materials following ferric sulfate pulpotomy. Pulpotomies were performed in 105 primary mandibular molars in 35 patients under six years of age (3 teeth in each patient). After traditional ferric sulfate pulpotomy, one of the three test materials, ZOE, Ca(OH)2 or MTA, was randomly assigned to each tooth. The pulp chambers were filled with IRM and restored by SSCs. Clinical and radiographic evaluations were carried out at 6- and 12-month follow-up visits. Data was analyzed with chi-square and Fisher’s exact tests (α=0.05). After 12 months, MTA group demonstrated higher overall success rate (100%) when compared with ZOE (86.67%) and Ca(OH)2 (80%) groups. There was a statistically significant difference between Ca(OH)2 and MTA groups (p value = 0.024). Internal resorption was the principal cause of radiographic failure in Ca(OH)2 and ZOE groups. Given the limitations of the present study, Ca(OH)2 cannot be recommended as a base material after ferric sulfate pulpotomy. It appears the base material has an important role in the success of ferric sulfate pulpotomy.