Preliminary Evaluation of Sodium Hypochlorite for Pulpotomies in Primary Molars

Resident’s Name: Jessica Wilson

Program: Lutheran Medical Center - Providence

Article title: Preliminary Evaluation of Sodium Hypochlorite for Pulpotomies in Primary Molars

Author(s): Vargas et al.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2006. 28:6. 511-517.

Major topic: Sodium Hypochlorite Pulpotomies

Overview of method of research: Scientific Article

Purpose:
To compare the effectiveness of 5% NaOCl and ferric sulfate as medicament agents in pulpotomies of primary molars.

Background:
Studies have shown that up to 40% of pulps treated with either ferric sulfate or formocresol have severe inflammation with 60% of those treated with ferric sulfate experiencing cold sensitivity.
NaOCl has been found to be compatible with the pulp with only superficial effects on vital tissue.

Methods:
23 subjects between the ages of 4 and 9 years old needing at least 2 pulpotomies in primary molars were recruited. They consented to either receive 5% NaOCl and ferric sulfate and restored with IRM and SSC. All teeth with mobility, spontaneous pain, swelling, percussion sensitivity, resorption, furcal radiolucency, widened PDL or unsuccessful hemostasis were excluded from this study. Follow-up appointments were held at 6 and 12 months where clinical and radiographic exams were performed.
The teeth were then treated accordingly; 15 seconds with ferric sulfate or 30 seconds with 5% sodium hypochlorite. If bleeding persisted, the teeth were then excluded from the study. The teeth were restored with IRM and an SSC.
Clinical exam was then performed immediately after treatment, at 6 months and at 12 months by the principal investigator without immediate knowledge of which medicament was used. Radiographic exam was completed by 2 calibrated investigators immediately after treatment, at 6 months and 12 months.

Findings:
A total of 60 primary molars were included in the study. 28 were treated with ferric sulfate and 32 with NaOCl. At 6 months, clinical success (asymptomatic, no mobility, fistula, swelling or inflammation) was found in 100% of treated teeth. At 12 months, 11 of the 13 ferric sulfate teeth that were evaluated (85%) were found to be clinically successful whereas14 of 14 NaOCl teeth that were evaluated were successful.
At 6 months, 32% (9/28) of the ferric sulfate teeth showed radiographic pathologic changes as did 9% (3/32) of those treated with NaOCl. The most common finding was internal resorption in both groups. After 12 months there were 2 new failures among the ferric sulfate group and no new NaOCl failures.
The overall success rates for ferric sulfate were 84% and 74% at 6 and 12 months respectively. Success rates for NaOCl were 96% and 90%.

Key points/Summary:
NaOCl can be used and is superior to ferric sulfate as a pulpotomy medicament.
The most common radiographic finding in 6 and 12 month follow up exams is internal resorption in both groups.

Assessment of Article:
Very interesting article. As always, need more research!