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Table of Contents   
ORIGINAL RESEARCH  
Year : 2011  |  Volume : 22  |  Issue : 3  |  Page : 385-390
Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth


Department of Pedodontia and Preventive Dentistry, Ragas Dental College, Uthandi, Chennai, India

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Date of Submission03-Jul-2010
Date of Decision27-Sep-2010
Date of Acceptance11-Nov-2010
Date of Web Publication3-Nov-2011
 

   Abstract 

Aim: To evaluate and compare mineral trioxide aggregate (MTA) and formocresol as pulpotomy medicaments by clinical and radiographic assessments and to assess the histological features of both pulpotomy medicaments in deciduous teeth.
Materials and Methods: This study was performed on 100 mandibular deciduous molar teeth requiring pulpotomy treatment. Children between age four and six years were randomly selected and divided into formocresol or MTA group. The patients were recalled after 3, 6, 9, 12 months respectively and evaluated clinically and radiographically. Histological assessment was done on lower deciduous canine teeth, which were undergoing serial extraction for interceptive orthodontic purpose. Pulpotomy was done on four teeth with formocresol and another four teeth with MTA. The teeth were extracted after six months following pulpotomy procedure and histologically evaluated. Two freshly extracted carious teeth were taken as controls.
Results: Clinical and radiographic criteria were laid and Chi analysis revealed significant difference in mobility ( P≤0.05), periodontal ligament widening ( P≤0.01 level) and inter - radicular radiolucency ( P≤0.02 level) between two groups at the end of 12 months. Histologically, in MTA group, a layer of new dentine formation with less dentinal tubules at the pulpotomized site was found. In formocresol group, increased inflammatory cells, a zone of atrophy, were noted in radicular portion of pulp.
Conclusion: MTA is superior to formocresol clinically, radiographically. Histological analysis showed better reparative ability with hard tissue barrier formation with MTA compared to formocresol.

Keywords: Deciduous teeth, dentine bridge, formocresol, mineral trioxide aggregate, pulpotomy

How to cite this article:
Srinivasan D, Jayanthi M. Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth. Indian J Dent Res 2011;22:385-90

How to cite this URL:
Srinivasan D, Jayanthi M. Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth. Indian J Dent Res [serial online] 2011 [cited 2018 Jul 22];22:385-90. Available from: http://www.ijdr.in/text.asp?2011/22/3/385/87058
The principle of pulp treatment in primary dentition is that tooth should remain in mouth in a non-pathological healthy condition to fulfill its role in primary dentition. Pulpotomy is indicated when caries removal results in pulp exposure of primary tooth with normal or reversible pulpitis or after traumatic pulp exposure. The coronal pulp tissue is amputated and remaining radicular pulp tissue is judged to be vital by clinical and /or radiographic criteria. The objective is that radicular pulp should remain healthy without adverse clinical signs or symptoms such as sensitivity, pain or swelling with no postoperative radiographic evidence of pathologic external or internal root resorption and no harm to succedaneous teeth.

Pulpotomy in primary dentition is developed along three lines.

Devitalization - destroy the vital tissue, example: formocresol, electrosurgery.

Preservation- maximal vital tissue is kept with no induction of reparative dentine, example glutaraldehyde.

Regeneration - stimulation of dentine bridge, example mineral trioxide aggregate (MTA), bone morphogenic protein (BMP), osteogenic protein.

For decades, formocresol has been widely used as a pulpotomy medicament. It is used as a standard for comparison of other materials. Yet there have been many concerns about positional alteration, enamel defects of sucedaneous tooth, [1] premature exfoliation of pulpotomized tooth when compared to its antimere. [2] In June 2004, International agency of cancer IARC of WHO has stated that formaldehyde causes nasopharyngeal cancer, limited evidence that it causes nasal and para nasal sinus carcinoma and strong but not sufficient evidence that formaldehyde causes leukemia in humans.

MTA introduced by Torabinejaad in 1993 has been useful in variety of clinical situations such as pulp capping, pulpotomy, and root end closures. [3] Its main components are tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicon di-oxide. Bismuth is added to get radiopacity. [4] Its mechanism of action is similar to calcium hydroxide and induces osteogenic phenotype activities like alkaline phosphatase, osteonidogen, osteonectin, osteocalcin, osteopontin [5] and results in hard tissue bridge formation.

It is available currently as two brand names, MTA Pro root (Densply) and MTA Angelus. The brands do not interfere with cytokine response by the macrophages. [6] It is available as grey and white types.

Thus, this study has been undertaken to evaluate and compare MTA and formocresol as pulpotomy medicaments in deciduous teeth by clinical and radiographic methods and to assess the histological features of both pulpotomy medicaments.


   Materials and Methods Top


The study was conducted on children who had attended the out patient department of Pediatric and Preventive dentistry, Ragas dental college, with good general health and no history of systemic illness or hospitalization. The Ethical Committee in Human Research of the Institution approved the study. Participation in the study was voluntary and a written consent was obtained from the parents or guardians.

The study was performed on 100 mandibular molar teeth requiring pulpotomy treatment. Children between ages 4-6 years of both the sexes were randomly selected and divided into either formocresol or MTA group. In case a child with two molars needed pulpotomy, the second tooth was assigned to the alternate group. In case more than two teeth were present in the same patient requiring for treatment, random assignment was used.

Histological assessment was done on lower deciduous canine teeth, which were undergoing serial extraction for interceptive orthodontic purpose. Pulpotomy was done on four teeth with formocresol and another four teeth with MTA. The teeth were extracted after six months following pulpotomy procedure and histologically evaluated. Two freshly extracted carious teeth were taken as controls.

The clinical criteria for tooth selection were the following: [7],[8]

  • Teeth with deep carious lesion (radiographically the caries approximating pulp) restorable after completion of the procedure.
  • Absence of symptoms indicative of advanced pulpal inflammation such as spontaneous pain or history of nocturnal pain.
  • Absence of clinical signs or symptoms suggesting a nonvital tooth such as suppurating sinus soft tissue swelling.
  • Absence of clinical radiographic signs of pulpal necrosis i.e. furcation involvement, periapical pathology, internal resorption, calcification in canal.
  • Hemorrhage should stop within 5 min from the amputated pulp stumps using a sterile pledget of moist cotton.


The study was done on lower right and left first and second molars for accessibility and accuracy. The tooth was anesthetized and rubber dam isolation obtained. Soft debris, caries and unsupported enamel and dentin were removed with spoon excavator before opening the pulp chamber. Caries removal and coronal access obtained with # 330 high-speed bur with water spray. Coronal pulp was removed with a small sharp spoon excavator. Pulp chamber was then irrigated with saline to remove all debris. Hemostasis obtained with a moistened cotton pellet gently pressed against the amputated pulp stumps in both the groups.

In formocresol (control) group - cotton pellet dipped and squeezed in diluted formocresol (Pharmadent Remedies-1/5 th dilution of Buckley formocresol) was placed in pulp chamber for 1 min. In the MTA (experimental) group - (gray 8202 Angelus, Brazil) paste was obtained by mixing three parts of powder with one part of water to obtain a putty consistency based on manufacturer's instruction. This mix was then placed in the pulp chamber with aid of plastic filling instrument. The pulp chambers of both the groups were covered with a zinc oxide eugenol thick mix. The coronal part of both group was restored with type II glass ionomer cement (GC Fuji 2) followed by stainless crown placement. The crown was luted with Type I GIC (GC Fuji 1). After cementation, immediate postoperative radiographs were taken for future review. The patients were recalled after 3, 6, 9 and 12 months respectively and evaluated clinically and radiographically. The radiographs were evaluated by two examiners at follow up who were blind to the group being studied. Teeth were considered to be clinically successful in the absence of [7],[8],[9] spontaneous pain, draining fistula, swelling or abscess, mobility, premature exfoliation. Teeth were considered to be radiographically successful in the absence of [7],[8],[9] abnormal root resorption, internal root resorption, furcation involvement, periapical bone destruction. Pulp canal obliteration and pulp calcification were not regarded as failures. [10],[11]

For the histological part, the extracted teeth were all fixed in buffered formalin and decalcified in 3% trichloroacetic acid. Buccolingual sections were processed and prepared for microscopic examination under 4Χ, 10Χ, and 40Χ magnifications. An examiner who was blind to the pulpotomy medicaments evaluated the slides. The histological features that were evaluated were odontoblastic integrity, pulp inflammation, pulp calcification, dentine bridge formation and presence of pulp stone.


   Results Top


In formocresol group, 50 teeth were treated at the start of the study [Table 1]. Two teeth were lost to follow up at the end of nine months and another two teeth were lost to follow up at the end of 12 months. Thus, 46 teeth were evaluated clinically and radiographically at the end of 12 months. In MTA group, 50 teeth were treated at the start of the study. Three teeth were lost to follow up at the end of nine months. Thus there were totally 47 teeth for evaluation clinically and radiographically at the end of 12 months. The teeth were lost to follow up because of transfer of parent's work to a different city. On three, six-month clinical evaluation, formocresol group did not show any clinical signs and symptoms with the success rate of 100%. Four teeth showed grade-1 mobility at nine months. The success rate at the end of nine months was 91.6% [Table 2]. The same clinical symptoms were noted at 12 months in the same four teeth. Two teeth were lost to follow up with success rate of 91.3% clinically at the end of 12 months. In MTA group, no clinical signs and symptoms were noted from 3 to 12 months. The clinical success rate was 100%.
Table 1: Distribution of sample during the study

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Table 2: Clinical evaluation

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In radiographic evaluation, no failure was noted in both the groups at three months interval [Table 3]. In six-month evaluation, five teeth in formocresol group showed periodontal ligament widening, out of which two teeth had associated interradicular radiolucency. The radiographic success rate was 90% with formocresol at the end of six-month interval. In MTA group, no failure was noted radiographically, success being 100% at the end of six months.
Table 3: Radiographic evaluation

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At nine-month evaluation, in formocresol group, additional four teeth had periodontal ligament widening, totally being nine teeth, out of which five had associated interradicular radiolucency and one had associated abnormal root resorption. The radiographic success rate was 81.25% at the end of nine months. In MTA group, at nine-month evaluation, two teeth had periodontal ligament widening. The radiographic success rate was 95.74%. In 12-month interval, in formocresol group, additional one tooth had periodontal ligament widening, totally being ten teeth, out of which seven had associated inter- radicular radiolucency and two teeth had associated abnormal root resorption. The success rate of formocresol at the end of 12 months was 78.26%. In MTA group, at 12-month evaluation in the same two teeth as in previous evaluation, periodontal ligament widening was noted and out of which one of the teeth had additional inter radicular radiolucency. The radiographic success rate of MTA at the end of 12 months was 95.74%.

With the above results, test of significance using Chi Square was carried out between the two groups. Statistical analysis revealed significant difference in mobility between two groups at the end of 12 months (P≤0.05). Significant differences were noted radiographically with respect to periodontal ligament widening (P≤0.01 level) and inter - radicular radiolucency (P≤0.02 level) between two groups at the end of 12 months. Other parameters were not significant between the two groups. Pulp canal obliteration was noted with MTA at the end of 12 months. A case of replacement resorption was noted with formocresol at 12 month. Both pulp canal obliteration [10],[11] and replacement resorption were not considered as failures of treatment. Thus, they were not included in statistical analysis of the study.

Histological evaluation

In formocresol group, increased inflammatory cells could be found in pulp. Odontoblastic layer was not intact throughout the dentine pulp complex. Pulp stones were isolated and scattered [Figure 1] and [Figure 2]. Dentine bridge was not seen. A zone of atrophy was noted in radicular portion of pulp [Figure 3].

In MTA group, odontoblastic layer integrity was well maintained [Figure 4]. Numerous pulp calcifications, pulp stones, were seen. These calcific masses were found isolated. The amounts of pulp stones were more than formocresol group. [Figure 5] The pulp was hyperemic, yet less inflammatory cells could be seen compared with formocresol group. Reversal line/ resting line were noted. An amorphous eosinophilic layer of new dentine formation with less dentinal tubules could be seen in the coronal portion of pulp. This could be considered as dentine bridge, which represents the pulpotomized regenerating site [Figure 6].
Figure 1: Formocresol 10× -Integrity of odontoblast is not maintained. Round hematoxiphilic masses are pulp stones

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Figure 2: Formocresol 4×-Integrity of odontoblast is not maintained throughout dentine pulp complex. Pulp stones are found as isolated discrete masses. Pulp is hyperemic with dilated blood vessels

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Figure 3: Formocresol- No evidence of dentine bridge formation

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Figure 4: MTA 10× -Integrity of odontobalst is maintained throughout the dentine pulp complex

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Figure 5: MTA 10×- Pulp stones are large, discrete, isolated and more in number

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Figure 6: MTA -Evidence of dentine bridge

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In control group in which teeth were extracted immediately without placement of medicaments, complete atrophy of pulpal space was noted.


   Discussion Top


Formocresol could inhibit macrophage function and modulate immune and inflammatory responses in dental pulp and periapical tissues. Buckley's formocresol was mutagenic for one patient in an in vivo study to lymphocyte cultures obtained from the peripheral blood, [12] raising doubt about the desirability of its use for pulpotomies in children.

WHO has estimated the use of formocresol through air, water and food at 1.5-to 14-mg/ day (mean 7.8 mg/day). The estimated dose of formaldehyde associated with one pulpotomy procedure, assuming a 1:5 dilution of formocresol placed on a number 4 cotton pellets that has been squeezed dry, is 0.02 - 0.1 mg. Thus, there is no inconsequential risk of carcinogenesis associated with the use of formaldehyde in pediatric pulp therapy. [13] Formocresol was selected as the control group, since it is still considered as the gold standard in primary tooth pulp therapy. The 1-min application of formocresol is found to be as effective as 5-min application(Garcia Godoy 1982) and have found that 1: 5 dilution (20% concentration) achieves desired cellular response and faster recovery of the affected cells. Thus, in the present study, diluted formocresol at 20% dilution at 1-min application was followed. The British Society of Paediatric Dentistry guidelines 2006 has stated that routine usage of 1: 5 dilution "may be imprudent given the availability of effective alternatives".

The mechanism of action of MTA is similar to that of calcium hydroxide and portland cement. [14] Calcium oxide, one of its components, is converted into calcium hydroxide when the paste is mixed with water. This in turn dissociates itself into Ca and OH ions upon contact with the tissue fluids. The calcium ions react with the carbon dioxide in the tissues, producing calcite granulations. Fibronectin accumulates with these granulations, which allows cellular adhesion and differentiation to occur.

The common radiographic failure in the present study in formocresol group was periodontal ligament widening and inter radicular radioluscency. The probable reason may be due to fixative effect of formocresol, ability of vapors to escape via apical foramen. The radiographic finding of periodontal ligament widening and inter radicular radiolucency seen in two cases of MTA as failures can be attributed to misdiagnosis of inflammation in the radicular pulp prior to treatment. [11] Yet the teeth did not show any clinical signs of failure. Pulp canal obliteration, as a result of odontoblastic activity, suggests that tooth is retaining its vitality and therefore is not regarded as a failure. [10],[11] An unusual single case of replacement resorption was noted with formocresol at the end of 12 months. Replacement resorption was not taken as a failure because it is also an accelerated odontoblastic activity. The greater success rate of MTA can be attributed to biocompatibility and sealing ability of MTA cement compared to formocresol.

Histological findings confirm that formocresol has no reparative ability and its action is limited as a fixative agent. In vitro investigation has demonstrated the ability of MTA to stimulate cytokine release from bone cells, indicating that it actively promotes hard tissue formation rather than being inert. [14] MTA maintains the integrity of the pulp. [15] MTA sections showed dentine bridge formation with more of neo dentine like tissue with less number of dentinal tubules at the pulpotomized site. Dentin bridges formed could be as a result of pulp irritation and/or inflammation, or alternatively due to a stimulus from the material placed over the exposed pulp. Large numbers of discrete calcification were seen suggesting a close relation between nerve fibers and odontoblastic cell differentiation suggesting repair of pulpotomized site. [16] The results of the study are comparable to other studies done earlier [9],[17],[18],[19],[20] In the present study, an evaluation criteria could not be done for histological assessment because of the smaller sample size and difficulty in getting extracted teeth after successful pulpotomy. The study is limited to a 12-month review and it requires complete follow up till the eruption of succedaneous tooth. From the present study, it can be concluded that MTA is superior to formocresol clinically and radiographically. Histological analysis showed better reparative ability with hard tissue barrier formation with MTA compared to formocresol. MTA has biological characteristics to be used as a pulpotomy medicament in deciduous teeth.


   Acknowledgment Top


We would like to thank Dr. K. Ranganathan, Professor and Head of the Department of Oral Pathology, Ragas Dental College, Uthandi, Chennai in helping out the evaluation of slides. We would also like to thank Dr. Nilaya Reddy for helping out in the evaluation of radiographs.

 
   References Top

1.Messer LB, Cline JT, Korf NW. Long term effects of primary molar pulpotomies on succedaneous bicuspids. J Dent Res 1980;59:116-23.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Lauterstein AM, Pruzansky S, Barbar TK. Effect of deciduous mandibular molar pulpotomy on the eruption of succedaneous premolar. J Dent Res 1962;41:1367-72.  Back to cited text no. 2
    
3.Schmitt D, Lee J, Bogen G. Multifaceted use of ProRoot MTA root canal repair material. Pediatr Dent 2001;23:326-30.  Back to cited text no. 3
[PUBMED]    
4.Camilleri J, Pitt Ford TR. Mineral trioxide aggregate: A review of the constituents and biological properties of the material. Int Endod J 2006;39:747-54.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  
5.Bonson S, Jeansonne BG, Lallier TE. Root-end filling materials alter fibroblast differentiation. J Dent Res 2004;83:408-13.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Rezende TM, Vargas DL, Cardoso FP, Sobrinho AP, Vieira LQ. Effect of mineral trioxide aggregate on cytokine production by peritoneal macrophages. Int Endod J 2005;38:896-903.  Back to cited text no. 6
[PUBMED]  [FULLTEXT]  
7.Waterhouse PJ, Nunn JH, Whitworth JM. An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy. Br Dent J 2000;188:32-6.  Back to cited text no. 7
[PUBMED]    
8.Kalskar RR, Damle SG. Comparative evaluation of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars. J Indian Soc Pedod Prev Dent 2004;22:24-9.  Back to cited text no. 8
    
9.Caicedo R, Abbott PV, Alongi DJ, Alarcon MY. Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth. Aust Dent J 2006;51:297-305.  Back to cited text no. 9
[PUBMED]  [FULLTEXT]  
10.Agamy HA, Bakry NS, Mounir MM, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomize primary teeth. Pediatr Dent 2004;26:302-9.  Back to cited text no. 10
[PUBMED]  [FULLTEXT]  
11.Holan G, Eidelman E, Fuks AB. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol. Pediatr Dent 2005;27:129-36.  Back to cited text no. 11
[PUBMED]  [FULLTEXT]  
12.Zarzar PA, Rosenblatt A, Takahashi CS, Takeuchi PL, Costa Júnior LA. Formocresol mutagenicity following primary tooth pulp therapy: An in vivo study. J Dent 2003;31:479-85.  Back to cited text no. 12
    
13.Milnes AR. Persuasive evidence that formocresol use in pediatric dentistry is safe. J Can Dent Assoc 2006;72:247-8.  Back to cited text no. 13
[PUBMED]  [FULLTEXT]  
14.Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 2005;31:97-100.  Back to cited text no. 14
[PUBMED]    
15.Dominguez MS, Witherspoon DE, Gutmann JL, Opperman LA. Histological and scanning electron microscopy assessment of various vital pulp-therapy materials. J Endod 2003;29:324-33.  Back to cited text no. 15
[PUBMED]  [FULLTEXT]  
16.Inoue H, Muneyuki H, Izumi T, Taguchi K, Nishigawa Y, Watanabe K, et al. Electron microscopic study on nerve terminals during dentin bridge formation after pulpotomy in dog teeth. J Endod 1997;23:569-71.  Back to cited text no. 16
[PUBMED]  [FULLTEXT]  
17.Aeinehchi M, Dadvand S, Fayazi S, Bayat-Movahed S. Randomized controlled trial of mineral trioxide aggregate and formocresol for pulpotomy in primary molar teeth. Int Endod J 2007;40:261-7.  Back to cited text no. 17
[PUBMED]  [FULLTEXT]  
18.Naik S, Hegde AM. Mineral trioxide aggregate as a pulpotomy agent in primary molars: An in vivo study. J Indian Soc Pedod Prev Dent 2005;23:13-6.  Back to cited text no. 18
[PUBMED]  Medknow Journal  
19.Peng L, Ye L, Tan H, Zhou X. Evaluation of the formocresol versus mineral trioxide aggregate primary molar pulpotomy: A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e40-4.   Back to cited text no. 19
[PUBMED]  [FULLTEXT]  
20.Ansari G, Ranjpour M. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: A 2-year follow-up. Int Endod J 2010;43:413-8.  Back to cited text no. 20
[PUBMED]  [FULLTEXT]  

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Correspondence Address:
Daya Srinivasan
Department of Pedodontia and Preventive Dentistry, Ragas Dental College, Uthandi, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.87058

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]

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