International Journal of Clinical Pediatric Dentistry

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VOLUME 15 , ISSUE 6 ( November-December, 2022 ) > List of Articles


Biodentine™ Pulpotomy in Stage I Primary Molars: A 12-month Follow-up

Hitaf Nasrallah, Balsam Noueiri

Keywords : Apical closure, Biodentine™, Primary teeth, Pulpotomy, Root edification

Citation Information : Nasrallah H, Noueiri B. Biodentine™ Pulpotomy in Stage I Primary Molars: A 12-month Follow-up. Int J Clin Pediatr Dent 2022; 15 (6):660-666.

DOI: 10.5005/jp-journals-10005-2400

License: CC BY-NC 4.0

Published Online: 14-02-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars. Materials and methods: A total number of 20 stage I primary molars requiring pulpotomy were selected from eight healthy patients aged between 34 and 45 months. Patients presenting a negative attitude toward dental treatment on the dental chair were scheduled for dental treatments under general anesthesia. Pulpotomy with Biodentine™ as a pulp-dressing material was performed on all selected molars. The patients were called back at 1 and 3 months for clinical follow-ups, then at 6 and 12 months for clinical and radiographic follow-ups. Data were tabulated according to follow-up intervals and occurrence of any changes in root maturation, pulp canal obliteration (PCO), periodontal ligament space (PLS), and bone or root lesion. Results: No statistically significant differences were recorded at 1, 3, 6, and 12 months. There was a statistically significant increase in number of roots with closed apices from six roots at 6 months to 50 roots at 12 months (p < 0.0005) and the PCO was present in all 50 roots at 12 months, after it was present in 36 roots only at 6 months (p = 0.0001). Conclusion: This is the first randomized clinical trial that evaluates the performance of Biodentine™ as a pulp-dressing agent in stage I primary molar pulpotomy over 12 months of follow-up. Contrary to previous studies, the present work highlights the continued root formation and apical closure (AC) in pulpotomized immature primary molars.

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  1. Girish MS, Chandra P, Anandakrishna L. Clinical and radiographic evaluation of mineral trioxide aggregate and electrosurgical pulpotomies in primary molars: an in-vivo study. J Int Oral Health 2016;8(5):601–606.
  2. Praveen P, Anantharaj A, Venkataraghavan K, et al. A review of obturating materials for primary tooth. SRM Univ J Dent Sci 2011;2: 42–44.
  3. Cohn C. Pulpotomy for primary teeth with tricalcium silicate material. Inside Dent 2013;9(9):100–102.
  4. Godhi B, Sood PB, Sharma A. Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: an in vivo study. Contemp Clin Dent 2011;2(4):296–301. DOI: 10.4103/0976-237X.91792
  5. Kusum B, Rakesh K, Richa K. Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth. Restor Dent Endod 2015;40(4): 276–285. DOI: 10.5395/rde.2015.40.4.276
  6. Havale R, Anegundi RT, Indushekar K, et al. Clinical and radiographic evaluation of pulpotomies in primary molars with formocresol, glutaraldehyde and ferric sulphate. Oral Health Dent Manag 2013;12(1):24–31.
  7. Pilipili CM, Vanden Abbeele A, van den Abbeele K. La pulpotomie de la dent temporaire [Pulpotomy of deciduous teeth]. Rev Belge Med Dent (1984) 2004;59(3):156–162.
  8. Demars C, Fortier JP. Propos sur l'endodontie des dents temporaires [Endodontics of temporary teeth]. Actual Odontostomatol (Paris) 1981;35(134):213–224.
  9. Chen Y, Chen X, Zhang Y, et al. Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis. BMC Oral Health 2019;19(1):227. DOI: 10.1186/s12903-019-0917-z
  10. Parisay I, Ghoddusi J, Forghani M. A review on vital pulp therapy in primary teeth. Iran Endod J 2015;10(1):6–15.
  11. Rodd HD, Waterhouse PJ, Fuks AB, et al. Pulp therapy for primary molars. Int J Paediatr Dent 2006;16 (Suppl 1):15–23. DOI: 10.1111/j.1365-263X.2006.00774.x
  12. Rajasekharan S, Martens LC, Vandenbulcke J, et al. Efficacy of three different pulpotomy agents in primary molars: a randomized control trial. Int Endod J 2017;50(3):215–228. DOI: 10.1111/iej.12619
  13. Caruso S, Dinoi T, Marzo G, et al. Clinical and radiographic evaluation of biodentine versus calcium hydroxide in primary teeth pulpotomies: a retrospective study. BMC Oral Health 2018;18(1):54. DOI: 10.1186/s12903-018-0522-6
  14. Rajasekharan S, Martens LC, Cauwels RG, et al. Biodentine™ material characteristics and clinical applications: a review of the literature. Eur Arch Paediatr Dent 2014;15(3):147–158. DOI: 10.1007/s40368-014-0114-3
  15. Cuadros-Fernández C, Lorente Rodríguez AI, Sáez-Martínez S, et al. Short-term treatment outcome of pulpotomies in primary molars using mineral trioxide aggregate and Biodentine: a randomized clinical trial. Clin Oral Investig 2016;20(7):1639–1645. DOI: 10.1007/s00784-015-1656-4
  16. Shayegan A, Jurysta C, Atash R, et al. Biodentine used as a pulp-capping agent in primary pig teeth. Pediatr Dent 2012;34(7): e202–e208.
  17. Grewal N, Salhan R, Kaur N, et al. Comparative evaluation of calcium silicate-based dentin substitute (Biodentine®) and calcium hydroxide (pulpdent) in the formation of reactive dentin bridge in regenerative pulpotomy of vital primary teeth: triple blind, randomized clinical trial. Contemp Clin Dent 2016;7(4):457–463. DOI: 10.4103/0976-237X.194116
  18. N Nasseh H, El Noueiri B, Pilipili C, et al. Evaluation of Biodentine pulpotomies in deciduous molars with physiological root resorption (stage 3). Int J Clin Pediatr Dent 2018;11(5):393–394. DOI: 10.5005/jp-journals-10005-1546
  19. Nasrallah H, El Noueiri B, Pilipili C, et al. Clinical and radiographic evaluations of Biodentine™ pulpotomies in mature primary molars (stage 2). Int J Clin Pediatr Dent 2018;11(6):496–504. DOI: 10.5005/jp-journals-10005-1564
  20. Kazeminia M, Abdi A, Shohaimi S, et al. Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis. Head Face Med 2020;16(1):22. DOI: 10.1186/s13005-020-00237-z
  21. Togoo RA. Early childhood caries—cause, diagnosis & management. Int J Health Sci Res 2012;1(2):148–160.
  22. Collado-González M, García-Bernal D, Oñate-Sánchez RE, et al. Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth. Int Endod J 2017;50 (Suppl 2): e19–e30. DOI: 10.1111/iej.12751
  23. Smaïl-Faugeron V, Courson F, Durieux P, et al. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2014;6(8):CD003220. DOI: 10.1002/14651858.cd003220
  24. Sultana A, Karim FA, Sheikh MAH, et al. Better outcome in pulpotomy on primary molar with Biodentine. Update Dent Coll J 2016;5(2):57–62. DOI: 10.3329/updcj.v5i2.27277
  25. Laurent P, Camps J, De Méo M, et al. Induction of specific cell responses to a Ca(3)SiO(5)—based posterior restorative material. Dent Mater 2008;24(11):1486–1494. DOI: 10.1016/
  26. Luo Z, Li D, Kohli MR, et al. Effect of Biodentine™ on the proliferation, migration and adhesion of human dental pulp stem cells. J Dent 2014;42(4):490–497. DOI: 10.1016/j.jdent.2013.12.011
  27. Çelik BN, Mutluay MS, Arıkan V, et al. The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth. Clin Oral Investig 2019;23(2):661–666.
  28. Guelmann M, Shapira J, Silva DR, et al. Esthetic restorative options for pulpotomized primary molars: a review of literature. J Clin Pediatr Dent 2011;36(2):123–126. DOI: 10.17796/jcpd.36.2.34h304265110137r
  29. Kuo HY, Lin JR, Huang WH, et al. Clinical outcomes for primary molars treated by different types of pulpotomy: a retrospective cohort study. J Formos Med Assoc 2018;117(1):24–33. DOI: 10.1016/j.jfma.2017.02.010
  30. El Meligy OAES, Alamoudi NM, Allazzam SM, et al. Biodentine versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial. BMC Oral Health 2019;19(1):3.
  31. Niranjani K, Prasad MG, Vasa AA, et al. Clinical evaluation of success of primary teeth pulpotomy using Mineral Trioxide Aggregate(®), laser and Biodentine(TM)—an in vivo study. J Clin Diagn Res 2015;9(4):ZC35–ZC37.
  32. Guagnano R, Romano F, Defabianis P. Evaluation of Biodentine in pulpotomies of primary teeth with different stages of root resorption using a novel composite outcome score. Materials (Basel) 2021;14(9):2179. DOI: 10.3390/ma14092179
  33. Ramanandvignesh P, Gyanendra K, Mridula DJKG. Clinical and radiographic evaluation of pulpotomy using MTA, Biodentine and Er,Cr:YSGG laser in primary teeth—a clinical study. Laser Ther 2020;29(1):29–34. DOI: 10.5978/islsm.20-OR-03
  34. Abuelniel GM, Duggal MS, Kabel N. A comparison of MTA and Biodentine as medicaments for pulpotomy in traumatized anterior immature permanent teeth: a randomized clinical trial. Dent Traumatol 2020;36(4):400–410. DOI: 10.1111/edt.12553
  35. Akhlaghi N, Khademi A. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature. Dent Res J (Isfahan) 2015;12(5):406–417. DOI: 10.4103/1735-3327.166187
  36. 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(1):32–36. DOI: 10.1038/sj.bdj.4800380
  37. Camp JH. Diagnosis dilemmas in vital pulp therapy: treatment for the toothache is changing, especially in young, immature teeth. Pediatr Dent 2008;30(3):197–205.
  38. Borum MK, Andreasen JO. Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition. Endod Dent Traumatol 1998;14(1):31–44. DOI: 10.1111/j.1600-9657.1998.tb00806.x
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