International Journal of Clinical Pediatric Dentistry

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VOLUME 10 , ISSUE 2 ( April-June, 2017 ) > List of Articles


Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study

Mohita Marwaha, Kavita Sirohi, Kalpana Bansal

Citation Information : Marwaha M, Sirohi K, Bansal K. Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study. Int J Clin Pediatr Dent 2017; 10 (2):147-151.

DOI: 10.5005/jp-journals-10005-1425

License: CC BY-NC 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; The Author(s).



Formocresol has been a popular pulpotomy medicament for many years. It is considered the “gold standard” in pediatric dentistry. However, concerns have been raised over its use in children. It has been reported that formocresol has toxic and mutagenic effects in cell culture, dental crypts, and precancerous epithelial cells. Therefore, additional biocompatible treatment alternatives are required to replace formocresol pulpotomy.


This study compared the clinical and radiographic success rates of ferric sulfate (FS) and bioactive tricalcium silicate cement (Biodentine, Septodont) as pulpotomy agents in primary molar teeth over a period of 9 months.

Materials and methods

Fifty primary molar teeth, symptom free, requiring pulpotomy in children aged 4 to 8 years were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 25 teeth) and Biodentine (for 25 teeth) were used as pulpotomy agents. Permanent restorations were stainless steel crowns in most cases, in both groups. Patients were recalled for follow-up at 1, 3, 6, and 9 months intervals. The data were statistically analysed using chi-square test.


At 9 months, 96% clinical success rate was observed in the FS and 100% in the Biodentine group. Radiographic success rate in the FS group was 84%, whereas 92% in the Biodentine group at 9 months. No statistically significant difference was found between the two groups.


Biodentine can be used as a pulpotomy agent but further long-term studies are required.

How to cite this article

Sirohi K, Marwaha M, Gupta A, Bansal K, Srivastava A. Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study. Int J Clin Pediatr Dent 2017;10(2):147-151.

  1. Guideline on pulp therapy for primary and immature permanent teeth. Reference manual 20012-13. Pediatr Dent 2009;37(6):222-229.
  2. Endodontic considerations in pediatric dentistry: a clinical perspective. Int Dent SA 2009;11(2):40-50.
  3. Comparison of clinical and radiographic success rates of pulpotomy in primary molars using formocresol, ferric sulfate and mineral trioxide aggregate (MTA). J Dent 2006;3(1):6-14.
  4. Pulpotomy in primary teeth – a review. JIADS 2011;2(2):29-31.
  5. Vital pulp therapy for the mature tooth – can it work? Endodontic topics 2003 July;5(1):49-56.
  6. Effects of calcium silicate-based materials on the flexural properties of dentin. J Endod 2012 May;38(5):680-683.
  7. A new bioactive cement for direct pulp capping. Int Dent SA 2008;2(2):64-69.
  8. Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: An in vivo study. Contemp Clin Dent 2011 Oct;2(2):296-301.
  9. ; Espelid, I.; Mejare, I. The caries lesion and its management in children and adolescents. In: Koch G, Poulsen S, editors. Pediatric Dentistry - a Clinical Approach, 2nd edition. Copenhagen, Denmark: Blackwell Munskgard; 2001. p. 173-212.
  10. Comparative investigation of clinical/radiographical signs of mineral trioxide aggregate and formocresol on pulpotomized primary molars. Contemp Clin Dent 2010 Jul;1(3):146-151.
  11. Mineral trioxide aggregate vs. formocresol in pulpotomized primary molars: a preliminary report. Pediatr Dent 2001 Jan-Feb;23(1):15-18.
  12. ; Kohli, A. Pediatric endodontics. In: Tandon S, editor. Textbook of Pedodontics, 2nd ed. New Delhi, India: Paras Publishers; 2008. p. 341-347.
  13. Calcium hydroxide pulpotomy for primary teeth: a clinical study. J Am Dent Assoc 1984 May;108(5):775-778.
  14. A clinical study of ferric sulfate as a pulpotomy agent in primary teeth. Pediatr Dent 1991 Nov-Dec;13(6):327-332.
  15. Ferric sulfate versus dilute formocresol in pulpotomized primary molars: long-term follow up. Pediatr Dent 1997 Jul-Aug;19(5):327-330.
  16. Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up. J Clin Pediatr Dent 2000 Summer;24(4):269-272.
  17. Ferric sufate and formocresol in pulpotomy of primary molars: long term follow-up study. Eur J Pediatr Dent 2003 Mar;4(1):28-32.
  18. Evaluation of three pulpotomy medicaments in primary teeth. Eur J Pediatr Dent 2005 Sep;6(3):133-138.
  19. A comparison of four pulpotomy techniques in primary molars: a long-term follow-up. J Endod 2008 Aug;34(8):950-955.
  20. Comparison of three pulpotomy agents in primary molars: a randomised clinical trial. Iran Endod J 2011 Winter;6(1):11-14.
  21. Mineral trioxide aggregate as a pulpotomy medicament: a narrative review. Eur Arch Pediatr Dent 2008 Mar;9(1):4-11.
  22. Success rates of mineral trioxide aggregate, ferric sulfate, and formocresol pulpotomies: a 24-month study. Pediatr Dent 2011 Mar-Apr;33(2):165-170.
  23. Comparison of ferric sulfate, formocresol, and a combination of ferric sulfate/formocresol in primary tooth vital pulpotomies: a retrospective radiographic survey. ASDC J Dent Child 2002 Jan-Apr;69(1):44-48.
  24. Clinical and radiographic success rates of mineral trioxide aggregate and ferric sulfate pulpotomies performed by dental students. Eur J Paediatr Dent 2012 Jun;13(2):118-122.
  25. Reviewing pulp treatment for primary teeth. J Am Dent Assoc 1991 Sep;122(9):83-85.
  26. The pharmacologic and toxicological properties of zinc oxide-eugenol. J Am Dent Assoc 1986 Nov;113(5):789-791.
  27. Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar. Dent Traumatol 2003 Dec;19(6):314-320.
  28. Biodentine(TM) induces TGF-β1 release from human pulp cells and early dental pulp mineralization. Int Endod J 2012 May;45(5):439-448.
  29. Biodentine induces immortalized murine pulp cell differentiation into Odontoblast-like cells and stimulates biomineralization. J Endod 2012 Sep;38(9):1220-1226.
  30. Effect of a calcium-silicate-based restorative cement on pulp repair. J Dent Res 2012 Dec;91(12):1166-1171.
  31. Clinical evaluation of the performance and safety of a new dentine substitute, Biodentine, in the restoration of posterior teeth - a prospective study. Clin Oral Investig 2013 Jan;17(1):243-249.
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