International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 15 , ISSUE S1 ( Special issue-1 (Pediatr Endodont), 2022 ) > List of Articles


Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial

Kakarla Sri RojaRamya, Rayala Chandrasekhar, KS Uloopi, C Vinay

Keywords : MTA, Propolis, Primary teeth, Pulpotomy, Randomized controlled trial, Vital pulp therapy

Citation Information :

DOI: 10.5005/jp-journals-10005-2120

License: CC BY-NC 4.0

Published Online: 28-02-2022

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


Aim and objective: To evaluate the clinical efficacy of propolis as pulpotomy medicament in human primary molars. Materials and methods: This randomized controlled trial is a two-arm, parallel group study with blinded outcome assessment. The study included a total of 60 primary molars that require pulpotomy treatment in 48-year old children. Teeth were assigned to two groups randomly: Propolis (Test group); Mineral trioxide aggregate (MTA) (Control group). All the pulpotomized teeth were given stainless steel crowns and the teeth were evaluated clinically and radiographically at 6, 12, and 24 months to grade them as either success or failure. Chi-square test was employed to analyze the data. Results: Success rates of pulpotomy with propolis and MTA were 80% and 93.1% respectively at 24 months of follow-up interval. Propolis has shown success rates of 90% and 80% at 6- and 12-month follow-up, while MTA has shown a consistent success rate of 93.1% at all the follow-up intervals. The difference in success rate between the groups at all the time intervals is statistically nonsignificant. Conclusion: Propolis has demonstrated a clinically acceptable success rate comparable to MTA as pulpotomy medicament in primary teeth. Clinical significance: Biocompatible materials with regenerative potential have drawn the momentum in vital pulp therapy. In this regard, MTA has been emerged as most successful material, but its high cost has limited its use. Hence, there is an absolute need of cost-effective pulpotomy material with regenerative potential. This study provides an evidence that propolis has clinically acceptable success rate as pulpotomy medicament. Considering its low cost and ready availability, it can be recommended as a cost-effective alternative for primary teeth pulpotomy.

  1. Lewis BB, Chestner SB. Formaldehyde in dentistry: A review of mutagenic and carcinogenic potential. J Am Dent Assoc 1981;103(3):429–434. DOI: 10.14219/jada.archive.1981.0341
  2. Ferreira FB, Torres SA, Rosa OP, et al. Antimicrobial effect of propolis and other substances against selected endodontic pathogens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(5):709–716. DOI: 10.1016/j.tripleo.2007.05.019
  3. Tan-No K, Nakajima T, Shoji T, et al. Anti-inflammatory effect of propolis through inhibition of nitric oxide production on carrageenin-induced mouse paw edema. Biol Pharm Bull. 2006;29(1):96–99. DOI: 10.1248/bpb.29.96
  4. Parolia A, Kundabala M, Rao NN, et al. A comparative histological analysis of human pulp following direct pulp capping with Propolis, mineral trioxide aggregate and Dycal. Aust Dent J 2010;55(1):59–64. DOI: 10.1111/j.1834-7819.2009.01179.x
  5. Ozorio JE, Carvalho LF, de Oliveira DA, et al. Standardised propolis extract and calcium hydroxide as pulpotomy agents in primary pig teeth. J Dent for child (Chic) 2012;79(2):53–58.
  6. Farsi N, Alamoudi N, Balto K, et al. Success of mineral trioxide aggregate in pulpotomized primary molars. J Clin Pediatr Dent 2005;29(4):307–311. DOI: 10.17796/jcpd.29.4.n80t77w625118k7
  7. Oliveira TM, Moretti AB, Sakai VT, et al. Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth. Eur Arch Paediatr Dent 2013;14(2):65–71. DOI: 10.1007/s40368-013-0015-x
  8. Ranly DM. Pulpotomy therapy in primary teeth: New modalities for old rationales. Pediatr Dent 1994;16(6):403–409.
  9. Holan G, Eidelman E, Fuks AB. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol. Pediatr Dent 2005;27(2):129–136.
  10. Jabbarifar SE, Khademi AA, Ghasemi D. Success rate of formocresol pulpotomy versus mineral trioxide aggregate in human primary molar tooth. J Res Med Sci 2004;9(6):304–307.
  11. Verma MK, Pandey RK, Khanna R, et al. The antimicrobial effectiveness of 25% Propolis extract in root canal irrigation of primary teeth. J Indian Soc Pedod Prev Dent 2014;32(2):120–124. DOI: 10.4103/0970-4388.130786
  12. Sabir A, Tabbu CR, Agustiono P, et al. Histological analysis of rat dental pulp tissue capped with propolis. J Oral Sci 2005;47(3):135–138. DOI: 10.2334/josnusd.47.135
  13. Dodwad V, Kukreja BJ. Propolis mouthwash: A new beginning. J Indian Soc Periodontol 2011:15(2):121-125. DOI: 10.4103/0972-124X.84379
  14. Ozan F, Polat ZA, Er K, et al. Effect of propolis on survival of periodontal ligament cells: new storage media for avulsed teeth. J Endod 2007;33(5):570–573. DOI: 10.1016/j.joen.2006.12.021
  15. Torabinejad M, Hong CU, McDonald F, et al. Physical and chemical properties of a new root-end filling material. J Endod1995a;21(7):349–353. DOI: 10.1016/S0099-2399(06)80967-2
  16. Sarkar NK, Caicedo R, Ritwik P, et al. Physicochemical basis of biological properties of mineral trioxide aggregate. J Endod 2005;31(2):97–100. DOI: 10.1097/01.don.0000133155.04468.41
  17. Shipper G, Grossman ES, Botha AJ, et al. Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root- end filling material: a low vacuum (LV) versus high vacuum (HV) SEM study. Int Endod J 2004;37(5):325–336. DOI: 10.1111/j.0143-2885.2004.00806.x
  18. Salako N, Joseph B, Ritwik P, et al. Comparison of bioactive glass, Mineral trioxide aggregate, ferric sulfate and formocresol as pulpotomy agents in rat molar. Dent Traumatol 2003;19(6):314–320. DOI: 10.1046/j.1600-9657.2003.00204.x
  19. Agamy HA, Bakry NS, Mounir MM, et al. Comparison of mineral trioxide aggregate and formocresol as pulp capping agents in pulpotomized primary teeth. Pediatr Dent 2004;26(4):302–309.
  20. 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
  21. Alolofi H, EI-Saved M, Taha S. Clinical and radiographical evaluation of propolis and thymus vulgaris extracts compared with formocresol pulpotomy in human primary molars. BDJ Open 2016;29;2:16005.
  22. Hugar SM, Kukreja P, Hugar SS, et al. Comparative evaluation of Clinical and Radiographic Success of Formocresol, Propolis, Turmeric Gel and Calcium Hydroxide on Pulpotomized Primary molars: A preliminary study. Int J Clin Pediatr Dent 2017;10(1):18–23. DOI: 10.5005/jp-journals-10005-1400
  23. Al-Haj Ali SN. In vitro toxicity of propolis in comparison with other primary teeth pulpotomy agents on human fibroblasts. J Investig Clin Dent 2016;7(3):308–313. DOI: 10.1111/jicd.12157
  24. Bretz WA, Chiego DJ, Marcucci MC, et al. Preliminary report on the effects of propolis on wound healing in the dental pulp. Z Naturforsch C 1998;53(11-12):1045–1048. DOI: 10.1515/znc-1998-11-1217
  25. Elbaz GA, Elsayad II. Comparison of the antimicrobial effect of Egyptian propolis vs New Zealand Propolis on Streptococcus mutants and Lactobacilli in Saliva. Oral Health Prev Dent 2012;10(2):155–160
  26. Mattigatti S, Ratnakar P, Moturi S, et al. Antimicrobial Effect of Conventional Root Canal Medicaments vs Propolis against Enterococcus faecalis, Staphylococcus aureus and Candida albicans. J Contemp Dent Pract 2012;13(3):305–309. DOI: 10.5005/jp-journals-10024-1142
  27. Mirzoeva OK, Grishanin RN, Calder PC. Antimicrobial action of propolis and some of its components: the effects on growth, membrane potential and motility of bacteria. Microbiol Res 1997;152(3):239–346. DOI: 10.1016/S0944-5013(97)80034-1
  28. Gebara ECE, Lima LA, Mayer MPA. Propolis antimicrobial activity against periodontopathic bacteria. Braz J Microbiol 2002;33(4):365–369. DOI: 10.1590/S1517-83822002000400018
  29. Meto A, Meto A, Bimbari B, et al. Anti-Inflammatory and Regenerative Effects of Albanian Propolis in Experimental Vital Amputations. Eur J Prosthodont Restor Dent 2016;24(3):145–151. DOI: 10.1922/EJPRD_1492Meto07
  30. Ansorge S, Reinhold D, Lendeckel U. Propolis and some of its constituents down-regulate DNA synthesis and inflammatory cytokine production but induce TGF-beta1 production of human immune cells. Z Naturforsch 2003;58(7-8):580–589. DOI: 10.1515/znc-2003-7-823
  31. Moradi S, Saghravanian N, Moushekhian S, et al. Immuno-histochemical Evaluation of Fibronectin and Tenascin Following Direct Pulp Capping with Mineral Trioxide Aggregate, Platelet-Rich Plasma and Propolis in Dogs Teeth. Iran Endod J 2015;10(3):188–192. DOI: 10.7508/iej.2015.03.009
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.