Comparison of Zinc Oxide Eugenol to Ferric Sulphate Pulpotomy in Primary Teeth
Study Details
Study Description
Brief Summary
In this prospective randomized, single blinded; split-mouth clinical trial the aim was to evaluate clinical and radiographic effects of placement of reinforced zinc oxide eugenol (ZOE) base directly over the amputated pulp stumps in pulpotomized primary molars, and to compare this technique to ferric sulphate (FS) in pulpotomized primary teeth. Included were 65 children using a split-mouth design, (130 teeth). All teeth were then restored with prefabricated stainless steel crowns (SSC). Patients were recalled for clinical and radiographical evaluation after 3, 6, 12 and 24 months. Two experienced and calibrated pediatric dentists who were not involved in the investigation blindly assessed the radiographs.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Purpose:
The purpose of this study was to evaluate the clinical and radiographic effects of placement of reinforced zinc oxide eugenol (ZOE) base directly over the amputated pulp stumps in pulpotomized primary molars, and to compare the effects of this technique to ferric sulphate (FS) agent in pulpotomized primary teeth.
Methods:
A sample of 65 children with bilateral deep carious mandibular primary molars who attended the pediatric dental clinics, at Jordan University of Science and Technology (JUST) were selected for this prospective randomized, single blinded; split-mouth clinical trial. The teeth were randomly divided into 2 treatment groups: in the ZOE group (n=65 teeth) hemostasis was achieved by a dry cotton pellet, then the chamber was filled with zinc oxide eugenol (ZOE) directly over the pulp on one side. In the FS group (n=65 teeth) hemostasis was achieved by a wet cotton pellet, ferric sulphate (FS) was applied on the pulp, then the chamber was filled with (ZOE) on the contralateral side. All teeth were restored with prefabricated stainless steel crowns (SSC). Patients were recalled for evaluation clinically after 1month, then clinically and radiographically after 3, 6, 12 and 24 months. Two experienced and calibrated pediatric dentists who were not involved in the investigation blindly assessed the radiographs.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: ZOE group Pulp hemostasis achieved by a dry cotton pellet applied on the pulp, then the chamber was filled with reinforced zinc oxide eugenol (ZOE) directly over the pulp. |
Procedure: Pulp hemostasis with a dry cotton pellet
Application of a dry cotton pellet, then the chamber was filled with ZOE directly over the pulp
Procedure: Stainless steel crown
Stainless steel crown placed as a final restoration
|
| Active Comparator: FS group Pulp hemostasis achieved by a wet cotton pellet impregnated with ferric sulphate (FS) applied on the pulp, then the chamber was filled with (ZOE) directly over the pulp. |
Procedure: Pulp hemostasis with a wet cotton pellet impregnated with FS
Application of a a wet cotton pellet impregnated with FS, then the chamber was filled with ZOE directly over the pulp
Procedure: Stainless steel crown
Stainless steel crown placed as a final restoration
|
Outcome Measures
Primary Outcome Measures
- Number of teeth which are asymptomatic without clinical signs of disease [24 months]
including percussion sensitivity, spontaneous pain, mobility, or abscess (Clinical)
- Number of teeth with no pathological changes present [24 months]
including radiolucency, root or bone resorption (Radiographic)
Eligibility Criteria
Criteria
Inclusion Criteria:
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Healthy children
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Child has cooperative behaviour in the dental chair
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No history of spontaneous pain
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Deep caries in the tooth
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Carious exposure of a vital pulp
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A restorable tooth after completion of the pulp treatment
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Healthy periapical tissue on pre-operative periapical radiograph
Exclusion Criteria:
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Presence of tenderness to percussion and/or mobility
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Pathologic radiographic signs on pre-operative periapical radiograph including external or internal root resorption, calcification in the canal, periodontal membrane widening, periapical pathology, and furcation radiolucency.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Jordan University of Science and Technology | Irbid | Jordan | 22110 |
Sponsors and Collaborators
- King Abdullah University Hospital
- Jordan University of Science and Technology
Investigators
- Principal Investigator: Ola B. Al-Batayneh, Jordan University of Science and Technology
Study Documents (Full-Text)
None provided.More Information
Publications
- Briso AL, Rahal V, Mestrener SR, Dezan Junior E. Biological response of pulps submitted to different capping materials. Braz Oral Res. 2006 Jul-Sep;20(3):219-25. doi: 10.1590/s1806-83242006000300007.
- Casas MJ, Kenny DJ, Johnston DH, Judd PL. Long-term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Pediatr Dent. 2004 Jan-Feb;26(1):44-8.
- Casas MJ, Layug MA, Kenny DJ, Johnston DH, Judd PL. Two-year outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Pediatr Dent. 2003 Mar-Apr;25(2):97-102.
- Chien MM, Setzer S, Cleaton-Jones P. How does zinc oxide-eugenol compare to ferric sulphate as a pulpotomy material? SADJ. 2001 Mar;56(3):130-5.
- Fei AL, Udin RD, Johnson R. A clinical study of ferric sulfate as a pulpotomy agent in primary teeth. Pediatr Dent. 1991 Nov-Dec;13(6):327-32.
- Hansen HP, Ravn JJ, Ulrich D. Vital pulpotomy in primary molars. A clinical and histologic investigation of the effect of zinc oxide-eugenol cement and Ledermix. Scand J Dent Res. 1971;79(1):13-25. No abstract available.
- Hui-Derksen EK, Chen CF, Majewski R, Tootla RG, Boynton JR. Retrospective record review: reinforced zinc oxide-eugenol pulpotomy: a retrospective study. Pediatr Dent. 2013 Jan-Feb;35(1):43-6.
- Huth KC, Hajek-Al-Khatar N, Wolf P, Ilie N, Hickel R, Paschos E. Long-term effectiveness of four pulpotomy techniques: 3-year randomised controlled trial. Clin Oral Investig. 2012 Aug;16(4):1243-50. doi: 10.1007/s00784-011-0602-3. Epub 2011 Aug 13.
- Huth KC, Paschos E, Hajek-Al-Khatar N, Hollweck R, Crispin A, Hickel R, Folwaczny M. Effectiveness of 4 pulpotomy techniques--randomized controlled trial. J Dent Res. 2005 Dec;84(12):1144-8. doi: 10.1177/154405910508401210.
- Ibricevic H, al-Jame Q. Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up. J Clin Pediatr Dent. 2000 Summer;24(4):269-72. doi: 10.17796/jcpd.24.4.d7u6405nw1132705.
- Markovic D, Zivojinovic V, Vucetic M. Evaluation of three pulpotomy medicaments in primary teeth. Eur J Paediatr Dent. 2005 Sep;6(3):133-8.
- Oliveira TM, Moretti AB, Sakai VT, Lourenco Neto N, Santos CF, Machado MA, Abdo RC. Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth. Eur Arch Paediatr Dent. 2013 Apr;14(2):65-71. doi: 10.1007/s40368-013-0015-x. Epub 2013 Apr 3.
- Papagiannoulis L. Clinical studies on ferric sulphate as a pulpotomy medicament in primary teeth. Eur J Paediatr Dent. 2002 Sep;3(3):126-32.
- Waterhouse PJ, Nunn JH, Whitworth JM, Soames JV. Primary molar pulp therapy--histological evaluation of failure. Int J Paediatr Dent. 2000 Dec;10(4):313-21. doi: 10.1046/j.1365-263x.2000.00211.x.
- Zurn D, Seale NS. Light-cured calcium hydroxide vs formocresol in human primary molar pulpotomies: a randomized controlled trial. Pediatr Dent. 2008 Jan-Feb;30(1):34-41.
- 19/2013