Premature exfoliation of primary molars related to the use of formocresol in a multivisit pulpotomy technique: a case report

A tunnel shape defect on maxillary bone after accidental injection of formocresol instead of anesthetic solution

Accidental injection or leakages of various chemical disinfectants used during root canal preparation into adjacent tissues have been shown to have deleterious effects on surrounding tissue. Formocresol (FC) is an effective intracanal disinfectant used in endodontic procedures. However, it is known to have harmful effects into adjacent tissues. The aim of this article is to present an unusual case in which a 28-year-old male patient developed gingival and bone necrosis after the accidental injection of FC instead of local anesthetic solution for tooth extraction and to review cases in the literature where complications have occurred due to the use of FC.

Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: An in vivo study

Background:

Preservation of pulp vitality is of utmost importance to the normal physiological functioning of tooth in situ and physiological process of exfoliation in a tooth affected by disease or trauma. Pulpotomy serves such a purpose using various medicaments applied directly on vital pulp.

Aim:

The aim of this study was to evaluate clinically and radiographically the effects of mineral trioxide aggregate (MTA) and formocresol (FC) as a pulp dressing after coronal pulp amputation (pulpotomy) in primary molars prospectively over a period of 1 year.

Materials and Methods:

Thirty-three healthy children, aged between 5 and 8 years, requiring pulp therapy were selected after clinical and radiographic assessment. A total of 50 maxillary and mandibular primary molars were treated by the conventional pulpotomy technique. The teeth were divided into two equal groups. In Group A, FC was used as the pulp dressing agent, and in Group B, MTA was used before restoration with stainless steel crowns. The research employed was a prospective study. The teeth treated were assessed postoperatively after 1, 3, 6 and 12 months. The observations were tabulated and statistically analyzed.

Results:

Clinically, both the groups showed 100% success at 1, 3, 6 and 12 months. At 3 months, the radiographic success rates of FC and MTA were 92% and 96%, respectively, and at 6 and 12 months, the radiographic success rates of FC and MTA were 88% and 96%, respectively.

Conclusion:

MTA showed a higher success rate than FC and may be a favorable material for pulpotomy in primary molars whose pulps have been compromised by a carious or mechanical pulp exposure

Randomized controlled trial of mineral trioxide aggregate and formocresol for pulpotomy in primary molar teeth

AIM

To compare the outcome after 6 months of the application of formocresol (FC) or mineral trioxide aggregate (MTA) during pulpotomy in primary molar teeth.

METHODOLOGY

A maximum of 126 children (aged 5-9 years) with carious primary teeth that required pulpotomy were selected. Following randomization, a standard pulpotomy preparation was undertaken, and the coronal pulp removed and bleeding arrested. In the FC group, cotton balls, soaked in FC, were placed for 5 min, and then the pulp chamber was filled with Zonalin, a pulpotomy agent. In the MTA group, a 1-mm-thick paste of MTA was used as a pulpotomy agent. The crowns in both groups were restored with amalgam or glass ionomer. The teeth of 100 patients were evaluated and compared clinically and radiographically after 3 and 6 months.

RESULTS

No signs of clinical failure were observed at the 3- and 6-month follow-up appointments in either group. There were no significant differences in the radiographic findings of the teeth and surrounding tissue at the 3-month follow-up. However, at the 6-month follow-up, significantly more cases (P = 0.036) with root resorption were seen in the FC group; no cases of resorption occurred amongst the MTA cases. The surrounding tissue showed radiographic signs of post-treatment disease in four FC cases; none was seen in the MTA cases.

CONCLUSION

After 6 months, pulpotomy with MTA was associated with fewer cases of root resorption and post-treatment disease. MTA appears to be a reliable alternative material for pulpotomy in primary molar teeth.