A Comparative clinico-radiographic evaluation of efficacy of different pulpotomy agents used in Primary molars - A Randomised Controlled Trial

Preserving primary teeth is a key goal in pediatric dentistry, especially in the context of Early Childhood Caries (ECC) and Traumatic Dental Injuries (TDI), both of which are prevalent globally, including in India. ECC affects 49.6% of children in India, while TDI occurs in 13% of children, with higher rates in those under 6 years old. If untreated, both conditions can lead to early pulp exposure, necessitating costly and complex treatments like endodontic therapy.

To manage pulp exposure, techniques like pulpotomy are commonly used. Pulpotomy involves removing the coronal pulp to preserve the vitality of the root portion, typically in cases of extensive caries or trauma without radicular pathology. Over the years, various materials have been used for pulpotomy, including formocresol, zinc oxide eugenol (ZOE), mineral trioxide aggregate (MTA), biodentine (BD), enamel matrix derivative (Emdogain), and laser therapy.

Formocresol was historically used but is no longer recommended due to its toxicity. Alternatives like MTA and BD are popular due to their biocompatibility, sealing ability, and favorable clinical outcomes. BD, in particular, offers advantages like quick setting time and ease of handling over MTA. Emdogain, a newer material, shows promise in regenerating tooth tissues and enhancing periodontal attachment, though research is limited.

Lasers, specifically diode lasers, are also being explored for pulpotomy, as they allow precise tissue removal with minimal impact on surrounding dental structures. Despite the variety of materials and techniques, few studies have directly compared their clinical and radiographic success, making this area an important focus for future research.