Effects of Buckley's Formocresol, Calcium Hydroxide, and MTA in Pulpotomies

OBJECTIVE: The purpose of this study was to compare the clinical, radiographic, and microscopic effectiveness of formocresol (FC), calcium hydroxide (CH), and trioxide mineral aggregate (MTA) in pulpotomies of human primary teeth. METHODS: Primary molars were randomly assigned to CH, MTA, and FC groups and treated by pulpotomy. Clinical and radiographic evaluations were recorded at 3, 6, 12, 18, 24, and 30 mos. Teeth in the regular exfoliation period, and considered as treatment failures, were extracted and further processed for microscopic analysis. RESULTS: Through clinical and radiographic results, success rates of 100%, 35.7%, and 100% were found for FC, CH, and MTA, respectively. Statistically significant differences were observed regarding the presence of internal resorption, inter-radicular bone destruction, mobility, and fistula for the CH group (p < 0.05). Microscopic analysis revealed the presence of intense inflammatory infiltrate and mineralized tissue deposition, which was irregular throughout the root canal in the FC group. In the MTA group, dentin-like mineralized material deposition obliterated the root canal. The CH group presented, in most of the sections, necrotic areas in the root canal. Other sections revealed the presence of a reactive dentin barrier and discrete chronic inflammatory infiltrate. CONCLUSION: MTA may serve as an effective substitute for FC; however, CH seems to be a technique-sensitive material and therefore is not indicated for pulpotomies of primary teeth.