Title Ferric Sulfate Provides the Same Clinical and Radiographic Results as Formocresol When Used for Primary Tooth Pulpotomies
Clinical Question Does ferric sulfate provide the same clinical and radiographic results as formocresol when used for primary tooth pulpotomies?
Clinical Bottom Line In primary molars where pulp is exposed by deep carious lesions, ferric sulfate as a dressing is just as effective as formocresol when analyzed clinically and radiographically. This is supported by two randomized controlled trials with follow up of 24 and 36 months that showed no significant difference in outcome between formocresol and ferric sulfate. Ferric sulfate may be a valid replacement for formocresol because it does not possess the same “cytotoxic effects and mutagenicity that formocresol is reported to have in studies.”
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
21842145Huth/2012N= 50 primary molars in healthy children (≤ 8 years old) with at least 1 symptom- free, restorable primary molar with cariously exposed vital pulp.Randomized Split-mouth Controlled Trial
Key resultsFollow up done after 12, 24 and 36 months of treatment revealed no significant differences in success rates between formocresol treated primary teeth and ferric sulfate treated primary teeth (p > 0.05 for all instances).
21703067Erdem/2011N=25 primary molars from childrenRandomized Split-mouth Controlled Trial
Key resultsNo statistically significant difference in radiographic and clinical outcomes in 6, 12, and 24 months follow ups after pulpotomies performed using ferric sulfate vs. formocresol (p value < 0.88).
Evidence Search ("formocresol"[Supplementary Concept] AND "ferric sulfate"[Supplementary Concept]) AND "Pulpotomy"[Mesh] AND Clinical Trial[ptyp]
Comments on
The Evidence
Validity: Both Randomized Controlled Trials showed high validity with patient groups being similar at start, greater than 80% completion rates, groups were treated the same, there was adequate follow up, a double-blind technique was used, unlikely recall bias and no competing interests.
Applicability Ferric sulfate is just as applicable for use on primary molar pulpotomies as formocresol but does not have the cytotoxic and mutagenic effects that have been linked to formocresol. Ferric sulfate is a safer alternative to formocresol.
Specialty (Endodontics) (Pediatric Dentistry)
Keywords Formocroseol, Ferric sulfate, primary molars, pulpotomy
ID# 2819
Date of submission 03/17/2015
E-mail dokt@livemail.uthscsa.edu
Author Kim Do
Co-author(s) e-mail
Faculty mentor Issa Sasa, BDS, MS
Faculty mentor e-mail sasa@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available