Comparing Biodentine and Ferric Sulfate as Pulpotomy Agents in Primary Molars: A Retrospective Study

Hypothesis: There is no difference in the clinical or radiographic success of Biodentine (BD) compared to Ferric Sulfate (FS) when used as pulpotomy agents in primary molars. Objectives: To compare the clinical and radiographic outcomes of primary molar therapeutic pulpotomy procedures completed with BD and FS over a 3 year-period. Methods: This was a retrospective cohort study of patients treated with pulpotomies in the post-graduate Pediatric Dentistry Clinic at UIC. The EHR notes of the first 400 deciduous teeth with a completed pulpotomy during the period 04/01/2016-10/01/2018 were assessed. The study inclusion criteria were satisfied by 102 primary molars in 84 children. All EHR notes and x-rays pertaining to the study teeth were evaluated against validated clinical and radiographic scoring criteria by a single investigator, and failures were verified by second investigator.. Study data was numerically coded and statistically analyzed using Chi-square test (α<0.05 significance level). Results: The sample was 63% female (n=53), 47% Hispanic (n=40), and the mean age was 4.5 years (range 2 to 8 years). The study sample included 83  deciduous molars, 78% treated with FS and 22% with BD. Follow-up periods ranged from 6 to 36 months (mean= 17 months). BD had a clinical and radiographic success rates of 100%, while FS demonstrated 84% clinical and 70% radiographic success. The combined (clinical and radiographic) outcome for BD was statistically significantly higher  than for FS (p=0.0006). Conclusions: Although FS showed acceptable success rates, BD outperformed FS when compared as primary molar pulpotomy materials. Both materials can be recommended for clinical practice, but BD should be the preferred option.