Comparing the Outcomes of Three Pulpotomy Agents in Primary Molars: A Retrospective Study

Purpose: To determine the long-term clinical and radiographic success of BiodentineTM(BD), Mineral Trioxide Aggregate (MTA), and Ferric Sulfate (FS) as primary molar pulpotomy materials. Methods: In this retrospective cross-sectional study, data of all completed primary molar therapeutic pulpotomy was obtained from the electronic health record (EHR) system of a university-based pediatric dental clinic from 04/01/2016 to 01/10/2020. Two trained and calibrated examiners evaluated the participants’ records using validated criteria for clinical and radiographic outcomes. Descriptive statistics and logistic regression were used (p<0.05), as well as survival analysis using Kaplan-Meier survival curve and Cox proportional hazard model. Cohen’s Kappa was used for inter- and intra-examiner reliability. Results: A total of 374 participants with 469 pulpotomies were enrolled. The sample included 51% male, age range of 2 to 10 years. FS was used in 76% (n=355), BD in 14% (n=67) and MTA in 10% (n=47). Follow-up periods ranged from 6 to 48 months. BD demonstrated the highest clinical and radiographic success of 98.5% and 95.2%, respectively. MTA had 97.9% clinical and 93.6% radiographic success, while FS showed 88.9% clinical and 80.9% radiographic success. Conclusions: While all three materials can be recommended for clinical practice, BD and MTA may be the preferred choices.