Skip to main content

Advertisement

Log in

Evaluation of the genotoxic effects of formocresol application in vital pulp therapy of primary teeth: a clinical study and meta-analysis

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

This in vivo research investigated whether pulp treatments using formocresol for 7 days would cause mutagenic changes in children’s lymphocytes.

Materials and methods

The mutagenicity was tested in lymphocyte cultures established from the peripheral blood of children living in Brazil. The samples consisted of 2000 cells from teeth undergoing formocresol pulpotomies in which the formocresol pellet was sealed in the primary tooth for 7 days. It was removed on the seventh day, the base was placed, and the tooth was restored. Two venous blood samples (6–8 ml) were collected from each child; the first was prior to pulp therapy, and the second was 7 days later. Two thousand metaphases were analyzed. The level of significance adopted for the statistics was P < 0.05, and a random effects meta-analysis was performed combining this and two previous studies.

Results

There was no significant difference found in the metaphase analysis between the blood samples taken before and after the pulpotomy treatment (Wilcoxon signed rank test); however, the meta-analysis showed a significant difference between the combined studies.

Conclusions

This study did not reveal any mutagenic effects, but based on the combined meta-analysis, we recommend the careful use of formocresol.

Clinical relevance

This research helps to bring scientific evidence of the safe use of formocresol in deciduous pulpotomy treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. American Academy of Pediatric Dentistry (A.A.P.D.). Guideline on pulp therapy for primary and immature permanent teeth. “http://www.aapd.org/media/Policies_Guidelines/G_Pulp.pdf”. Accessed 20 July 2017

  2. Dunston B, Coll JA (2008) A survey of primary tooth pulp therapy as taught in US dental schools and practiced by diplomats of the American Board Of Pediatric Dentistry. Pediatr Dent 30(1):42–48

    PubMed  Google Scholar 

  3. Buckley JP (1906) A rational treatment for putrescent pulps and their sequelae. Dental Cosmos 48:537–544

    Google Scholar 

  4. Buckley JP (1904) The chemistry of pulp decomposition with a rational treatment for this condition and its sequelae. Am Dent J 3:764–771

    Google Scholar 

  5. Roberts JF (1996) Treatment of vital and non-vital primary molar teeth by one-stage formocresol pulpotomy: clinical success and effect upon age at exfoliation. Int J Paediatr Dent 6(2):111–115

    Article  PubMed  Google Scholar 

  6. International Agency for Research on Cancer (IARC), Formaldehyde. IARC monographs on the evaluation of carcinogenic risks to humans. “http://www.monographs.iarc.fr/ENG/Classification/ClassificationAlphaOrder.pdf” . Accessed 20 July 2017

  7. Strange DM, Seale NS, Nunn ME, Strange M (2001) Outcome formocresol/ZOE sub-base pulpotomies using alternative radiographic success criteria. Pediatr Dent 23(4):331–336

    PubMed  Google Scholar 

  8. Morawa AP, Straffon LH, Han SS, Corpron RE (1975) Clinical evaluation of pulpotomies using dilute formocresol. J Dent Child 42(5):360–363

    Google Scholar 

  9. Coll JA (2008) Indirect pulp capping and primary teeth: is the primary tooth pulpotomy out of date? Pediatric Dent 30:230–236

    Google Scholar 

  10. Casas MJ, Kenny DJ, Judd PL, Johnson DH (2005) Do we still need formocresol in pediatric dentistry? J Can Dent Assoc 71(10):749–751

    PubMed  Google Scholar 

  11. National Toxicology Program (2010) Final report on carcinogens background document for formaldehyde. Rep Carcinog Backgr Doc i:512

    Google Scholar 

  12. Fuks AB (2008) Vital pulp therapy with new materials for primary teeth: new directions and treatment perspectives. Pediatr Dent 30(3):211–219

    PubMed  Google Scholar 

  13. Abuabara A, Crozeta BM, Baratto-Filho F (2012) Review of pulp therapy in primary teeth. RSBO 9:474–477

    Google Scholar 

  14. Zarzar PA, Rosenblatt A, Takahashi CS, Takeuchi PL, Costa Júnior LA (2003) Formocresol mutagenicity following primary tooth pulp therapy: an in vivo study. J Dent 31(7):479–485. https://doi.org/10.1016/S0300-5712(03)00087-3

    Article  PubMed  Google Scholar 

  15. Wesley DJ, Marshall FJ, Rosen S (1970) The quantification of formocresol as a root canal medicament. Oral Surg Oral Med Oral Pathol 29(4):603–612. https://doi.org/10.1016/0030-4220(70)90472-X

    Article  PubMed  Google Scholar 

  16. Moorhead PS, Nowell PC, Mellman WJ, Battips DM, Hungerford DA (1960) Chromosome preparations of leucocytes cultured from human peripheral blood. Exp Cell Res 20(3):613–616. https://doi.org/10.1016/0014-4827(60)90138-5

    Article  PubMed  Google Scholar 

  17. Kirsch-Volders M, Sofuni T, Aardema M, Albertini S, Eastmond D, Fenech M, Ishidate M Jr, Kirchner S, Lorge E, Morita T, Norppa H, Surrallés J, Vanhauwaert A, Wakata A (2003) Report from the in vitro micronucleus assay working group. Mutat Res 540(2):153–163. https://doi.org/10.1016/j.mrgentox.2003.07.005

    Article  PubMed  Google Scholar 

  18. Albertini RJ, Anderson D, Douglas GR, Hagmar L, Hemminki K, Merlo F, Natarajan AT, Norppa H, Shuker DEG, Tice R, Waters MD, Aitio A (2000) IPCS guidelines for monitoring the genotoxic effect of carcinogens in humans. International Programme on Chemical Safety. Mutat Res 463(2):111–172. https://doi.org/10.1016/S1383-5742(00)00049-1

    Article  PubMed  Google Scholar 

  19. International Atomic Energy Agency (1986). Biological dosimetry: chromosomal aberrations analysis for dose assessment. Technical Report Series Number 260. Vienna

  20. Cardoso L, Zembruski C, Fernandes DSC, Boff I, Pessin V (2005) Evaluation of prevalence of precocious losses of deciduous molars. Pesq Bras Odontoped Clin Integr 5:17–22

    Google Scholar 

  21. Milnes AR (2006) Persuasive evidence that formocresol use in pediatric dentistry is safe. J Can Dent Assoc 72(3):247–248

    PubMed  Google Scholar 

  22. McClellan RO (1996) Reducing uncertainty in risk assessment by using specific knowledge to replace defaults options. Drug Metab Rev 28(1-2):149–179. https://doi.org/10.3109/03602539608993997

    Article  PubMed  Google Scholar 

  23. Ni Chaollai A, Monteiro J, Duggal MS (2009) The teaching management of the pulp in primary molars in Europe: a preliminary investigation in Ireland and the UK. Eur Arch Paediatr Dent 10(2):98–103. https://doi.org/10.1007/BF03321609

    Article  PubMed  Google Scholar 

  24. Leite AC, Rosenblatt A, Calixto MS, Silva CM, Santos N (2012) Genotoxic effect of formocresol pulp therapy of deciduous teeth. Mutat Res 30:93–97

    Article  Google Scholar 

  25. Ranly DM (1985) Assessment of the systemic distribution and toxicity of formaldehyde following pulpotomy treatment: part one. ASDC J Dent Child 6:431–435

    Google Scholar 

  26. Marrazzini A, Betti C, Bernacchi F, Barrai I, Barale R (1994) Micronucleus test and metaphase analysis in mice exposed to known and suspected spindle poisons. Mutagenesis 9(6):505–515. https://doi.org/10.1093/mutage/9.6.505

    Article  PubMed  Google Scholar 

  27. Ribeiro-Silva A, Zucoloto S (2003) The p53 family: structural and functional aspects of p73 and p63. J Bras Patol Med Lab 39:179–184

    Article  Google Scholar 

  28. Friedenson B (2011). Mutations in pathways depending on BRCA1 and BRCA2 may increase cancer risks from an environmental carcinogenic. Nat Proc. https://doi.org/10.1038/npre.2011.5669.1

  29. Symington L, Gautier J (2011) Double-strand break and resection and repair pathway choice. Annu Rev Genet 45(1):247–271. https://doi.org/10.1146/annurev-genet-110410-132435

    Article  PubMed  Google Scholar 

  30. Jacobs A, Schar P (2012) DNA glycosylases: in DNA repair and beyond. Chromosoma 121(1):1–20. https://doi.org/10.1007/s00412-011-0347-4

    Article  PubMed  Google Scholar 

  31. Smaïl-Faugeron V. et al. (2014) Pulp treatment for extensive decal in primary teeth (review). Cochrane Database of Systematic Reviews 1–193

  32. Hugar SM, Reddy R, Deshpande SD, Shigli A, Gokhale NS, Hugar SS (2017) In vivo comparative evaluation of mineral trioxide aggregate and formocresol pulpotomy in primary molars: a 60-month follow-up study. Contemp Clin Dent 8(1):122–127. https://doi.org/10.4103/ccd.ccd_849_16

    Article  PubMed  PubMed Central  Google Scholar 

  33. Coll JA, Seale NS, Vargas K, Marghalani AA, Al Shamali S, Graham L (2017) Primary tooth vital pulp therapy: a systematic review and meta-analysis. Pediat Dent 39(1):16–123

    Google Scholar 

Download references

Acknowledgments

The authors would like to thank the Brazilian Ministry of Education (Coordination for the Improvement of Higher Education Personnel, CAPES) for their support during the development of this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arnoldo Vasconcelos de Alencar Filho.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The ethical committee of Medical Center Fernando Figueira Institute (IMIP – Brazil – IRB 748/2006) approved the study.

Informed consent

For all participating children, parents and/or guardians provided written informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Alencar Filho, A.V., dos Santos Junior, V.E., da Silva Calixto, M. et al. Evaluation of the genotoxic effects of formocresol application in vital pulp therapy of primary teeth: a clinical study and meta-analysis. Clin Oral Invest 22, 2553–2558 (2018). https://doi.org/10.1007/s00784-018-2352-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-018-2352-y

Keywords

Navigation