Pulpotomy Techniques: Cervical (Traditional) and Partial

  • Kaaren G. VargasEmail author
  • Anna B. Fuks
  • Benjamin Peretz


The conservation of primary teeth in form and function until their normal exfoliation is one of the fundamental objectives of pediatric dentistry. Not only is it important for normal speech, development, and self-esteem, it is the best way to preserve arch length and avoid secondary issues such as space loss and permanent tooth impaction.


Ferric Sulfate Primary Tooth Pediatric Dentistry Calcium Hydroxide Mineral Trioxide Aggregate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Bjorndal L. The caries process and its effect on the pulp: the science is changing and so is our understanding. Pediatr Dent. 2008;30:192–6.PubMedGoogle Scholar
  2. 2.
    Mount GJ. A new paradigm for operative dentistry. Aust Dent J. 2007;52:264–70; quiz 342.CrossRefPubMedGoogle Scholar
  3. 3.
    Vij R, Coll JA, Shelton P, Farooq NS. Caries control and other variables associated with success of primary molar vital pulp therapy. Pediatr Dent. 2004;26(3):214–20.PubMedGoogle Scholar
  4. 4.
    Al-Zayer MA, Straffon LH, Feigal RJ, Welch KB. Indirect pulp treatment of primary posterior teeth: a retrospective study. Pediatr Dent. 2003;25(1):29–36.PubMedGoogle Scholar
  5. 5.
    Fuks AB, Kupietzki A, Guelmann M. Pulp therapy for the primary dentition. In: infancy through adolescence. In: Casamassimo PS, Fields Jr HW, McTigue DJ, Nowak AJ, editors. Pediatric dentistry: infancy through adolescence. 5th ed. St. Louis: Elsevier Saunders; 2015. p. 333–51.Google Scholar
  6. 6.
    Buckley JP. The chemistry of pulp decomposition with a rational treatment for this condition and its sequelae. Am Dent J. 1904;3:764–71.Google Scholar
  7. 7.
    Ranly DM. Pulpotomy therapy in primary teeth: new modalities for old rationales. Pediat Dent. 1994;16:403–9.Google Scholar
  8. 8.
    Doyle WA, McDonald RE, Mitchell DF. Formocresol versus calcium hydroxide in pulpotomy. ASDC J Dent Child. 1962;29:86–97.Google Scholar
  9. 9.
    Sweet Jr CA. Procedure for treatment of exposed and pulpless deciduous teeth. J Am Dent Assoc. 1930;17:1150–3.Google Scholar
  10. 10.
    Emmerson CC, Miyamoto O, Sweet Sr CA, Bhatia HL. Pulpal changes following formocresol applications on rat molars and human primary teeth. J Cal Dent Assoc. 1959;27:309–23.Google Scholar
  11. 11.
    Redig DF. A comparison and evaluation of two formocresol pulpotomy technics utilizing “Buckley’s” formocresol. J Dent Child. 1968;35(1):22–30.PubMedGoogle Scholar
  12. 12.
    Loos PJ, Han SS. An enzyme histochemical study of the effect of various concentrations of formocresol on connective tissues. Oral Surg Oral Med Oral Path. 1971;31(4):571–85.CrossRefPubMedGoogle Scholar
  13. 13.
    Rolling I, Lambjerg-Hansen H. Pulp condition of successfully formocresol-treated primary molars. Scand J Dent Res. 1978;86(4):267–72.Google Scholar
  14. 14.
    Ranly DM. Assessment of the systemic distribution and toxicity of formaldehyde following pulpotomy treatment: part one. J Dent Child. 1985;52:4331–4.Google Scholar
  15. 15.
    Myers D, Shoaf K, Dirksen T, Pashley DH, Whitford GM, Reynolds KE. Distribution of 14C-formaldehyde after pulpotomy with formocresol. J Am Dent Assoc. 1978;96:805–13.CrossRefPubMedGoogle Scholar
  16. 16.
    Pashley E, Myers D, Pashley DH, Whitford G. Systemic distribution of 14C-formaldehyde from formocresol- treated pulpotomy sites. J Dent Res. 1980;59:602–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Milnes A. Is formocresol obsolete? a fresh look at the evidence concerning safety issues. Pediatr Dent. 2008;30:237–46.PubMedGoogle Scholar
  18. 18.
    Praveen K, Rashmi N, Vipin B, Pujan M. Pulpotomy medicaments: continued search for new alternatives- a review. Oral Health Dent Manag. 2014;13(4):883–90.Google Scholar
  19. 19.
    ‘s-Gravenmade EJ. Some biochemical considerations of fixation in endodontics. J Endod. 1973;1:233–7.CrossRefGoogle Scholar
  20. 20.
    Kopel HM, Bernick S, Zachrisson E, De Romero SA. The effects of glutaraldehyde on primary pulp tissue following coronal amputation: an in vivo histological study. J Dent Child. 1980;47:425–30.Google Scholar
  21. 21.
    García-Godoy F. Clinical evaluation of glutaraldehyde pulpotomies in primary teeth. Acta Odontol Pediatr. 1984;4:41–4.Google Scholar
  22. 22.
    Fuks AB, Bimstein E, Klein H. Assessment of a 2 % buffered glutaraldehyde solution as a pulp dressing in pulpotomized human primary teeth. J Pedod. 1986;10:323–30.PubMedGoogle Scholar
  23. 23.
    Fuks AB, Bimstein E, Guelmann M, Klein H. Assessment of a 2 per cent buffered glutaraldehyde solution in pulpotomized primary teeth of school children. J Dent Child. 1990;57:371–5.Google Scholar
  24. 24.
    Davis MJ, Myers R, Switkes MD. Glutaraldeyde: an alternative to formocresol for vital pulp therapy. J Dent Child. 1982;49(3):176–80.Google Scholar
  25. 25.
    Lloyd MJ, Seale NS, Wilson CFG. The effects of various concentrations and lengths of application of glutaraldehyde on monkey pulp tissue. Pediatr Dent. 1988;10(2):115–20.PubMedGoogle Scholar
  26. 26.
    Fuks AB, Eidelman E, Cleaton-Jones P, Michaeli Y. Pulp response to ferric sulfate, diluted formocresol and IRM in pulpotomized primary baboon teeth. ASDC J Dent Child. 1997;64(4):254–9.PubMedGoogle Scholar
  27. 27.
    Fuks AB, Holan G, Davis JM, Eidelman E. Ferric sulfate versus dilute formocresol in pulpotomized primary molars: long-term follow up. Pediatr Dent. 1997;19:327–30.PubMedGoogle Scholar
  28. 28.
    Landau MJ, Johnson DC. Pulpal response to ferric sulfate in monkeys. J Dent Res. 1988;67:215 [Abstr #822].Google Scholar
  29. 29.
    Fei AL, Udin RB, Johnson R. A clinical study of ferric sulfate as a pulpotomy agent in primary teeth. Pediatr Dent. 1991;13(6):327–32.PubMedGoogle Scholar
  30. 30.
    Vargas K, Packham B. Radiographic success of ferric sulfate and formocresol pulpotomies and its relationship to early exfoliation. Pediatr Dent. 2005;27:233–337.PubMedGoogle Scholar
  31. 31.
    Vargas KG, Packham B, Lowman D. Preliminary evaluation of sodium hypochlorite for pulpotomies in primary molars. Pediatr Dent. 2006;28(6):511–7.PubMedGoogle Scholar
  32. 32.
    Rosenfeld EF, James GA, Burch BS. Vital pulp tissue response to sodium hypochlorite. J Endod. 1978;5:140–6.CrossRefGoogle Scholar
  33. 33.
    Hafez AA, Kopel HM, Cox CF. Pulpotomy reconsidered: application of an adhesive system to pulpotomized permanent primate pulps. Quintessence Int. 2000;31:579–89.PubMedGoogle Scholar
  34. 34.
    Hafez AA, Cox CF, Tarim B, Otsuki M, Akimoto N. An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one or two component adhesive system in exposed nonhuman primate pulps. Quint Int. 2002;33(4):261–72.Google Scholar
  35. 35.
    Accorinte MLR, Loguercio AD, Reis A, Muench A, Araujo VC. Responses of human pulp capped with a bonding agent after bleeding control with hemostatic agents. Oper Dent. 2005;2:147–55.Google Scholar
  36. 36.
    Al-Mutairi MA, Bawazir OA. Sodium hypochlorite versus formocresol in primary molars pulpotomies: a randomized clinical trial. Eur J Ped Dent. 2013;14(1):33–6.Google Scholar
  37. 37.
    Ruby JD, Cox CF, Mitchell SC, Makhija S, Chompu-Inwai P, Jackson JA. Randomized study of sodium hypochlorite versus formocresol pulpotomy in primary molar teeth. Int J Ped Dent. 2013;23(2):145–52.CrossRefGoogle Scholar
  38. 38.
    Shabzendedar M, Mazhari F, Alami M, Talebi M. Sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars: 1-year follow-up. Pediatr Dent. 2013;35(4):329–32.PubMedGoogle Scholar
  39. 39.
    Zander HA. Reaction of the pulp calcium hydroxide. J Dent Res. 1939;18:373–9.CrossRefGoogle Scholar
  40. 40.
    Magnusson B. Therapeutic pulpotomy in primary molars – Clinical and histological follow-up. I. Calcium hydroxide paste as wound dressing. Odontol Revy. 1970;21:415–31.PubMedGoogle Scholar
  41. 41.
    Schroder U. A 2-year follow-up of primary molars pulpotomized with a gentle technique and capped with calcium hydroxide. Scand J Dent Res. 1978;86:273–8.PubMedGoogle Scholar
  42. 42.
    Waterhouse PJ, Nunn JH, Whitworth JM. An investigation of the relative efficacy of Buckley’s Formocresol and calcium hydroxide in primary molar vital pulp therapy. Br Dent J. 2000;188:32–6.PubMedGoogle Scholar
  43. 43.
    Ketley CE, Goodman JR. Formocresol toxicity: is there a suitable alternative for pulpotomy in primary molars? Int J Pediatr Dent. 1991;2:67–72.Google Scholar
  44. 44.
    Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod. 1995;21:349–53.CrossRefPubMedGoogle Scholar
  45. 45.
    Sarkar NK, Caidedo R, Tirwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31:97–100.CrossRefPubMedGoogle Scholar
  46. 46.
    Torabinejad M, Hong CU, Pitt Ford TR, Kettering JD. Antibacterial effects of some root-end filling materials. J Endod. 1995;21:403–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Eidelman E, Holan G, Fuks AB. Mineral trioxide aggregate vs. formocresol in pulpotomized primary molars: a preliminary report. Pediatr Dent. 2001;23(1):15–8.PubMedGoogle Scholar
  48. 48.
    Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review-part III: clinical applications, drawbacks, and mechanism of action. Endod. 2011;36:400–13.CrossRefGoogle Scholar
  49. 49.
    Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2014;(8):1–193.Google Scholar
  50. 50.
    International Agency for Research on Cancer. Press release no. 153. 15 Jun 2004.
  51. 51.
    Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod. 1978;4:232–7.CrossRefPubMedGoogle Scholar
  52. 52.
    Cvek M, Cleaton-Jones PE, Austin JC, Andreasen JO. Pulp reactions to exposure after experimental crown fractures or grinding in adult monkeys. J Endod. 1982;8:391–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Holan G, McTique DJ. Introduction to dental trauma: managing traumatic injuries in the primary dentition. In: Casamassimo PS, Fields Jr HW, McTigue DJ, Nowak AJ, editors. Pediatric dentistry: infancy through adolescence. 5th ed. St. Louis: Elsevier Saunders; 2015. p. 213–30.Google Scholar
  54. 54.
    Fuks AB, Gavra S, Chosck A. Long-term followup of traumatized incisors treated by partial pulpotomy. Pediatr Dent. 1993;15:334–6.PubMedGoogle Scholar
  55. 55.
    Ram D, Holan G. Partial pulpotomy in a traumatized primary incisor with pulp exposure: case report. Pediatr Dent. 1994;16:44–8.PubMedGoogle Scholar
  56. 56.
    Petel R, Fuks A. Pink spot – A case report and literature review (in press) 2015.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Kaaren G. Vargas
    • 1
    Email author
  • Anna B. Fuks
    • 2
  • Benjamin Peretz
    • 3
  1. 1.Private Practice Iowa USANorth LibertyUSA
  2. 2.Department of Pediatric DentistryHebrew University, Hadassah School of Dental MedicineJerusalemIsrael
  3. 3.Department of Pediatric DentistryThe Maurice and Gabriela Goldschleger School of Dental MedicineTel AvivIsrael

Personalised recommendations