Two-year outcomes of primary molar ferric sulfate pulpotomy and root canal therapy.

PURPOSE The objective of this outcome study was to compare ferric sulfate pulpotomy (FS) and primary tooth root canal therapy (RCT) on cariously exposed vital pulps of primary molars. METHODS A total of 291 molars were treated in 130 children--182 molars received FS and 109 received RCT by random selection. RESULTS At 2-year reassessment, 116 molars (73 FS, 43 RCT) were available for clinical and radiographic examination. There was no clinical evidence of pathosis in 96% of FS and 98% of RCT molars. Two independent pediatric dentists evaluated periapical radiographs of the treated molars. Molars were classified into 1 of 4 outcomes: (1) N--normal treated molar, (2) H--nonpathologic radiographic change present, (3) P(O)--pathologic change present, follow-up in 6 months, and (4) P(X)--pathologic change present, extract immediately. Survival analysis was applied. A good level of agreement between raters was found for molars with outcome P(X) (kappa=0.745). Intrarater reliability was good for molars with outcome P(X) (kappa=0.710). Significantly greater numbers of FS than RCT molars were rated P(X) at the 2-year recall (chi2=5.8; P=.02). No significant difference in survival between the 2 types of vital pulp treatments was detected in log rank tests (P=.22). CONCLUSIONS Outcomes for FS were poorer than RCT outcomes at 2 years; however, at 2 years, the survival rates were not statistically different.