Materials and methods: Clinical and radiographic records of all pediatric patients who had pulpotomy of primary molar teeth between July 2005 and October 2008 were evaluated. A total of 55 pulpotomized primary molars were observed. Clinical assessments were carried out during the second visit to assess the presence of sinus tract, gingival swelling, excessive tooth mobility, tenderness to percussion, and abnormal exfoliation of the treated teeth. Periapical radiographs were reviewed for evidence of pathologic root resorption, radicular and/or periapical radiolucency, and abnormal pulp canal calcification. Treatments were regarded as failure in the presence of one or more of the above clinical and/or radiographic signs and symptoms.

Results: Of 55 pulpotomized teeth, 26 (47.3%) remained free from any clinical signs and symptoms and 48 (87.3%) showed no pathological radiographic findings. The clinical success rates of ferric sulfate and formocresol pulpotomy were 44.4% and 60.0%, respectively, whereas the radiographic success rates of ferric sulfate and formocresol pulpotomy were 86.7% and 90.0%, respectively. Although teeth treated with formocresol had higher both clinical and radiographic success rates compared with those treated with ferric sulfate, it was not statistically significant.

Conclusion: The clinical success rates of pulpotomy were lower compared with radiographic success rates. Ferric sulfate is an alternative to formocresol; however, the use of both agents in the dental undergraduate teaching at Universiti Sains Malaysia can still be recommended.

Clinical significance: Formocresol and ferric sulfate are advocated as pulpotomy agents in primary molar teeth since both agents showed comparable clinical and radiographic success rates.

METHOD: Resin-modified GIC, Fuji II LC (F2) and high-fluoride cGIC, Fuji VII (F7) were used as controls. HCD was synthesized in-house, incorporated into both RMGIC and cGICs at 1 % and 2 % weight percentages (w/w), and chemically analyzed using Fourier transform infrared (FTIR) spectroscopy. Then, the F2 containing HCD (GIC-HCD F2) and F7 containing HCD (GIC-HCD F7) were evaluated for HCD and fluoride release profiles using UV Visible spectrophotometer and pH/ISE benchtop fluoridemeter, respectively. The antibacterial properties were assessed against Streptococcus sanguinis using the agar well diffusion method and measurement of bacterial growth turbidity, followed by the observation of the bacterial morphology using scanning electron microscope. The data were statistically analyzed using one-way ANOVA and Bonferroni post-hoc tests.

RESULTS: The FTIR spectra confirmed the presence of HCD in the GIC-HCD matrices. HCD was successfully released from both GIC-HCD F2 and GIC-HCD F7 matrices at both weight percentages. Higher fluoride release and inhibitory zones were observed compared to the control groups, with GIC-HCD F2 having a more significant effect than GIC-HCD F7. Additionally, the incorporation of HCD slowed down the growth of Streptococcus sanguinis and showed remarkable changes in bacterial shape specifically on GIC-HCD F2.