Evaluation of the effect of ozone gel on clinical and radiographic success of primary molars pulpotomy with ferric sulfate

Abstract

Background and goal: Palpotomy is the most common treatment for pediatric molars with reversible pulpitis. Most failures of pulpotomy treatment are due to the lack of sterility in the environment. The material used to place on the remaining pulp in the pulpotomy should have the appropriate antimicrobial and anticoagulant effect. Recently, ferric sulfate pulpotomy is one of the pulpotomy methods that has attracted a lot of attention and is preferred over formocresol due to its lack of toxic and mutagenic properties as well as reduced clinical work time. This substance has a high anticoagulant effect, but its antimicrobial effect is not desirable. This study aimed to evaluate the disinfection effect of ozone gel on clinical success and radiography of pediatric molars with ferric sulfate Methods and Materials: This single-blind randomized clinical trial study with coded IRCT20190514043585 N3 was conducted on 48 deciduous molars in 24 children aged 4 to 8 years who required bilateral pediatric molars in the maxilla or mandible using a SPLITE MOUTH technique. Patients were enrolled in two groups of case (ferric sulfate with ozone gel) and control (ferric sulfate without ozone gel). In the case group, the desired tooth was anesthetized and isolated with a rubberdam. After removing all the caries and debris, an access hole was created. The contents of the pulp chamber were removed and then ozone gel (Vitomex) was placed for disinfection and after a few minutes the gel melted, 15.5% ferric sulfate (ULTRADENT ASTINGEDENT) was placed in place with cotton for 10-15 seconds, and finally ZOE (zooliran) was applied and the final repair was done in the same session. In the control group, all the steps performed for the case group were repeated, except that ozone gel was not used for disinfection and finally the crown of the teeth were restored with SSC or amalgam. Clinical and radiographic success were evaluated by two pediatricians who were unaware of the type of treatment (one-blind) during a 6-month clinical and radiographic follow-up. Results: In this study, out of 25 patients, finally 24 patients referred for follow-up and 48 teeth were examined as splite mouth. 50% of children were girls and 50% were boys. • The comparison of clinical success rates in the two groups of case (95.8%) and control (100%) is similar. • The comparison of radiological success rates in the two groups of case (100%) and control (95.8%) is similar. • In the case group, clinical success (95.8%) and radiography (100%) are similar. • In the control group, clinical success (100%) and radiography (95.8%) are similar. Conclusion: The use of ozone gel as a disinfectant with ferric sulfate in palpotomy of deciduous molars with reversible pulp as in the control group, has been a significant success.