The major challenge of performing root canal treatment in an open apex pulp-less tooth is to obtain a good apical seal. MTA has been successfully used to achieve a good apical seal, wherein the root canal obturation can be done immediately. MTA and White Portland Cement has been shown similarity in their physical, chemical and biological properties and has also shown similar outcome when used in animal studies and human trials. In our study, open apex of three non vital upper central incisors has been plugged using modified white Portland cement. 3 to 6 months follow up revealed absence of clinical symptoms and disappearance of peri-apical rarefactions. The positive clinical outcome may encourage the future use of white Portland cement as an apical plug material in case of non vital open apex tooth as much cheaper substitute of MTA.

A different concept of formocresol pulpotomy procedure has been proposed where the formocresol pulpotomy is done with smaller access to the pulp chamber. In our study formocresol pulpotomy was carried out in 128 primary molar teeth with a limited amount of access opening, saving a bit of more tooth structure, which excludes the requirement of placement of a stainless steel crown (SSC). In 2 years follow-up period, no crown fracture was reported. One hundred fifteen teeth remain vital at the end of 2 years period of observation with the periodic clinical and radiographic review. The result shows 89.4% clinical and radiographic success of this nonconventional pulpotomy procedure that corroborates with several studies of the conventional formocresol pulpotomy procedure. How to cite this article Chakraborty A, Dey B, Jana S. A Nonconventional Approach to Formocresol Pulpotomy. Int J Clin Pediatr Dent, 2018;11(6):490-495

Background: Effective anesthesia in endodontic treatment in cases of pediatric patients is very important to achieve patients' co-operation. Profound anesthesia is required to access the chamber and extirpate the pulp. If patient discomfort is encountered, intrapulpal injection may be used as a supplement for pulpal anesthesia. Aims and Objectives: This study aims to analyze the efficacy of different anesthetic solutions and sterile saline for intrapulpal injections in primary vital teeth with irreversible pulpitits. Materials and Methods: Forty volunteers, patients with irreversible pulpitis whose pain persists after conventional anesthesia during treatment, were selected from Haldia. Patients were divided into four groups to administer intrapulpal solutions (bupivacaine, articaine, and lidocaine) and sterile saline to the respective groups to analyze the efficacy of the solutions in pain relief during pulp extirpation. Results: Positive back pressure was present in case of all anesthetic solution which was administered on the selected patients. Conclusion: On the basis of the results, we can conclude that effectiveness of intrapulpal injection is dependent on back pressure.