Background
This study aimed to compare and histologically evaluate the pulpal inflammatory response and dentin bridge formation using Formocresol (FC), Enamel Matrix Derivative (EMD), and Turmeric Extract (TE) as pulpotomy agents in primary teeth.
Methods
Eighty-one patients, aged 8–10 years, requiring both serial extraction and pulpotomy of primary molars were enrolled in this study. One symptomless carious molar tooth from each patient was selected. The participants were divided into three equal groups (n = 27 each) based on the time planned for serial extraction: 1 week, 2 weeks, and 6 months. Each group was subdivided into three sub-groups (n = 9) according to the pulpotomy agent used (FC, EMD, or TE). Histological evaluations were performed post-extraction to assess pulpal inflammatory response and dentin bridge formation. Statistical analysis was carried out using Fisher’s exact test, with a significance threshold set at p < 0.05.
Results
A statistically significant difference was observed among the three materials regarding pulpal inflammatory response and dentin bridge formation. At 1 week, the FC and EMD groups had moderate inflammation in 88.9% and 77.8% of cases, respectively, while the TE group showed mild inflammation in 55.6% of cases. After 2 weeks, 77.8% of the TE group displayed mild inflammation, 66.7% of the EMD group showed moderate inflammation, and 22.2% of the FC group exhibited severe inflammatory response. By 6 months, 88.9% of the TE group had mild inflammation, while 44.4% of the EMD group showed moderate and 33.3% of the FC group demonstrated severe inflammation. Regarding dentin bridge formation after 6 months, 77.8% of the EMD group exhibited over 75% bridge formation whereas 88.9% of the FC group showed no bridge formation. The TE group showed moderate development with 66.7% showing less than 25% bridge formation.
Conclusion
TE and EMD demonstrated promising results in this study. Compared to FC, TE showed potential in reducing pulpal inflammation, while EMD was the most effective at promoting dentin bridge formation. However, further studies with extended follow-up are needed to determine the safe clinical indications for these alternative pulpotomy agents in primary teeth.