Review Article
Volume 20 Issue 7 - 2021
Formocresol and Alternative Pulpotomy Medicaments used in Primary Teeth: A Review
Manal A Almutairi*
Department of Pediatric Dentistry and Orthodontics, King Saud University, Saudi Arabia
*Corresponding Author: Manal A Almutairi, Assistant Professor, Division of Pediatric Dentistry, Department of Pediatric Dentistry and Orthodontics, Dental college, King Saud University, Riyadh, Saudi Arabia.
Received: June 14, 2021; Published: June 30, 2021


Background: Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars. Several pulpotomies medicaments have been used to devitalize remaining pulp or maintain pulp vitality and promote healing.

Objectives: To review different material used so far for pulpotomy that has appeared in previously published papers.

Search Methods: An electronic search was undertaken on Cochrane Database, PubMed, Science Direct, and Google Scholar for articles on medicament agent used in pulpotomy in children. All electronic searches were last updated in May 2021. Search terms used were pulpotomy, formocresol, electrosurgery, mineral trioxide aggregate, zinc oxide-eugenol, calcium hydroxide, laser, glutaraldehyde, ferric sulfate, sodium hypochlorite, Portland cement and Biodentine.

Results: All significant pulpotomy agents were being found from 57 published papers. All these medicaments had been compared with the standard pulpotomy agents and their success rates has been demonstrated.

Conclusion: The use of formocresol or formaldehyde-based medicaments should be replaced with more biocompatible medicaments possessing antimicrobial and pulpal regenerative properties. There is a continual search on finding an ideal material with good success rate.

Keywords: Formocresol; Medicaments; Primary Teeth; Pulp; Pulpotomy


  1. American Academy of Pediatric Dentistry. ‘’Pulp therapy for primary and immature permanent teeth’’. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry (2020): 384-392.
  2. Sipes R and C J Binkley. “The use of formocresol in dentistry: a review of the literature”. Quintessence International 7 (1986): 415-417.
  3. Buckley JP. “The chemistry of the pulp decomposition with a rational treatment for this condition and its sequelae’’. Journal of the American Dental Association 3 (1904): 764-771.
  4. Dunston Bryan and James A Coll. “A survey of primary tooth pulp therapy as taught in US dental schools and practiced by diplomates of the American Board Of Pediatric Dentistry”. Pediatric Dentistry1 (2008): 42-48.
  5. Zurn Derek and N Sue Seale. “Light-cured calcium hydroxide vs formocresol in human primary molar pulpotomies: a randomized controlled trial”. Pediatric Dentistry1 (2008): 34-41.
  6. Ranly DM and E P Lazzari. “The formocresol pulpotomy--the past, the present, and the future”. The Journal of Pedodontics2 (1978): 115-127.
  7. Nelson JR., et al. “Biochemical effects of tissue fixatives on bovine pulp”. Journal of Endodontics5 (1979): 139-144.
  8. Fuks AB and E Bimstein. “Clinical evaluation of diluted formocresol pulpotomies in primary teeth of school children”. Pediatric Dentistry4 (1981): 321-324.
  9. Waterhouse PJ., et al. “An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy”. British Dental Journal1 (2000): 32-36.
  10. Zarzar PA., et al. “Formocresol mutagenicity following primary tooth pulp therapy: an in vivo study”. Journal of Dentistry7 (2003): 479-485.
  11. Srinivasan V., et al. “Is there life after Buckley's Formocresol? Part I -- a narrative review of alternative interventions and materials”. International Journal of Paediatric Dentistry2 (2006): 117-127.
  12. Lewis B. “The obsolescence of formocresol”. British Dental Journal11 (2009): 525-528.
  13. Ranly DM. “Pulpotomy therapy in primary teeth: new modalities for old rationales”. Pediatric Dentistry6 (1994): 403-409.
  14. Markowitz K., et al. “Biologic properties of eugenol and zinc oxide-eugenol. A clinically oriented review”. Oral Surgery, Oral Medicine, and Oral Pathology6 (1992): 729-737.
  15. Glass RL and Zander HA. “Pulp healing”. Journal of Dental Research 28 (1949): 97-107.
  16. Magnusson B. “Therapeutic pulpotomy in primary molars--clinical and histological follow-up. II. Zinc oxide-eugenol as wound dressing”. Odontologisk Revy1 (1971): 45-54.
  17. Ranly DM., et al. “A comparison of the effects of cresol and eugenol on bovine pulp”. Endodontics and Dental Traumatology2 (1988): 70-75.
  18. Huth KC., et al. “Effectiveness of 4 pulpotomy techniques--randomized controlled trial”. Journal of Dental Research12 (2005): 1144-1148.
  19. Law DB. “An evaluation of the vital pulpotomy technique’’. Journal of Dentistry for Children - AAPD 23 (1956): 40.
  20. Ketley CE and J R Goodman. “Formocresol toxicity: is there a suitable alternative for pulpotomy of primary molars?”. International Journal of Paediatric Dentistry2 (1991): 67-72.
  21. Yildiz Esma and Gul Tosun. “Evaluation of formocresol, calcium hydroxide, ferric sulfate, and MTA primary molar pulpotomies”. European Journal of Dentistry2 (2014): 234-240.
  22. Schröder U and L E Granath. “On internal dentine resorption in deciduous molars treated by pulpotomy and capped with calcium hydroxide”. Odontologisk Revy2 (1971): 179-188.
  23. Anderman II. “Indications for use of electrosurgery in pedodontics”. Dental Clinics of North America4 (1982): 711-728.
  24. Udin RD. “The formocresol pulpotomy revisited: looking at alternatives”. Journal of the California Dental Association9 (1991): 27-34.
  25. Sheller B and TH Morton Jr. “Electrosurgical pulpotomy: a pilot study in humans”. Journal of Endodontics2 (1987): 69-76.
  26. Dean JA., et al. “Comparison of electrosurgical and formocresol pulpotomy procedures in children”. International Journal of Paediatric Dentistry3 (2002): 177-182.
  27. Shaw DW., et al. “Electrosurgical pulpotomy--a 6-month study in primates”. Journal of Endodontics10 (1987): 500-505.
  28. Kimura Y., et al. “Lasers in endodontics: a review”. International Endodontic Journal3 (2000): 173-185.
  29. Pick RM. “Using lasers in clinical dental practice”. Journal of the American Dental Association2 (1993): 37-34.
  30. Adrian JC. “Pulp effects of neodymium laser. A preliminary report”. Oral Surgery, Oral Medicine, and Oral Pathology2 (1977): 301-305.
  31. Wilder-Smith P., et al. “CO2 laser treatment of traumatic pulpal exposures in dogs”. Lasers in Surgery and Medicine5 (1997): 432-437.
  32. Dang J., et al. “Clinical preconditions and treatment modality: effects on pulp surgery outcome”. Lasers in Surgery and Medicine1 (1998): 25-29.
  33. Liu Jeng-fen. “Effects of Nd:YAG laser pulpotomy on human primary molars”. Journal of Endodontics5 (2006): 404-407.
  34. Hannah DR. “Glutaraldehyde and calcium hydroxide. A pulp dressing material”. British Dental Journal6 (1972): 227-231.
  35. Lloyd JM., et al. “The effects of various concentrations and lengths of application of glutaraldehyde on monkey pulp tissue”. Pediatric Dentistry2 (1988): 115-120.
  36. Fuks AB., et al. “Assessment of a 2 percent buffered glutaraldehyde solution in pulpotomized primary teeth of schoolchildren”. ASDC Journal Of Dentistry for Children5 (1990): 371-375.
  37. Havale Raghavendra., et al. “Clinical and radiographic evaluation of pulpotomies in primary molars with formocresol, glutaraldehyde and ferric sulphate”. Oral Health and Dental Management1 (2013): 24-31.
  38. Soria HMA., et al. “Mutagenic and genotoxic comparison of formocresol, cresol, formaldehyde and glutaraldehyde’’. Acta Pediátrica de México4 (2005): 190-195.
  39. Seow WK and Thong FY. “Modulation of polymorphonuclear leukocyte adherence by pulpotomy medicaments: effects of formocresol, glutaraldehyde, eugenol, and calcium hydroxide’’. Pediatric Dentistry1 (1986): 16-21.
  40. Larson PO. “Topical hemostatic agents for dermatologic surgery”. The Journal of Dermatologic Surgery and Oncology6 (1988): 623-632.
  41. Landau MJ and Johnson DC. “Pulpal response to ferric sulfate in monkeys’’. Journal of Dental Research 67 (1988): 215.
  42. Lemon RR., et al. “Ferric sulfate hemostasis: effect on osseous wound healing. Left in situ for maximum exposure”. Journal of Endodontics4 (1993): 170-173.
  43. Fuks AB., et al. “Ferric sulfate versus dilute formocresol in pulpotomized primary molars: long-term follow up”. Pediatric Dentistry5 (1997): 327-330.
  44. Ibricevic H and Q al-Jame. “Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up”. The Journal of Clinical Pediatric Dentistry4 (2000): 269-272.
  45. Ozmen B and S Bayrak. “Comparative evaluation of ankaferd blood stopper, ferric sulfate, and formocresol as pulpotomy agent in primary teeth: A clinical study”. Nigerian Journal of Clinical Practice7 (2017): 832-838.
  46. Schwartz RS., et al. “Mineral trioxide aggregate: a new material for endodontics”. Journal of the American Dental Association7 (1999): 967-975.
  47. Koh ET., et al. “Cellular response to Mineral Trioxide Aggregate”. Journal of Endodontics8 (1998): 543-547.
  48. Holan Gideon., et al. “Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol”. Pediatric Dentistry2 (2005): 129-136.
  49. Olatosi OO., et al. “Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: a clinical and radiographic study”. Nigerian Journal of Clinical Practice2 (2015): 292-296.
  50. Lin Chih-Yu., et al. “Clinical and radiographic evaluation of different materials in primary molar pulpotomies: A retrospective study”. Journal of Dental Sciences4 (2019): 408-412.
  51. Tang HM., et al. “Pulpal response to prolonged dentinal exposure to sodium hypochlorite”. International Endodontic Journal6 (2000): 505-508.
  52. Accorinte Maria de Lourdes Rodrigues., et al. “Response of human pulp capped with a bonding agent after bleeding control with hemostatic agents”. Operative Dentistry2 (2005): 147-155.
  53. Ruby John D., et al. “A randomized study of sodium hypochlorite versus formocresol pulpotomy in primary molar teeth”. International Journal of Paediatric Dentistry2 (2013): 145-152.
  54. Shabzendedar Mahboobeh., et al. “Sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars: 1-year follow-up”. Pediatric Dentistry4 (2013): 329-332.
  55. Chauhan Shikhar P., et al. “Evaluation and Comparison between Formocresol and Sodium Hypochlorite as Pulpotomy Medicament: A Randomized Study”. The Journal of Contemporary Dental Practice11 (2017): 1029-1033.
  56. Al-Mutairi MA and OA Bawazir. “Sodium hypochlorite versus Formocresol in primary molars pulpotomies: a randomized clinical trial”. European Journal of Paediatric Dentistry1 (2013): 33-36.
  57. Taha NA and SZ Abdelkhader. “Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis”. International Endodontic Journal8 (2018): 819-828.
  58. Cannon Mark., et al. “Primate pulpal healing after exposure and TheraCal application”. The Journal of Clinical Pediatric Dentistry4 (2014): 333-337.
  59. Jose Bijimole., et al. “Calcium phosphate cement as an alternative for formocresol in primary teeth pulpotomies”. Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research4 (2013): 522.
  60. Qureshi Asma., et al. “Recent advances in pulp capping materials: an overview”. Journal of Clinical and Diagnostic Research: JCDR1 (2014): 316-321.
Citation: Manal A Almutairi. “Formocresol and Alternative Pulpotomy Medicaments used in Primary Teeth: A Review”. EC Dental Science 20.7 (2021): 132-134.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

February Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the February issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before February 17, 2023.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.