Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial

Abstract Background Sodium hypochlorite (NaOCl) gel can be a potential substitute in daily pediatric dentistry practice. Given its high antimicrobial efficacy, NaOCl gel is expected to induce healing and improve pulpotomy treatment outcomes. This study aimed to perform a histological, clinical, and...

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Main Authors: Mawia Karkoutly, Amirah Alnour, Amjad Abu Hasna, Ok Hyung Nam, Saleh Al Kurdi, Nada Bshara
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06438-9
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author Mawia Karkoutly
Amirah Alnour
Amjad Abu Hasna
Ok Hyung Nam
Saleh Al Kurdi
Nada Bshara
author_facet Mawia Karkoutly
Amirah Alnour
Amjad Abu Hasna
Ok Hyung Nam
Saleh Al Kurdi
Nada Bshara
author_sort Mawia Karkoutly
collection DOAJ
description Abstract Background Sodium hypochlorite (NaOCl) gel can be a potential substitute in daily pediatric dentistry practice. Given its high antimicrobial efficacy, NaOCl gel is expected to induce healing and improve pulpotomy treatment outcomes. This study aimed to perform a histological, clinical, and radiographical evaluation of pulpotomy in human primary molars utilizing 2.25% (NaOCl) gel as a medicament, followed by white mineral trioxide aggregate (WMTA) as a base material. Materials and methods A randomized, second-blinded, split-mouth clinical trial was conducted in cooperative patients aged 8–10 years with 48 carious first primary molars, which were treated by: (I) NaOCl gel group: following hemostasis, teeth were pulpotomized utilizing 2.25% NaOCl gel, and then WMTA paste was applied as a dressing material, and (II) control group: following hemostasis, WMTA paste was applied as a dressing material. Later, each group was sub-divided into three sub-groups (n = 8) according to the time planned for serial extraction: (I) 7 days, (II) 30 days, and (III) 90 days for histological evaluation. In addition, 40 s primary molars in cooperative patients aged 5–10 years indicated for pulpotomy were randomly allocated into two groups for clinical and radiographical evaluation at 3, 6, and 12 months follow-up. Data were analyzed by applying the chi-square test (p < 0.05). Results NaOCl gel improved odontoblastic integrity and dentin bridge formation (p < 0.001) without increasing pulp necrosis or calcifications. The NaOCl gel group showed a 90% clinical and radiographical success rate at 3, 6, and 12 months of follow-up. In the control group, the clinical success rate was 85% after 3, 6, and 12 months, whereas the radiographical success rate was 100% at 3 months and decreased to 85% after 6 and 12 months. Conclusions Utilizing 2.25% NaOCl gel as a medicament in human primary molars pulpotomy improved the treatment outcomes of the WMTA. Trial registration ISRCTN registry, ISRCTN15908457, registered 22 July 2024.
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spelling doaj-art-a8e0cd25237b45c6b467388f087cb3162025-08-20T04:01:42ZengBMCBMC Oral Health1472-68312025-07-0125111410.1186/s12903-025-06438-9Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trialMawia Karkoutly0Amirah Alnour1Amjad Abu Hasna2Ok Hyung Nam3Saleh Al Kurdi4Nada Bshara5Department of Pediatric Dentistry, Faculty of Dentistry, Damascus UniversityDepartment of Oral and Maxillofacial Pathology, Faculty of Dentistry, Damascus UniversityDepartment of Restorative Dentistry, Endodontics Division, Institute of Science and Technology (UNESP), São Paulo State UniversityDepartment of Pediatric Dentistry, School of Dentistry, Kyung Hee UniversityDepartment of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Arab International UniversityDepartment of Pediatric Dentistry, Faculty of Dentistry, Damascus UniversityAbstract Background Sodium hypochlorite (NaOCl) gel can be a potential substitute in daily pediatric dentistry practice. Given its high antimicrobial efficacy, NaOCl gel is expected to induce healing and improve pulpotomy treatment outcomes. This study aimed to perform a histological, clinical, and radiographical evaluation of pulpotomy in human primary molars utilizing 2.25% (NaOCl) gel as a medicament, followed by white mineral trioxide aggregate (WMTA) as a base material. Materials and methods A randomized, second-blinded, split-mouth clinical trial was conducted in cooperative patients aged 8–10 years with 48 carious first primary molars, which were treated by: (I) NaOCl gel group: following hemostasis, teeth were pulpotomized utilizing 2.25% NaOCl gel, and then WMTA paste was applied as a dressing material, and (II) control group: following hemostasis, WMTA paste was applied as a dressing material. Later, each group was sub-divided into three sub-groups (n = 8) according to the time planned for serial extraction: (I) 7 days, (II) 30 days, and (III) 90 days for histological evaluation. In addition, 40 s primary molars in cooperative patients aged 5–10 years indicated for pulpotomy were randomly allocated into two groups for clinical and radiographical evaluation at 3, 6, and 12 months follow-up. Data were analyzed by applying the chi-square test (p < 0.05). Results NaOCl gel improved odontoblastic integrity and dentin bridge formation (p < 0.001) without increasing pulp necrosis or calcifications. The NaOCl gel group showed a 90% clinical and radiographical success rate at 3, 6, and 12 months of follow-up. In the control group, the clinical success rate was 85% after 3, 6, and 12 months, whereas the radiographical success rate was 100% at 3 months and decreased to 85% after 6 and 12 months. Conclusions Utilizing 2.25% NaOCl gel as a medicament in human primary molars pulpotomy improved the treatment outcomes of the WMTA. Trial registration ISRCTN registry, ISRCTN15908457, registered 22 July 2024.https://doi.org/10.1186/s12903-025-06438-9PulpotomyPrimary teethMolarSodium hypochloriteMineral trioxide aggregate
spellingShingle Mawia Karkoutly
Amirah Alnour
Amjad Abu Hasna
Ok Hyung Nam
Saleh Al Kurdi
Nada Bshara
Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
BMC Oral Health
Pulpotomy
Primary teeth
Molar
Sodium hypochlorite
Mineral trioxide aggregate
title Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
title_full Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
title_fullStr Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
title_full_unstemmed Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
title_short Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial
title_sort treatment outcomes of pulpotomy in primary molars utilizing 2 25 sodium hypochlorite gel a randomized controlled trial
topic Pulpotomy
Primary teeth
Molar
Sodium hypochlorite
Mineral trioxide aggregate
url https://doi.org/10.1186/s12903-025-06438-9
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