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. 2018 May 31;2018(5):CD003220. doi: 10.1002/14651858.CD003220.pub3

Alaçam 2009.

Methods RCT, parallel‐arm
Children randomly assigned
Conducted in the University of Gazi Department of Pediatric Dentistry, Turkey. Operators were undergraduate dental students supervised by members of senior staff clinics
Participants 105 children, 105 teeth, mean age 6.4 years, age range 4 to 8 years
Interventions Group 1:Pulpotomy (formocresol); n = 35 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, moistened cotton pellet with saline

  • No irrigation

  • Cotton wool pellet soaked with FC placed on pulp stumps for 3 minutes after pulpotomy, followed by 1 non‐specified medicament dressings before being restored with stainless‐steel crowns


Group 2:Pulpotomy (calcium hydroxide); n = 35 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, moistened cotton pellet with saline

  • No irrigation

  • CH applied after pulpotomy, followed by one non‐specified medicament dressings before being restored with stainless‐steel crowns


Group 3:Pulpotomy (calcium hydroxide/iodoform)n = 35 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, moistened cotton pellet with saline

  • No irrigation

  • CH/iodoform applied after pulpotomy, followed by 1 non‐specified medicament dressings before being restored with stainless‐steel crowns

Outcomes Clinical success (teeth remained asymptomatic, no tenderness to percussion, no sinus tract or no premature tooth loss), radiological success (no furcal or periapical radiolucencies or internal or external root resorption), tenderness to percussion, swelling, spontaneous pain, fistula, internal root resorption, external root resorption, periapical radiolucency, furcal radiolucency, widened periodontal ligament: evaluation at 1, 3, 6, 9 and 12 months (at tooth level)
Notes Quote: "9 children, with 9 pulpotomized molars, failed to return for evaluations and were excluded from the study"
"5 bleeding cases were excluded from analysis"
Group 1 ‐ received intervention, n = 35; no exclusions
Group 2 ‐ received intervention, n = 33; excluded due to uncontrolled bleeding from paste placement n = 2
Group 3 ‐ received intervention, n = 32; excluded due to uncontrolled bleeding from paste placement n = 3
Source of funding: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Insufficient information to make a clear judgement
Allocation concealment (selection bias) Unclear risk Insufficient information to make a clear judgement
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Insufficient information to make a clear judgement
Blinding of clinical outcomes assessment Unclear risk Insufficient information to make a clear judgement
Blinding of radiological outcomes assessment Low risk Quote: "Radiographic outcome assessments were made by the primary investigator and 1 independent experienced clinician who was blind to the treatment"
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Proportion of missing outcomes < 10% of children randomly assigned
Selective reporting (reporting bias) Unclear risk Insufficient information to make a clear judgement