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

Bahrololoomi 2008.

Methods RCT, parallel‐arm
Teeth randomly assigned
Conducted in the Pedodontics Department of Yazd Faculty of Dentistry, Iran. Operators were the principal investigator or co investigators
Participants 46 children, 70 teeth, mean age 6.1 years, standard deviation age 1.4 years, age range 4 to 10 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, slow‐speed bur, or both

  • For haemostasis, cotton pellet

  • No irrigation

  • Cotton wool pellet soaked with FC placed on pulp stumps for 5 minutes after pulpotomy, followed by ZOE dressings before being restored with amalgam


Group 2:Pulpotomy (electrosurgery); n = 35 (2 visits)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high‐speed bur

  • Pulpotomy amputation with excavator, slow‐speed bur, or both

  • For haemostasis, cotton pellet

  • No irrigation


In the experimental electrosurgical group, a series of large, sterile cotton pellets were placed in the chamber with pressure to obtain temporary haemostasis. The cotton pellets were then removed and the electrosurgery dental U‐shaped electrode (Whaledent perfect TCS, Colten Whaledent Inc., USA) was immediately placed 1 to 2 mm above the tissue. The electrosurgery unit power was set at 40%. The electrical arc was allowed to bridge the gap to the first pulpal stump for 1 second followed by a cool‐down period of 10 to 15 seconds. Heat was minimised by keeping the electrode as far away from the pulpal stumps and the tooth structure as possible while still allowing electrical arcing to occur. This procedure was repeated up to 3 times at each pulpal orifice. To avoid heat build‐up in any 1 area of the tooth, single applications of 1 second were performed to each orifice in a rotational sequence. After each current application, a new large sterile cotton pellet was placed with pressure on the next pulpal orifice to be electrosurgically treated to absorb any blood or tissue fluid before the next current application (i.e. pellet‐electrode‐pellet‐electrode). Pulpal stumps were dry and blackened, followed by ZOE dressings before being restored with amalgam
Outcomes Clinical success (absence of pain, abscess, fistula or excessive mobility), radiological success (presence of a normal periodontal ligament space, absence of pathological root resorption or canal calcification, and no periradicular or furcal radiolucency): evaluation at 9 months (at tooth level)
Pain symptoms, fistula, pathological mobility, abscess, furcal radiolucency, internal resorption, external resorption: evaluation at 3, 6 and 9 months
Notes 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 Low risk Quote: "...examiner who was ...blind to the treatment"
Blinding of radiological outcomes assessment Low risk Quote: "...examiner who was ...blind to the treatment"
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No missing outcome data
Selective reporting (reporting bias) Unclear risk Insufficient information to make a clear judgement