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

Dean 2002.

Methods RCT, parallel‐arm
Children randomly assigned
Conducted in the dental clinics of the Indiana University Institutional Review Board, USA. Operators were investigators: "...standardization of the investigators in the experimental technique was attempted by using a clinician with over 20 years of experience in performing the electrosurgical…"
Participants 50 children, 50 teeth mean age 5.3 years, age range 2.2 to 8.1 years
Interventions Group 1:Pulpotomy (formocresol); n = 25 (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, dry cotton pellet

  • No irrigation

  • Cotton wool pellet soaked with FC placed on pulp stumps for 5 minutes after pulpotomy, followed by IRM dressings before being restored with stainless‐steel crown


Group 2:Pulpotomy (electrosurgery); n = 25 (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, dry cotton pellet

  • No irrigation

  • Pulpotomy, haemorrhage control with sterile cotton wool pellet and electrosurgery to pulp stumps. Maximum of 3 applications of 1 second to each pulpal orifice, with cool‐down periods of 5 seconds between applications to limit heat build‐up. Unit at 40% power. Followed by IRM dressings before being restored with stainless‐steel crown

Outcomes Clinical success (no pain, no abscess, no fistula or no excessive mobility), radiological success (normal periodontal ligament space, no pathological root resorption, no canal calcification and no periradicular radiolucency): mean evaluation at 11.5 (range 5‐25) months for Group 1 and 10.9 (6‐31) for Group 2 (at tooth level)
Notes Source of funding: quote: "This study was supported by Birtcher Medical Services, Inc"
 Comment: Birtcher Medical Systems, Inc. is a USA manufacturer of medical and surgical instruments
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "...the patients were assigned randomly by the flip of a coin"
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 Unclear risk Insufficient information to make a clear judgement
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