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PubMed1978

Antibody formation to dog pulp tissue altered by formocresol uithin the root canal.

After pulpal extirpation of twenty teeth in each of five dogs, these animals were primarily immunized intramuscularly by combining formocresol with the dog's own pulp (three dogs), saline solution with pulp (one dog) and injecting sheep erythrocytes (one dog). A sixth dog was used as a control for the Arthus skin test. Secondary immunizations were accomplished via the root canal every 7 days over a 28-day period. Arthus skin-test reactions demonstrated less of a response to the formocresol alone than when the dogs' pulp was conbined with this material. In vitro analysis of hemagglutinating antibody titer showed a tremendous increase when pulp was incubated with formocresol as compared to the saline-treated pulp. Therefore, dogs' pulp tissue became antigenically altered by the formocresol recognized by the host, and a specific humoral response resulted.

Animals↗

PubMed1982

Diffusion of carbon-14-labeled formocresol and glutaraldehyde in tooth structures.

14C-Formocresol and 14C-glutaraldehyde were placed in the root canals of freshly extracted human teeth. The outward diffusion of labeled aldehydes was then measured and autoradiograms of cross-sections taken. No diffusion of glutaraldehyde was detectable within 72 hours, whereas there was a rapidly increasing outflow of formocresol during the same period. In a separate group normal root canal treatment was completed until 2 mm. short of the roentgenologic apex with glutaraldehyde as an irrigant. The walls of the root canals of some of the specimens were examined with electron microscopy and the outflow of 14C-formocresol which was later placed in some specimens was counted. The use of glutaraldehyde as an irrigant resulted in closure of the apical third of the root canal as indicated by the absence of 14C-formocresol diffusion.

Aldehydes↗

PubMed1991

Comparison of antimicrobial and cytotoxic effects of glutaraldehyde and formocresol.

The in vitro antimicrobial and cytotoxic concentrations of glutaraldehyde and formocresol were determined. Minimal antimicrobial concentrations of these two agents against selected microbial flora reported in carious primary teeth were 3.125% for glutaraldehyde and 0.75% for formocresol. At a doubling of these concentrations, most organisms, except Candida albicans, Staphylococcus epidermidis, and Streptococcus mutans, were killed by both substances in 30 seconds. Cytotoxicity was evaluated on tissue cultures of pulp fibroblasts and HeLa cells at minimal cidal concentrations and at 10- and 100-fold dilutions. Exposure of pulp fibroblasts and HeLa cells to formocresol and indirect exposure to vapors caused the cells to become atrophic and to form a less dense tissue pattern. Cells directly exposed to glutaraldehyde retained their normal cell shape and tissue pattern, whereas cells indirectly exposed to vapors continued to proliferate. These data showed effective antimicrobial activity at concentrations of 3.125% glutaraldehyde and 0.75% formocresol and suggested that glutaraldehyde may exert a less cytotoxic effect on the immediate and surrounding tissues when used as a pulpotomy agent.

Bacteria↗

PubMed2003

Formocresol mutagenicity following primary tooth pulp therapy: an in vivo study.

OBJECTIVES: To investigate whether formocresol, in Buckley's original formulation, is mutagenic in vivo to lymphocyte cultures obtained from the peripheral blood of children aged from 5 to 10 years old. These children were recruited from those attending the dental clinics of Recife City Council and the University of Pernambuco School of Dentistry, Brazil. METHODS: The sample comprised 20 children who had primary teeth with cariously exposed vital pulps. Two venous blood samples were collected (6-8 ml) from each child, the first prior to vital pulpotomy (control group) and the second 24 h after pulpotomy (treated group). This research is a case-control study. The peripheral lymphocytes were grown in a complete culture medium consisting of 78% RPMI 1640 medium (a), supplemented with streptomycin (0.01 mg/ml), penicillin (0.005 ml(-1)), 20% fetal bovine serum (b) and 2% phytohemagglutinin (c). The lymphocytes were assessed for chromosomal aberrations via a previously published method which was modified. The cytogenetic analysis was performed in a blind test, where the slides were codified by an annotator and the scorers did not know which group they were analyzing. For each sample, this envolved the analysis of 200 metaphases. The level of significance adopted in the statistical test was 5.0% (p<0.05). RESULTS: There was no statistically significant difference in clinical doses between the control and treated groups, using Wilcoxon's Signed Ranks test, for the chromosomal aberrations (P=0.251) and for the total chromosomal breaks (P=0.149). Although there were no statistically significant differences between the control and treated groups, Buckley's formocresol was mutagenic for one patient, raising doubt about the desirability of its use for pulpotomies in children. CONCLUSIONS: The results revealed that, from a statistical standpoint, formocresol is not mutagenic. However, further investigations are required, preferably with a larger sample, in patients needing more than one pulpotomy in order to observe whether an increase in the quantity of the drug would increase the quantity of chromosome aberrations and also to verify individual susceptibility to chromosome alterations with the use of formocresol.

Case-Control Studies↗

PubMed2002

Comparison of electrosurgical and formocresol pulpotomy procedures in children.

OBJECTIVES: Although previous studies have examined the electrosurgical pulpotomy technique for primary teeth, no well-controlled, clinical human trials have been published. The purpose of this study was to prospectively compare electrosurgical pulpotomies vs. formocresol pulpotomies in human vital primary molar teeth. DESIGN: Fifty children were randomly divided into two groups, 25 receiving an electrosurgical pulpotomy and 25 receiving a formocresol pulpotomy. RESULTS: After at least 5 months postoperative observation time, the clinical and radiographic success rates for the electrosurgical groups were 96 and 84%, respectively; and for the formocresol group, 100 and 92%, respectively. CONCLUSION: There were no statistically significant differences between the success rates for the two groups at the P < 0.05 level as tested by Fisher's exact test. This study failed to demonstrate a difference in the success rate between the electrosurgical and formocresol pulpotomy techniques.

Child↗

PubMed2006

Is there life after Buckley's Formocresol? Part I -- a narrative review of alternative interventions and materials.

OBJECTIVES: (1) To present a narrative review of the currently available alternative interventions and materials to formocresol pulpotomy for the management of extensive caries in the primary molar, and (2) to produce a clinical protocol for pulp therapy techniques in the extensively carious primary molar. INTRODUCTION: The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. Since Buckley's Formocresol contains 19% formaldehyde in its full strength and, therefore, 1% in a 20% dilution, a safer alternative should be identified. METHODS: A narrative review of the published literature for primary molar pulp therapy techniques was undertaken following an extensive and appropriate literature search. A specialist group of paediatric dentists was formed to arrive at a consensus and establish an evidence-based protocol for the management of extensively carious primary molar teeth. Part I of this paper explores the currently available alternative interventions and materials to formocresol in the form of a narrative review. The second part of the paper will present the formation of a specialist group to arrive at a consensus and establish an evidence-based protocol for the management of the extensively carious primary molar. CONCLUSIONS: After consideration of a review of extensively searched literature, a protocol and key points document have been developed to assist clinicians in their treatment planning. Further long-term studies with the highest level of evidence (i.e. randomized controlled trials) are required to enable us to identify acceptable alternatives which can replace formocresol.

Aluminum Compounds↗

PubMed2003

Ferric sulphate and formocresol in pulpotomy of primary molars: long term follow-up study.

AIM: The objective of this study was to compare the effects of ferric sulphate (FS) to that of the full strength of formocresol (Buckley's formula) (FC) as pulpotomy agents in primary human molar teeth 42-48 months after treatment. This was to assess the succeeding premolar teeth for decalcification, abnormal morphology or any other defect. METHODS: Seventy children, ranging in age from 3 to 6 years, mean 4.3 years, were treated for pulpotomy of primary molars. Ferric sulphate 15.5% solution (applied for 15 seconds for 84 teeth) and formocresol solution (5 minutes procedure for next the 80 teeth) were used as pulpotomy agents. In both groups, pulp stumps were covered with zinc oxide eugenol paste. Permanent restorations were, in most cases, stainless steel crowns and in some of them amalgams. Follow-up clinical assessments were every 3 months and the radiographic follow-up time was 6, 20 and 42-48 months after treatment. STATISTICS: The differences were statistically analyzed using the Chi square test. RESULTS: These revealed 96.4% clinical success rate in the FS and 97.5% in the FC groups. Radiographic success rate in the FS group was 92.0%, while 94.6% in the FC group. No statistical significant differences were found between the radiographic assessment of the two pulpotomy agents. CONCLUSION: Ferric sulphate showed similar clinical and radiographic success rate as a pulpotomy agent for primary molar teeth after long term evaluation period, compared with formocresol. Ferric sulphate, because of its lower toxicity, may become a replacement for formocresol in primary molar teeth.

Child↗

PubMed1991

Formocresol toxicity: is there a suitable alternative for pulpotomy of primary molars?

Some concern has been expressed in recent years about the use of formocresol for vital pulpotomy treatment of primary molars. This paper reviews the literature concerning the toxicity of formocresol and considers the evidence for the use of calcium hydroxide and glutaraldehyde. It is concluded that more work is required in this field before an alternative to formocresol can be recommended and that, in the meantime, a 1:5 dilution of the standard formocresol solution should be used but not included in the zinc oxide-eugenol sublining.

Animals↗

PubMedDate not supplied

[Clinical and radiographic evaluation of deciduous molars with necrotic pulp treated with two concentrations of formocresol].

The purpose of this investigation was to evaluate clinically and radiographically primary molars with necrotic pulps treated with two different formocresol concentrations (full-strength formocresol and 20% dilution of formocresol). A total of 50 cases were evaluated at 3, 6 and 12 months after the treatment. There were not significant statistical differences in the results obtained between both concentrations; therefore it can be conclude that the 20% dilution of formocresol represent a satisfactory treatment for primary molars with necrotic pulps. Due to this findings is possible to assure that this procedure in easy, reliable and cheap; and also is possible to apply to all ages and socioeconomic label.

Child↗

PubMedDate not supplied

Glutaraldehyde: an alternative to formocresol for vital pulp therapy.

Based on the limited results of this eight-week comparison of formocresol and glutaraldehyde, it would appear that glutaraldehyde may offer distinct advantages over formocresol, in the treatment of cariously exposed primary and young permanent teeth. In particular, due to its chemical structure, it is more active in fixing the surface tissues and is more rapidly limited in its depth of penetration through these tissues. Glutaraldehyde does not exhibit as significant an ability to induce the total loss of vitality, in the radicular pulp tissues. The progression of formocresol treated pulps to apparent fibrotic replacement via granulation-tissue ingrowth, through the apex, does not occur with the glutaraldehyde-treated pulp tissues. There may, however, be a slow progression of fibrotic replacement of the glutaraldehyde fixed tissue, in the coronal portion of the radicular pulp. Perhaps most importantly it would seem that since the glutaraldehyde does not perfuse the tissues to the apex, it will not demonstrate systemic distribution and other extradental phenomena, as have been identified with the use of formocresol

Aldehydes↗

PubMed1976

Morphologic and enzyme histochemical observations on the pulp of human primary molars 3 to 5 years after formocresol treatment.

The state of the pulp of twenty-seven primary teeth treated by formocresol pulpotomy (clinically and radiographically successful) was assessed 3 to 5 years after treatment. A wide variation was found in the pulpal condition, from normal pulp tissue to total necrosis. Resorption and apposition of hard tissue were common findings. Five teeth were freeze-sectioned and incubated for histochemical demonstration of oxidative enzymes. The pulps of two teeth were vital; two teeth had necrotic areas subjacent to the amputation paste; and one pulp was totally necrotic. Six teeth were extracted 5 minutes after formocresol pulpotomy and incubated for demonstration of oxidative enzymes. An unstained zone, 1 to 2 mm. deep, was seen in all incubated sections. In conclusion, it seems that the formocresol method should be regarded only as a means to keep primary teeth with pulp exposures functioning for a relativley short period of time.

Dental Pulp↗

PubMed1979

Comparison of Dycal and formocresol pulpotomies in young permanent teeth in monkeys.

This study compared Dycal and formocresol pulpotomies on young healthy permanent teeth with respect to continued dentinogenesis and root end development. Pulpotomy was performed on a total of forty permanent teeth with incompletely developed roots in three young stump-tailed monkeys (Macaca speciosa). Twenty teeth were treated with Dycal and twenty with formocresol. At the end of the experimental periods the animals were killed and the specimens were prepared and sectioned en bloc for histologic examination. The interval between treatment and death ranged between 7 and 797 days. Before each experimental procedure a Procion vital dye was administered as a marking agent for continued root development. Twelve of twenty teeth treated with Dycal and seventeen of twenty teeth treated with formocresol were judged to be successful as evidenced by continued root development, absence of periapical pathoses, and the presence of noninflamed or only mildly inflamed pulps. Brown and Brenn staining showed bacteria within the pulps of the teeth that failed. All but one of the teeth in this study showed evidence of continued root development as confirmed by Procion labeling.

Animals↗

PubMed1980

Antibacterial properties of dilute formocresol and eugenol and propylene glycol.

Formocresol and eugenol are the two nonspecific intracanal medicaments commonly used in endodontic practice. Both have high tissue irritation potential when used in conventional strength. Propylene glycol is an alcohol that is injectable and itself possesses significant antibacterial action. It is a popular vehicle and hence was used to modify the two drugs. Standard bacteriologic methods were employed to test the antibacterial action of these lower concentrations of the two drugs against four test organisms. The investigations indicate that formocresol at as low as 10 to 20% and eugenol at 75% are bactericidal in action and hence may be useful at these concentrations for clinical use. Evaluation of these lower concentrations is warranted for possible clinical use. Propylene glycol, which possesses antibacterial action and is remarkably innocuous to tissues, appears to be a suitable vehicle for dilution of formocresol and eugenol.

Anti-Infective Agents, Local↗

PubMed1982

Histologic evaluation of the effect of formocresol and glutaraldehyde on the periapical tissues after endodontic treatment.

The root canals of twelve pairs of human incisors without hard tissue or periodontal disease were treated with either formocresol or glutaraldehyde. The periapical reactions were compared histologically after periods varying between 6 and 8 weeks. A formocresol dressing always resulted in irritation of the periapical tissues, whereas little or no irritation was found after treatment with glutaraldehyde. It can be concluded that, after a vital pulpectomy, treatment of root canals with glutaraldehyde is faster than, as efficient as, and less irritating than treatment with formocresol.

Adult↗

PubMed1984

In vivo fixative effect of formocresol on pulpotomized deciduous teeth of dogs.

Formocresol was checked with respect to its in vivo fixative effect after pulpotomy, through observation of tissue resistance to necrosis. The root pulps were freed from their hard-tissue wrapping and processed for 48 hours, followed or not by capping (15 days) with zinc oxide-eugenol or with zinc oxide-eugenol-formocresol. The effect of only capping with zinc oxide-eugenol, with or without formocresol, was also recorded.

Animals↗

PubMed1990

Embryotoxicity and teratogenicity of formocresol on developing chick embryos.

White Leghorn chick embryos were used to investigate the embryotoxicity and teratogenicity of 25 and 50% Buckley's formocresol. Embryos were injected at 48 h and sacrificed on the ninth day of incubation. The percentage of mortality of sham and vehicle controls was 4.8 and 17.7%, respectively, whereas eggs injected with 25 and 50% formocresol displayed a 40 and 100% mortality rate. Gross morphological abnormalities, weights, and crown-rump lengths were determined, demonstrating that Buckley's formocresol is embryotoxic and teratogenic in chick embryos. Gross morphological changes were noted to include cranial hematomas, facial abnormalities, eye and beak deformities as well as alterations in feather germ appearance. Histological changes included alterations in the organization of the eyes, and formation of the beak, palate, vasculature, musculature, cartilage, and bone. Moreover, experimental embryos displayed a retardation of development in that they lagged behind their controls by approximately 24 to 36 h.

Abnormalities, Drug-Induced↗

PubMed2000

An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy.

OBJECTIVE: To compare the clinical and radiological outcomes following two different, single visit vital pulp therapy techniques, in cariously exposed primary molar teeth. SETTING: A paediatric dental clinic within the Dental Hospital, Newcastle upon Tyne, UK. SUBJECTS: Fifty two child patients were sequentially enrolled in the clinical investigation, 26 males and 26 females with an age range of 3.3-12.5 years. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). The total number of teeth treated was 84. DESIGN: Recruitment was on the basis of strict inclusion criteria. Coronal pulp amputation was prescribed only in teeth with vital, cariously exposed pulp tissue. Treatment was undertaken between October 1994 and December 1996. All cases were reviewed using predefined clinical and radiological criteria. The statistical tests used were logistic regression of a triple nested data structure, chi-squared analysis of equality of treatment and probability of success with relation to subject age. RESULTS: Eighty-four cariously exposed primary molars required vital pulp therapy. Forty six (55%) teeth were included in the F group and 38 (45%) allocated to the C group. Five teeth were lost to follow-up, leaving 79 teeth: forty four (56%) in group F and 35 (44%) in group C. Eighty four percent (37/44) of teeth treated with formocresol and 77 percent (27/35) treated with calcium hydroxide were classed as clinically and radiographically successful at the cut-off date, December 1997, after a mean clinical review of 22.5 months (range 6.1-38.5 months) and a mean radiographic review of 18.9 months (range 1.3-36.9 months). CONCLUSION: This investigation confirms the clinical efficacy of a one-fifth dilution of Buckley's Formocresol as an agent in pulp treatment of cariously exposed, vital primary molar teeth. However, calcium hydroxide in its pure, powder form is a clinically acceptable alternative when combined with strict selection criteria for this method of restorative care. There was a statistically insignificant difference in successful clinical and radiological outcome between the two treatment groups. Success was unrelated to the duration of time taken to achieve haemostasis and the presence or absence of bleeding after placement of the medicament.

Calcium Hydroxide↗

PubMed2004

Lack of genotoxicity of formocresol, paramonochlorophenol, and calcium hydroxide on mammalian cells by comet assay.

Formocresol, paramonochlorophenol, and calcium hydroxide are widely used in dentistry because of their antibacterial activities in root canal disinfection. However, the results of genotoxicity studies using these materials are inconsistent in literature. The goal of this study was to examine the genotoxic potential of formocresol, paramonochlorophenol, and calcium hydroxide using mouse lymphoma cells and human fibroblasts cells in vitro by the comet assay. Data were assessed by Kruskal-Wallis nonparametric test. The results showed that all compounds tested did not cause DNA damage for the tail moment or tail intensity parameters. These findings suggest that formocresol, paramonochlorophenol, and calcium hydroxide do not promote DNA damage in mammalian cells and that the comet assay is a suitable tool to investigate genotoxicity.

Analysis of Variance↗