Pulpotomy in Primary Dentition: Current Practice and Knowledge of Emerging Materials among Nigerian Paediatric Dentists

Abstract

Objective: To assess the current pulpotomy practices and knowledge of emerging pulpotomy materials among Nigerian paediatric dentists

Methods: This study was a cross-sectional survey using a self-administered questionnaire via google form. A structured online questionnaire via google form was sent via WhatsApp monthly from July 2024 till October 2024 in which participants were asked to fill the google form after giving an online informed consent. The questionnaire used was a modification of that used in a similar study.  It included questions on use of the vital pulpotomy technique for primary molars; use of preoperative and follow-up assessment radiographs; use of local anaesthesia; choice of pulpotomy agent; choice of restorative material for definitive restoration of molars treated by vital pulpotomy; and management of failures. Other questions were on concerns about preferred pulpotomy agents, willingness to use safer agents and knowledge of natural pulpotomy medicaments.

Results: Forty-nine paediatric dentists participated in the study, consisting of 13 males (26.5%) and 36 females (73.5%). The population was made up of specialists (40.8%), senior registrars (26.5%) and registrars (32.7%). 98% of participants practice vital pulpotomy in primary dentition.  The most favoured pulpotomy medicament was formocresol, used by thirty-five (71.4%) respondents. Seventeen (34.7%) participants used glass ionomer cement and stainless-steel crowns as final restorative material following pulpotomy. A pulpectomy procedure was preferred by thirty-five (71.4%) respondents in cases of failure of pulpotomy treatment. More than half of the participants 33 (67.3%) expressed concerns about the use of their preferred pulpotomy medicament, with 22(62.9%) respondents who use formocresol expressing concerns on safety and toxicity. Majority (77.6%) of study participants expressed willingness to use a safer pulpotomy agent if available.  Twenty-nine (59.1%) respondents were unaware of natural pulpotomy medicaments as newer agents for pulpotomy. Among the participants who demonstrated awareness of natural agents, aloe vera was the most common agent mentioned by 18(45%) respondents. Thirty-four (67.3%) of participants expressed willingness to use a natural pulpotomy medicament if available.

Conclusion: This study highlights that pulpotomy remains a widely practiced and essential procedure in management of primary molars among Nigerian Paediatric Dentists, with varying practices and knowledge of emerging materials. Standardization of pulpotomy protocols and continuing education on newer materials are essential to optimize treatment outcomes.