Abstract
BACKGROUND: Pulpotomy is a vital pulp therapy performed following the removal of infected or affected coronal pulp. However, there is no consensus on the most effective pulpotomy agent. This study aimed to evaluate and compare the effectiveness of formocresol, ferric sulfate, Ankaferd Blood Stopper (ABS), and chitosan in pulpotomy treatment. Previous studies have suggested that chitosan is a promising pulpotomy agent. Our findings align with these results, yet further research is needed. We hope that this study will provide valuable data for future research and support the potential of chitosan in pulpotomy treatment. METHODS: Twenty female Wistar rats (8 weeks old) were used, with a total of 80 teeth treated. The animals were randomly divided into four groups, and pulpotomy was performed using the designated agents. Histological evaluations were conducted at 2nd and 4th weeks posttreatment to assess calcified tissue formation, odontoblast layer thickness, and inflammatory cell density. RESULTS: Odontoblast layer formation was observed in all groups from the 2nd week. At the 4th week, the odontoblast layers in the former group were significantly thinner than those in the other groups. Intragroup comparisons revealed a progressive increase in odontoblast thickness, with a significant difference noted only in the chitosan group. At the 2nd week, odontoblast thickness was observed in all groups with no significant differences. By the 4th week, the formocresol group showed significantly lower odontoblast layer thickness compared to the others (p < 0.05). Only the chitosan group demonstrated a significant increase in odontoblast thickness between the 2nd and 4th weeks. Regarding calcified tissue formation, significant increases were found in all groups over time (p < 0.05). At the 2nd week, the chitosan group exhibited significantly lower calcified tissue thickness than the ferric sulfate and formocresol groups. At the 4th week, ferric sulfate showed significantly greater calcified tissue thickness compared to the ABS and chitosan groups (p < 0.05). In terms of inflammation, the chitosan group exhibited mild inflammation within an acceptable range. Comparisons indicated that inflammation levels were lower in the chitosan group than in the other groups. CONCLUSIONS: These findings suggest that chitosan may be a promising alternative pulpotomy agent because of its favorable inflammatory response and odontoblast layer development. However, further studies are needed to confirm its clinical applicability.