A Survival Analysis of Different Pulp Therapies in Decayed Primary Teeth

Authors

  • Aluhê Lopes-Fatturi
  • Juliana Feltrin de Souza
  • José Vitor Nogara Borges Menezes
  • Fabian Calixto Fraiz
  • Luciana Reichert da Silva Assunção

Keywords:

Root Canal Therapy, Tooth, Primary, Survival Analysis

Abstract

Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 records of children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation. Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively). Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.

References

Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 2017; 96(4):380-7. https://doi.org/10.1177/0022034517693566

Piva F, Pereira JT, Luz PB, Hugo FN, de Araujo FB. Caries progression as a risk factor for increase in the negative impact on OHRQOL - a longitudinal study. Clin Oral Investig 2018; 22(2):819-28. https://doi.org/10.1007/s00784-017-2157-4

Godhi B, Tyagi R. Success rate of MTA pulpotomy on vital pulp of primary molars: a 3-year observational study. Int J Clin Pediatr Dent 2016; 9(3):222-7. https://doi.org/10.5005/jp-journals-10005-1368

Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA, Moffat MA, British Society of Paediatric Dentistry. Pulp therapy for primary molars. Int J Paediatr Dent 2006; 16(Suppl 1):15-23. https://doi.org/10.1111/j.1365-263X.2006.00774.x

de Assuncao IV, da Costa Gde F, Borges BC. Systematic review of noninvasive treatments to arrest dentin non- cavitated caries lesions. World J Clin Cases 2014; 2(5):137-41. https://doi.org/10.12998/wjcc.v2.i5.137

Schwendicke F, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res 2016; 28(2):58-67. https://doi.org/10.1177/0022034516639271

Mathur VP, Dhillon JK, Logani A, Kalra G. Evaluation of indirect pulp capping using three different materials: a randomized control trial using cone-beam computed tomography. Indian J Dent Res 2016; 27(6):623-9. https://doi.org/10.4103/0970-9290.199588

Gupta S, Das G. Clinical and radiographic evaluation of zinc oxide eugenol and metapex in root canal treatment of primary teeth. J Indian Soc Pedod Prev Dent 2011; 29(3):222-8. https://doi.org/10.4103/0970-4388.85829

Brustolin JP, Mariath AA, Ardenghi TM, Casagrande L. Survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. Braz Dent J 2017; 28(1):121-8. https://doi.org/10.1590/0103-6440201601009

Wunsch PB, Kuhnen MM, Best AM, Brickhouse TH. Retrospective study of the survival rates of indirect pulp therapy versus different pulpotomy medicaments. Pediatr Dent 2016; 38(5):406-11.

Melgar XC, Opdam NJM, Britto Correa M, Franzon R, Demarco FF, Araujo FB, et al. Survival and associated risk factors of selective caries removal treatments in primary teeth: a retrospective study in a high caries risk population. Caries Res 2017; 51(5):466-74. https://doi.org/10.1159/000478535

American Academy of Pediatric Dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Available from: https://www.aapd.org/media/Policies_Guidelines/BP_PulpTherapy.pdf. [Accessed on Dec 10, 2018].

Holan G, Fuks AB. A comparison of pulpectomies using ZOE and KRI paste in primary molars: a retrospective study. Pediatr Dent 1993; 15(6):403-7.

Moura-Netto C, Palo RM, Pinto LF, Mello-Moura ACV, DaltoÉ G, Wilhelmsen NSW. CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas. Braz Oral Res 2014; 29(1):1-6. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0006

Navit S, Jaiswal N, Khan SA, Malhotra S, Sharma A, Mukesh, et al. Antimicrobial efficacy of contemporary obturating materials used in primary teeth - an in-vitro study. J Clin Diagn Res 2016; 10(9):ZC09-ZC12. https://doi.org/10.7860/JCDR/2016/21883.8426

Coll JA, Seale NS, Vargas K, Marghalani AA, Al Shamali S, Graham L. Primary tooth vital pulp therapy: a systematic review and meta-analysis. Pediatr Dent 2017; 39(1):16-123.

Rocha MJ, Cardoso M. Survival analysis of endodontically treated traumatized primary teeth. Dent Traumatol 2007; 23(6):340-7. https://doi.org/10.1111/j.1600-9657.2006.00470.x

Mendoza AM, Reina JE, Garcia-Godoy F. Evolution and prognosis of necrotic primary teeth after pulpectomy. Am J Dent 2010; 23(5):265-8.

Moskovitz M, Sammara E, Holan G. Success rate of root canal treatment in primary molars. J Dent 2005; 33(1):41-7. https://doi.org/10.1016/j.jdent.2004.07.009

Pinky C, Shashibhushan KK, Subbareddy VV. Endodontic treatment of necrosed primary teeth using two different combinations of antibacterial drugs: an in vivo study. J Indian Soc Pedod Prev Dent 2011; 29(2):121-7. https://doi.org/10.4103/0970-4388.84684

Thomas AM, Chandra S, Chandra S, Pandey RK. Elimination of infection in pulpectomized deciduous teeth: a short- term study using iodoform paste. J Endod 1994; 20(5):233-5.

Jha D, Guerrero A, Ngo T, Helfer A, Hasselgren G. Inability of laser and rotary instrumentation to eliminate root canal infection. J Am Dent Assoc 2006; 137(1):67-70. https://doi.org/10.14219/jada.archive.2006.0023

Portella PD, Menoncin BLV, de Souza JF, de Menezes J, Fraiz FC, Assuncao L. Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: a hierarchical approach. Int J Paediatr Dent 2019; 29(4):496-506. https://doi.org/10.1111/ipd.12482

Holan G, Needleman HL. Premature loss of primary anterior teeth due to trauma - potential short- and long-term sequelae. Dent Traumatol 2014; 30(2):100-6. https://doi.org/10.1111/edt.12081

Downloads

Published

2022-03-18

How to Cite

Lopes-Fatturi, A. ., de Souza, J. F. ., Menezes, J. V. N. B. ., Fraiz, F. C. ., & Assunção, L. R. da S. . (2022). A Survival Analysis of Different Pulp Therapies in Decayed Primary Teeth. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 20, e4822. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1088

Issue

Section

Original Articles