Attempts to predict prognosis of pulpotomy in primary molars. Bacteriologic and histologic examination.

Abstract

Abstract— In connection with therapeutic pulpotomy in primary mandibular molars, samples for bacteriologic examination were taken from the orifice of the distal root canal immediately before application of calcium hydroxide paste. Of samples from 60 teeth examined, half gave growth in broth media. No correlation was found between the results of bacteriologic examinations and the outcome of treatment as judged on histologic grounds. In a further 40 pulpotomized primary mandibular molars the tissue removed from immediately above the orifice of the distal root canal was studied histologically. Of these biopsy specimens from teeth where the pulp had been exposed during excavation of caries, but which had not produced clinical evidence of pulpitis, only 5 appeared free from inflammation. Biopsy specimens from the successfully treated s cases showed very moderate inflammatory changes but no certain correlation between the condition of the extirpated tissue and the result of treatment could be demonstrated. The investigation shows that bacteriologic contamination of the wound surface during operation cannot be the dominant cause of failure. It is instead more likely that the outcome of the pulpotomy depends on the extent to which microorganisms in superficial parts of the pulp have damaged the pulpal tissue in the root canals.