Abstract
Aim The aim of this retrospective study was to evaluate the clinical and radiographic success of pulpotomy on primary molars performed by dental students compared to that performed by an expert operator. Methods The study was conducted on 142 second primary molars in 102 children. The patients were randomly selected from the available records. The test group (treated by dental students) included 51 subjects (28 males and 23 females, mean age: 7.2 ± 1) and the control group included 51 children (29 males and 22 females, mean age: 7.4 ± 1.2 years). After pulpotomy, a clinical and radiographic evaluation after 12 months was performed. Chi-square test and odds ratio were calculated and significance level was set at p < 0.05. Results The success rate was significantly lower, 81.6% (p < 0.05), in the test group than in the control group (93%). The test group showed less clinical and radiographic success (86% and 80%, resp.) compared to the control group (97.2% for clinical success and 93% for radiographic success). Conclusions Pulpotomy with MTA is an effective method that ensures a good percentage of success. The clinical experience of the operator is a contributing factor.
Highlights
Patients in the test group showed a total percentage of therapeutic successes after pulpotomy statistically lower than the control group (p < 0.05)
As far as clinical success is concerned, the group of patients treated by an expert operator has achieved almost a 100% success, while in the group of children treated by a less expert operator, a good clinical but statistically inferior success was achieved (p < 0.05)
The results of the present study showed that pulpotomy is an effective therapeutic method that can be performed on primary molars, in order to ensure good long-term success
Summary
Pulpotomy is a therapeutic procedure, frequently used in paediatric dentistry, which aims at eliminating the pulp from the pulp chamber while maintaining the vitality of the root pulp [1].Before performing it, patient history is necessary in order to exclude the presence of spontaneous pain; in addition, sensitivity to percussion or to palpation should be absent, with positive response to vitality tests.Pulpotomy is contraindicated in the presence of swelling, fistula, pathological mobilization, internal root resorption, pulp calcifications, or excessive bruising of the root pulp [2].It can be performed in case of exposure of the vital pulp in presence of a sufficient rooting structure and in absence of periradicular pathologies that may affect the permanent teeth still to be erupted.It can be performed on permanent teeth but only as emergency intervention until complete endodontic therapy can be performed or as a temporary intervention on permanent teeth with immature root formation to allow it to be developed [3].The partial removal of carious dentin is the currently indicated technique in extensive caries lesions. Pulpotomy is contraindicated in the presence of swelling, fistula, pathological mobilization, internal root resorption, pulp calcifications, or excessive bruising of the root pulp [2]. It can be performed in case of exposure of the vital pulp in presence of a sufficient rooting structure and in absence of periradicular pathologies that may affect the permanent teeth still to be erupted. It can be performed on permanent teeth but only as emergency intervention until complete endodontic therapy can be performed or as a temporary intervention on permanent teeth with immature root formation to allow it to be developed [3]. In dentinal cavitated caries lesions that radiographically appear to extend less than 75 percent into the dentin, this technique is often used without the risk of exposing the pulp [4]
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