Abstract

Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.

Highlights

  • IntroductionThe early loss of primary teeth due to caries or trauma leads to functional, aesthetic and psychological sequelae in the pediatric patient and, the maintenance of these teeth in the oral cavity until the period of physiological exfoliation is among the main objectives of Pediatric Dentistry [1,2]

  • The early loss of primary teeth due to caries or trauma leads to functional, aesthetic and psychological sequelae in the pediatric patient and, the maintenance of these teeth in the oral cavity until the period of physiological exfoliation is among the main objectives of Pediatric Dentistry [1,2]. the worldwide population experienced an overall reduction of caries prevalence, its occurrence in the primary dentition is still high

  • There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p

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Summary

Introduction

The early loss of primary teeth due to caries or trauma leads to functional, aesthetic and psychological sequelae in the pediatric patient and, the maintenance of these teeth in the oral cavity until the period of physiological exfoliation is among the main objectives of Pediatric Dentistry [1,2]. The worldwide population experienced an overall reduction of caries prevalence, its occurrence in the primary dentition is still high. Lesion progression may lead to irreversible pulp inflammation or necrosis and, the necessity to perform endodontic treatment. The occurrence of dento-alveolar traumatisms at preschool age is of high prevalence, which may compromise pulp vitality and requires endodontic treatment [1,3]. Endodontic treatment in primary teeth is indicated when there is irreversible pulpal inflammation or pulpal necrosis, and is considered a more conservative alternative in comparison with tooth extraction. The clinical diagnosis of these conditions comprises the presence of signs and symptoms such as spontaneous tooth pain, gingival edema (not resulting from gingivitis or periodontitis), fistula, dental mobility not associated with trauma or exfoliation, presence of apical / furcation bone radiolucency or radiographic evidence of internal or external inflammatory resorption [4]

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