Abstract
Background: Early childhood caries is a serious public health problem in both developing and industrialized countries. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. The choice of proper technique is as important as choosing between different pharmacotherapeutic agents used in treatment of primary teeth. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies for pulp treatment of vital primary anterior teeth. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors. Methods: We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and ClinicalTrials.gov for ongoing trials. Randomized controlled trials comparing between pulpotomy and pulpectomy in treatment of vital pulp exposure in primary incisors were included. Primary outcomes were clinical failure and radiological failure. Data synthesis was performed with a pair wise meta-analysis using fixed-effect models. Results: Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical and radiographic failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was 0.74 with 95% CI 0.46 to 1.21 for radiographic failure and RR 2.69, 95% CI 0.76 to 9.58 for clinical failure. The evidence was limited by the small number of trials included in the meta-analysis. Conclusions: Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time.
Highlights
Dental caries is an international public health challenge, especially among young children
Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time
Radiographical failure was in 41% in the pulpotomy group and 18% in pulpectomy group at 2 years follow up trial by Casas et al.[21]
Summary
Dental caries is an international public health challenge, especially among young children. Childhood caries (ECC) is a serious public health problem in both developing and industrialized countries[1]. The choice of technique is as important as the choice between the different pharmacotherapeutic agents which are used in the treatment of primary teeth[7]. Childhood caries is a serious public health problem in both developing and industrialized countries. The choice of proper technique is as important as choosing between different pharmacotherapeutic agents used in treatment of primary teeth. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors. Randomized controlled trials comparing between pulpotomy and pulpectomy in treatment of vital pulp exposure in primary incisors were included. Conclusions: Both pulpotomy and pulpectomy can be used successfully in
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