Survival and Factors Associated with Failure of Pulpectomies Performed in Primary Teeth by Dental Students.

Juliane Priscila Brustolin,Luciano Casagrande,Adriela Azevedo Souza Mariath,Thiago Machado Ardenghi

doi:10.1590/0103-6440201601009

Juliane Priscila Brustolin, Luciano Casagrande + Show 2 more

Open Access

https://doi.org/10.1590/0103-6440201601009

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Abstract

Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.

Highlights

The preservation of primary teeth in the arch closer to their physiological exfoliation is fundamental for space maintenance and eruption of the permanent successors [1]
Most randomized clinical trials (RCT) report a satisfactory success rate for primary tooth pulpectomies [4], it might have resulted in selection bias with regard to patient enrolment and adherence when patients are motivated towards regular attendance and oral hygiene aspects [5]
There were no significant differences in the failure rates according to the other individual and clinical parameters (Table 2). This prospective university-based study involved the clinical and radiographic evaluation of endodontic treatment performed in primary teeth by dental students and the factors associated with the treatment failures

Summary

Introduction

The preservation of primary teeth in the arch closer to their physiological exfoliation is fundamental for space maintenance and eruption of the permanent successors [1]. Most randomized clinical trials (RCT) report a satisfactory success rate for primary tooth pulpectomies [4], it might have resulted in selection bias with regard to patient enrolment and adherence when patients are motivated towards regular attendance and oral hygiene aspects [5]. These studies are generally conducted in specific clinical situations by highly skilled professionals, and do not consider other factors that may play a role in the treatment outcome. Risk factors for failure were identified in multi-surface fillings and in glass ionomer cement restorations [7]

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