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

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.

Analysis of survival and factors associated with failure of primary tooth pulpectomies performed under general anaesthesia in children from South China

“…Several studies show that most of the failures occur in the first 3 months following pulpectomy . In our study, the recovery rate at 3 months follow‐up is quite high.…”

“…Several studies show that most of the failures occur in the first 3 months following pulpectomy. 18 In our study, the recovery rate at 3 months follow-up is quite high. The survival curve turned steeper abruptly from the third year of followup.…”

Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12‐month short‐term evaluation

“…Deciduous tooth preservation near to their shedding time is a vital issue from several aspects such as the child's growth and development, esthetic, functional, psychological, and dental arch integrity aspects (Barberia, Lucavechi, Cardenas, & Maroto, 2006;Setia, Pandit, Srivastava, Gugnani, & Sekhon, 2013;Tunison, Flores-Mir, ElBadrawy, Nassar, & El-Bialy, 2008). Pulpectomy is one of treatment choices to achieve this goal and it is suitable for treatment of primary teeth with irreversible pulpitis, necrosis, or periodontitis due to caries or trauma (Barcelos, Tannure, Gleiser, Luiz, & Primo, 2012;Brustolin, Mariath, Ardenghi, & Casagrande, 2017). The complex nature of the deciduous root canal system facilitates the spread of pathogenic microbes through lateral and accessory canals, dentinal tubules, apical ramifications, and the possibility of harming the tooth germ of permanent successor, and subsequently, these barriers make total removal of necrotic tissue by instrumentation alone impossible (Camp, 2008;Pazelli et al, 2003;Pozos-Guillen, Garcia-Flores, Esparza-Villalpando, & Garrocho-Rangel, 2016;Vianna et al, 2004).…”

Desempenho de dois materiais obturadores iodoformados para pulpectomia de dentes decíduos: um ensaio clínico randomizado com dois anos de acompanhamento

“…Os dois materiais testados em nosso estudo apresentaram taxas de sucesso dentro do esperado pelos pesquisadores, sem apresentar diferença estatística, apesar da pasta Guedes mostrar um menor número de falhas após os dois anos de acompanhamento. (Mortazavi;Mesbahi, 2004;Barja-Fidalgo et al, 2011;Barcelos et al, 2011;Brustolin et al, 2017 (Guedes Pinto et al, 1981;Ahmed, 2013). Nosso trabalho incluiu dentes anteriores e posteriores que necessitassem de tratamento.…”

“…A literatura aponta algumas características iniciais como fatores predisponentes ao fracasso dos tratamentos, como: grau de rizólise maior que 1 mm, presença de fístula, abcesso, alteração de contorno gengival, tipo de restauração, entre outros Garcia-Godoy, 1991;Ng et al, 2007;Barcelos et al, 2012;Funks;Guelmann, 2013;Chen et al, 2015;Brustolin et al, 2017). Nosso trabalho analisou estas características e nenhuma delas aumentou a chance dos dentes apresentarem insucesso.…”