Influence of treatment setting on success of pulpectomy in primary molars: a retrospective analysis up to 4 years.

OBJECTIVES: The objective of this study was to analyze the success of primary molar pulpectomy with a minimum of 1 year and up to 4 years follow-up with focus on the treatment setting (general anesthesia, sedation, local anesthesia alone). METHOD AND MATERIALS: Data were retrieved from 92 patients' records between 2012 and 2020. The pulpectomy treatment using calcium-hydroxide/iodoform paste was performed under general anesthesia (n = 45), nitrous oxide sedation (n = 21), or local anesthesia alone (n = 39). Bivariate and multivariate analyses were performed. RESULTS: The overall success of pulpectomy was 59.5% 4 years post-treatment. The 4-years clinical success rate was clinically relevantly higher under general anesthesia (78.6% vs 57.1% under nitrous oxide sedation, 43.8% with local anesthesia only) and in the mandibular arch (70.8% vs 38.5% in the maxillary arch). This could be related to the strict case selection under sedation and especially general anesthesia. Despite statistically significant differences in the bivariate analysis for most outcomes and follow-up periods, this was not the case in multivariate regression. CONCLUSION: Pulpectomy performed in primary molars offers a successful long-term treatment option especially with a strict case selection as under general anesthesia.

One year clinical success of pulpectomy in primary molars with iodoform-calcium hydroxide paste.

OBJECTIVES: In order to retain primary molars, eg with irreversible pulpitis or pulp necrosis, pulpectomy can be an alternative to extraction. However, reports on the success of pulpectomies in primary teeth vary widely in the literature. Thus, the objective of this study was not only to analyze the success rate of primary tooth pulpectomy 12 months posttreatment in the setting of a specialized clinic, but also to identify and analyze various factors that modify the outcome. METHOD AND MATERIALS: Between 2012 and 2018, a total of 76 dental records of the Department of Preventive and Pediatric Dentistry at the University of Greifswald fulfilled the inclusion criteria, resulting in a 1-year analysis of 62 primary molars with an idoform-calcium hydroxide paste as root canal filling material almost exclusively covered by a stainless steel crown as restoration. RESULTS: The pulpectomy treatment was successful after 1 year in 93.5%, with a significantly higher survival for mandibular primary molars (100.0% vs 83.3%; chi-square test P = .01). Apart from the very few cases in the mixed dentition, no other factors related to the patient (sex, caries level, general health conditions, distance to clinic), tooth (first or second primary molar, pulpal and periapical condition before treatment), or treatment (indication, academic qualification of the operator, number of visits) proved to be of significance for the treatment outcome due to the overall high success rate. CONCLUSION: Pulpectomies for pulpally involved or even necrotic primary molars followed by stainless steel crowns as restoration should be considered as a treatment option, especially in the mandible. (Quintessence Int 2021;52:528-537; doi: 10.3290/j.qi.b1244443).