Factors associated with survival of primary teeth pulpotomies: a practice-based study

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ABSTRACT

Aim

To investigate factors associated with survival of pulpotomies on primary molars in a primary healthcare setting.

Methods

The data were collected from an electronic patient record system. Dental files of patients who received a pulpotomy procedure on a primary molar between Jan 2015 and Dec 2017 at the primary health care clinics in the City of Oulu, Finland, were included. The follow-up period lasted until May 28th, 2020. For the analysis, the study population was grouped into three different age groups: younger than 6 years of age, 6-9 years of age and older than 9 years of age.

Results

Altogether 411 primary molars in 362 patients were treated with pulpotomy. The mean age of the participants was 7.68 years (SD 3.01). Less than two-thirds (58.2%) of the primary molars treated with pulpotomy survived throughout the follow-up period, and more than 40% of the teeth ended up being extracted due to infection (n=172, estimated survival time: HR 4.028; 95% CI 3.8-4.3). The most common ICD-10 diagnosis code leading to pulpotomy was pulpitis (36.7%, n=151) and the second most common was dental caries (32.6%, n=134). Pulp necrosis or periodontal periodontitis were registered as a diagnosis code in thirteen cases (3.2%). In more than 25% of cases, a diagnosis code was not recorded in the patient files at all (n=108).

Conclusion

It seems that pulpotomies are often performed at primary health care clinics without adequate initial diagnosis or it is made to teeth tested non-vital, teeth with severe pain and even to necrotic teeth. These results suggest that more education about this manner is needed for dentists who work with child patients.

Study Design

Retrospective register-based study.

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