Survival analysis of pulpotomy versus pulpectomy in primary molars with carious pulp exposure: a retrospective cohort study.

INTRODUCTION

Both pulpotomy and pulpectomy are indicated in deciduous teeth with carious pulp exposure. Pulpotomy is recommended for treating carious pulp exposure in primary molars with the development of dental biomaterials. However, it is difficult to determine the severity of pulpitis as children frequently have difficulty communicating their clinical symptoms and there is no objective diagnostic method to assess pulpal status. Thus, therapeutic interventions for deciduous teeth with carious pulp involvement are controversial in clinical applications. This study compared the clinical and radiographic survival time of iRoot BP Plus pulpotomy and Vitapex pulpectomy in treating extremely deep caries with carious pulp exposure in deciduous molars under general anaesthesia.

METHODS

The 876 deciduous teeth in patients aged 3 to 6 years diagnosed with extremely deep caries were categorised into Group A (iRoot BP Plus pulpotomy) and Group B (Vitapex pulpectomy) based on treatment methods in this retrospective cohort study. The Kaplan-Meier survival curves were used to compare the survival rates and time between the groups. The Cox proportional hazards model was used to evaluate the factors associated with success.

RESULTS

876 primary molars were collected, including Group A (504) and Group B (372). The clinical and radiographic survival time in Group A (54.394 ± 1.388(months) and 48.978 ± 1.413(months)) were significantly higher than that in Group B (47.867 ± 0.956 (months) and 38.834 ± 0.981 (months)) (P < 0.05). The clinical and radiographic survival rates of Group A at 48 months were 77.0% and 69.5%, respectively. Group B's clinical and radiographic survival rates at 48 months were 53.1% and 29.1%. Younger age and treatment with iRoot BP Plus pulpotomy might predict higher success rates (P < 0.05).

CONCLUSIONS

The long-term prognosis of iRoot BP Plus pulpotomy for treating extremely deep caries with carious pulp exposure in primary molars under general anesthesia was better than Vitapex pulpectomy.