Pulpectomy versus Extraction for the Treatment of Nonvital Primary Second Molars: A Retrospective Chart Review.

OBJECTIVES

The current investigation evaluated parameters leading to the utilization of pulpectomy versus extraction for treatment of nonvital primary second molars.

STUDY

DESIGN

This retrospective chart review identified patients up to 8-years of age with primary second molars treated by pulpectomy or extraction. Patients in the extraction group were age and gender-matched to the pulpectomy group. Demographic, clinical, radiographic and behavioral data were extracted for comparison. Chi-square, Fisher and T-test were performed for statistical analysis.

RESULTS

There were 23 patients in each group, with a mean age of 5 years (ranging 3-8 years, ±1.5 for pulpectomy and ±1.3 for extraction). Significantly more pulpectomies were performed in the mandible (p=0.002), specifically on the left side (p=0.0035). Internal and external root resorption were significantly higher in the extraction group (p=0.033 and p=0.007 respectively). Restorability was significantly lower in the extraction group (p<0.0001). Pre-procedural pain was reported by 76.5 percent of all patients, but pharmacologically treated in 15.2 percent. Nitrous oxide was administered to 73.9 percent of patients for behavior guidance.

CONCLUSION

Pathologic root resorption and non-restorability were significantly higher in the extraction group. Behavior and pathologic bone resorption did not influence treatment choice. A higher proportion of children reported pre-treatment pain and needed adjunctive behavior guidance than children who did not have pre-treatment pain or did not need adjunctive behavior guidance.