Radiographic changes associated with pulp infection in primary incisor roots and in their developing permanent dental follicles.

PURPOSE: Early diagnosis and treatment of pulp infection in primary incisors are important for preventing systemic infection and damage to the permanent tooth bud. The purpose of this retrospective case-control study was to identify radiographic changes associated with pulp infection in primary incisor roots and their developing permanent dental follicles.

METHODS

Oblique occlusal radiographs of 102 primary maxillary incisors with sinus tracts were compared to 390 radiographs of incisors from healthy same-age children.

RESULTS

Compared with controls, teeth with sinus tracts had more inflammatory root resorption (odds ratio [OR]=50.7, P<.001), pulp pathosis (OR=13.0, P<.001), deep caries (OR=3.9, P<.001), past traumatic injury (OR=3.4, P<.001), enlarged dental sac (OR=10.8, P<.001), loss of lamina dura of the dental sac (OR=27.5, P<.001), and increased radiolucency of the dental sac of the corresponding permanent tooth bud (OR=19.5, P<.001). In multivariate logistic regression, 2 variables were associated with radiographic changes in the primary root (inflammatory resorption, P<.001; and pulp pathosis, P=.004). Two variables associated with changes in the permanent tooth bud (loss of lamina-dura and increased radiolucency) were independently associated with the presence of a sinus tract, P<.001.

CONCLUSION

Deep caries, inflammatory resorption, pulp pathosis, loss of lamina-dura, and increased radiolucency of the dental sac were statistically associated with presence of a sinus tract.