A retrospective study on the long-term outcomes of pulpectomy and influencing factors in primary teeth

BACKGROUND/PURPOSE: Pulpectomy is the last means to preserve primary teeth with pulpitis or pulp necrosis. The aim of the study was to investigate the survival rate of primary teeth after pulpectomies and to explore the factors influencing the prognosis of pulpectomy. MATERIALS AND METHODS: This retrospective study was performed on patients who received primary tooth pulpectomy in the Department of Pediatric Dentistry at Peking University Hospital of Stomatology between January 2014 and February 2019. The demographic characteristics of children and the information of teeth treated were collected, and the clinical and radiographic examination after treatment were evaluated. Survival analysis was performed to determine the influencing factor of pulpectomy failure. RESULTS: A total of 592 primary anterior teeth and 583 primary molars were included. The 30-month survival rate of primary anterior teeth was 58.5% and that of primary molars was 37.0%. The survival rate of postoperative primary molars was lower than that of primary anterior teeth (P < 0.05). Primary anterior tooth interventions with preoperative periapical lesions, Vitapex® filling, or nongeneral anesthesia treatment had a higher failure risk (P < 0.05). Treatment at an older age and glass ionomer cement filling indicated a higher failure risk for primary molar pulpectomies. CONCLUSION: Primary anterior teeth after pulpectomies had a higher survival rate than primary molars. Periapical lesions, treatment methods, and root filling materials had significant impacts on the prognosis of primary anterior pulpectomies, and children's age significantly affected the prognosis of primary molar pulpectomies, which has not been reported before.