Caries control and other variables associated with success of primary molar vital pulp therapy.
OBJECTIVE
This research evaluated initial treatment of deep dental caries with caries control (CC) procedure and the effect of other factors on the success of indirect pulp therapy (IPT) and formocresol pulpotomy (FP).


METHODS
Retrospective chart audits were performed on 226 primary molars with deep caries approaching the pulp that were treated using IPT and FP. Mean follow-up was 3.4 years. CC with glass ionomer cement (GIC) was performed on 50 of the 226 teeth 1 to 3 months before pulp therapy.


RESULTS
IPT therapy was successful 94% of the time, whereas FP was successful 70% of the time. The initial use of CC increased the IPT/FP success rate to 92% vs a 79% success rate in teeth without CC. Primary molar FP success on primary first molars was 61% vs 83% in second molars. IPT therapy was successful 92% of the time for first molars vs 98% of the time for second molars. Thirty-six percent of the FP-treated teeth exfoliated early vs 2% of the IPT-treated teeth. Primary first molars with reversible pulpitis had a higher success with IPT (85%) vs FP (53%). The type of final restoration did not affect IPT or FP success, except that FPs restored with an immediate IRM (Dentsply/Caulk, Milford, Del) restoration decreased success to 39%.


CONCLUSIONS
IPT for the treatment of deep dental caries lesions produced greater long-term success than FP. FP success in primary first molars was lower compared to IPT success, especially in teeth with reversible pulpitis. Also FP-treated teeth showed significantly earlier exfoliation patterns. The prior treatment of deep dental caries lesions with CC procedures improved the subsequent IPT or FP success.
Vij
Raj
R
University of Maryland Dental School, Baltimore, MD, USA.
Coll
James A
JA
Shelton
Preston
P
Farooq
Naila S
NS
D002648:Child; D019230:Dental Audit; D003731:Dental Caries / Q000517:prevention & control* / Q000628:therapy; D003737:Dental Cavity Preparation / Q000379:methods; D003785:Dental Pulp Capping; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000379:methods; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008768:Methylmethacrylates / Q000627:therapeutic use; D008963:Molar / Q000473:pathology*; D011671:Pulpitis / Q000628:therapy; D011672:Pulpotomy; D012189:Retrospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D014080:Tooth Exfoliation / Q000503:physiopathology; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
D005899:Glass Ionomer Cements; D008768:Methylmethacrylates; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C031667:IRM cement