title: Radiographic changes associated with pulp infection in primary incisor roots and in their developing permanent dental follicles.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: malka.ashkenazi@gmail.com
authors.forename: Malka
authors.initials: M
authors.lastname: Ashkenazi
authors.forename: Efrat
authors.initials: E
authors.lastname: Hershkovitz
authors.forename: Limor
authors.initials: L
authors.lastname: Afek
mesh_terms: D000704:Analysis of Variance; D001424:Bacterial Infections / Q000150:complications / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000150:complications / Q000000981:diagnostic imaging; D003751:Dental Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D003790:Dental Pulp Necrosis / Q000150:complications / Q000000981:diagnostic imaging*; D003795:Dental Sac / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging* / Q000293:injuries / Q000473:pathology; D007223:Infant; D016015:Logistic Models; D008297:Male; D008437:Maxilla; D011859:Radiography; D012189:Retrospective Studies; D012391:Root Resorption / Q000000981:diagnostic imaging* / Q000209:etiology; D018677:Tooth Injuries / Q000150:complications; D014092:Tooth Root / Q000000981:diagnostic imaging*; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging* / Q000293:injuries