title: Pulp prognosis following conservative pulp treatment in teeth with complicated crown fractures-A retrospective study.
abstract: OBJECTIVE
  Complicated crown fractures are relatively common in children where the maintenance of the pulp is especially important in young permanent teeth. The aim of this study was to analyze the pulp prognosis of permanent teeth with complicated crown fractures treated with conservative pulp treatment in adolescents.
  
  
  METHODS
  Complete dental records of teeth with complicated crown fractures treated with conservative pulp treatment were obtained. The risk of pulp necrosis and infection was evaluated by the Kaplan-Meier method and Cox regression (P<.05). Risk factors included gender, age, time interval between dental injury and treatment, stage of root development, type of pulp treatment, and coronal restoration.
  
  
  RESULTS
  The study involved 375 teeth treated with direct pulp capping, partial or coronal pulpotomy, and direct pulp capping retreated by pulpotomy (partial or coronal). The frequency of pulp necrosis and infection was 10.1% (11/109) for partial pulpotomy and 9.8% (22/205) for coronal pulpotomy. There was no difference between partial and coronal pulpotomy (P=.673). The risk of pulp necrosis and infection was not significantly different between pulpotomy (partial and coronal; 33/314, 10.5%) and retreatment by pulpotomy (partial or coronal) after direct pulp capping (2/33, 6.1%; P=.436). However, the frequency of pulp necrosis and infection after direct pulp capping (16/28, 57.1%) was significantly higher than that with pulpotomy (partial or coronal; odds ratio=8.216, P<.001). The time interval between dental injury and treatment did not significantly influence pulp survival after pulpotomy (partial or coronal; P=.312), but the stage of root development had a significant impact (P<.001).
  
  
  CONCLUSIONS
  Partial or coronal pulpotomy, employed either as a primary pulp treatment or secondary to emergency pulp capping, had similarly satisfactory pulp survival rates.
authors.affiliation: Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Guiyan
authors.identifier: http://orcid.org/0000-0003-4555-5862
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Man
authors.initials: M
authors.lastname: Qin
mesh_terms: D000293:Adolescent; D002648:Child; D003782:Dental Pulp / Q000293:injuries*; D003785:Dental Pulp Capping / Q000379:methods*; D003789:Dental Pulp Exposure / Q000209:etiology* / Q000628:therapy*; D003790:Dental Pulp Necrosis / Q000209:etiology* / Q000628:therapy*; D019229:Dentition, Permanent; D005260:Female; D006801:Humans; D007180:Incisor / Q000293:injuries*; D008297:Male; D011379:Prognosis; D011672:Pulpotomy / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D019228:Tooth Crown / Q000293:injuries*; D014082:Tooth Fractures / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome
keywords: complicated crown fracture; direct pulp capping; permanent teeth; pulp prognosis; pulpotomy