The success of pulpotomy procedures in primary molars has been demonstrated to be higher than 80%. Clinical studies included teeth with a negative history of pain and definitive restorative treatment was performed immediately. In acute situations, pulp tissue is inflamed and the prognosis is questionable.
Objective: The purpose of this retrospective study was to assess the long-term success of pulpotomy procedures in primary molars when performed on an emergency basis and restored temporarily with a reinforced ZOE material.
Methods: Data were collected from 216 formocresol pulpotomies performed at the pediatric emergency dental clinic at the University of Florida between July 1999 and June 2001. The selection criteria included teeth with a positive history of pain, absence of abnormal mobility, sinus tract and swelling. Radiographically, the decay was close to the pulp, and roots showed no signs of external or internal resorption and no furcation radiolucency.
Results: During the two-year period, 64 teeth were clinically and radiographically evaluated for final restorations; 39 teeth were free of pathology. The average time interval between treatments was 212 days. A 53% success rate was observed within the first 90 days post-emergency treatment. A high failure rate was found after 365 days (69%). These results were statistically significant (p=0.016). When the early failures (<90 days) were eliminated, the increase failure rate after 365 days was highly significant when compared to the intermediary period (p=0.005). Patients younger than 6 years old showed statistically significant higher chances for success than older children (p=0.018). No significant differences were found for gender, type of tooth or arch.
Conclusions: The low success rate on the first 3 months post emergency treatment may be attributed to the undiagnosed, subclinical inflamed pulp status, while long-term failure may be associated with microleakage of the temporary restorative material.