Success Rates of Indirect Pulp Therapy Compared to Therapeutic Pulpotomy in Primary Molar Teeth

Objectives: The purpose of this retrospective chart review was to determine how primary molars in need of vital pulp therapy have been treated over a period of four years at a university-based pediatric dental practice (UBP) and to determine which treatments: indirect pulp therapy (IPT), formocresol pulpotomy (FC), and ferric sulfate pulpotomy (FS) have been successful.
Methods: Electronic patient records (axiUm®) that contained the procedure codes D3120 (Pulp Cap – Indirect) or D3220 (Therapeutic Pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures i.e. extractions (D7140) or pulpectomy (D3221/D3240). A total of 2,001primary molar teeth (n=2001) were included in the study.
Results: In 2010, 52% of vital pulp therapies were FS, 38% were IPT followed by FC at 5%. In 2014 91% were IPT, followed by FC and FS, each at 2%. At three years follow-up, IPT had a 96.2% success rate, FC had a 65.8% success rate and FS had a 62.9% success rate (P<.0001).
Conclusions: Over a four year period of time, IPT became the more commonly used vital pulp therapy treatment at this UBP. IPT was significantly more successful at three years than FC or FS providing clinical justification. IPT is a successful conservative treatment option for primary molar teeth with deep caries.