The success of emergency pulpotomies in primary molars

The purpose of this retrospective study was to assess the success of pulpotomies performed on an emergency basis and restored with a temporary zinc-oxide eugenol restorative material.

Records were collected from 216 pulpotomies in primary molars performed on an emergency basis by pediatric dental residents at the University of Florida pediatric dental clinic between July 1999 and June 2001. The selection criteria include teeth with a positive history of pain but with absence of clinical and radiographic signs of pulp degeneration. Formocresol was the medicament used and the teeth were restored temporarily with a reinforced zinc-oxide eugenol material. Treatment success or failure was determined, at the definitive restorative appointment, by the presence or absence of clinical and/or radiographic pathology. The time interval between emergency and definitive treatment appointments, tooth-type, arch, age, and gender were the variables analyzed in this study. Chi-square analysis was used to assess the effect of the different variables on the outcome of the treatment.

Sixty-four teeth were available for assessment in the two-year period. A 53% success rate was observed, if the tooth was evaluated and restored with the definitive restoration, within the first 90 days post-emergency treatment. A 31% success rate was observed after 365 days. These results were statistically significant (P=0.016). Patients younger than six years old showed statistically significant higher chances for success than older children did (P=0.018). No significant differences were found for gender, type of tooth, or arch.

The low success rate found during the first three months post emergency treatment may be attributed to undiagnosed, subclinical inflamed pulp, while long-term failure may be associated with microleakage of the temporary restorative material.