Permanent versus temporary restorations after emergency pulpotomies in primary molars

The purpose of this retrospective study was to determine if immediate placement of a stainless steel crown (SSC) after emergency pulpotomies in primary molars would result in a better outcome when compared to different temporary restorations.

Records of 94 emergency pulpotomies in primary molars performed at a university pediatric graduate dental clinic between July 2001 and June 2004 were analyzed. Inclusion criteria included: (1) teeth with a positive history of spontaneous or elicited pain; (2) deep caries with close approximation to the pulp; (3) absence of clinical and radiographic signs of pulpal degeneration; (4) abnormal mobility; or (5) swelling. Pulpotomized teeth were temporarily restored with a zinc oxide eugenol-based temporary restoration (IRM) covered with Ketac Molar or with a permanent restoration (SSC). The time interval between emergency and definitive treatment or recall, age, gender, tooth type, and arch were the variables analyzed in the study. Success was determined by record (progress notes and radiographs) verification of SSC placement in case of a temporary restoration and by confirmation of crown presence during recall exam. Data from emergency pulpotomies restored only with IRM was added to the study and included in the statistical analysis.

Superior clinical success was obtained when emergency pulpotomies were restored with SSC (86%) when compared to IRM only (61%) or IRM and Ketac Molar combined (77%). Statistical significance was obtained in favor of SSC when survival analysis was performed (P<.001). No statistically significant difference was found for any of the other variables (P>.05).

Immediate placement of an SSC tended to improve the chances for success when emergency pulpotomies are performed.