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Published on: October 27, 2023
Radiographic changes associated with pulp infection in primary incisor roots and in their developing permanent dental
Malka Ashkenazi1, Efrat Hershkovitz, Limor Afek
1malka.ashkenazi@gmail.com
Purpose:
Early diagnosis and treatment of pulp infection in primary incisors are important for preventing systemic infection and damage to the permanent tooth bud. The purpose of this retrospective case-control study was to identify radiographic changes associated with pulp infection in primary incisor roots and their developing permanent dental follicles.
Methods:
Oblique occlusal radiographs of 102 primary maxillary incisors with sinus tracts were compared to 390 radiographs of incisors from healthy same-age children.
Results:
Compared with controls, teeth with sinus tracts had more inflammatory root resorption (odds ratio [OR]=50.7, P<.001), pulp pathosis (OR=13.0, P<.001), deep caries (OR=3.9, P<.001), past traumatic injury (OR=3.4, P<.001), enlarged dental sac (OR=10.8, P<.001), loss of lamina dura of the dental sac (OR=27.5, P<.001), and increased radiolucency of the dental sac of the corresponding permanent tooth bud (OR=19.5, P<.001). In multivariate logistic regression, 2 variables were associated with radiographic changes in the primary root (inflammatory resorption, P<.001; and pulp pathosis, P=.004). Two variables associated with changes in the permanent tooth bud (loss of lamina-dura and increased radiolucency) were independently associated with the presence of a sinus tract, P<.001.
Conclusion:
Deep caries, inflammatory resorption, pulp pathosis, loss of lamina-dura, and increased radiolucency of the dental sac were statistically associated with presence of a sinus tract.
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