Predictive factors for pulp necrosis in traumatized primary incisors: a longitudinal study

Area of Science:

• Pediatric Dentistry
• Dental Traumatology
• Endodontics

Background:

• Traumatized primary incisors can lead to pulp necrosis (PN), impacting long-term dental health.
• Understanding factors associated with PN is crucial for predicting outcomes in pediatric dental trauma.

Purpose of the Study:

• To identify and assess factors linked to the occurrence of pulp necrosis in traumatized primary incisors.
• To provide insights into the prognosis of pulp necrosis following dental trauma in children.

Main Methods:

• Retrospective analysis of clinical files from 521 patients with 727 traumatized primary incisors.
• Poisson regression analysis was employed to determine the relative risk (RR) of PN.
• Factors evaluated included trauma type, clinical signs, and radiographic findings.

Main Results:

• Pulp necrosis (PN) affected 23.8% of traumatized primary incisors.
• Factors positively associated with PN included displacement trauma, pulp exposure, pain, crown discoloration (yellow, grey, brown), internal root resorption, and bone loss.
• Factors negatively associated with PN were trauma in children aged 4-5 years and older, pulp canal obliteration, and external root resorption with bone formation.

Conclusions:

• More severe injuries, pain, specific discolorations, and internal root resorption significantly increase the likelihood of pulp necrosis.
• Conversely, older age at trauma, canal obliteration, and external resorption indicate a lower probability of pulp necrosis, aiding in prognosis.