Caries Color, Extent, and Preoperative Pain as Predictors of Pulp Status in Primary Teeth

Area of Science:

• Pediatric Dentistry
• Caries Management
• Pulp Therapy

Background:

• Accurate diagnosis of pulpal status in primary teeth is crucial for appropriate treatment selection.
• Hemostasis at canal orifices is a key indicator for determining pulpotomy versus pulpectomy.

Purpose of the Study:

• To evaluate the correlation between preoperative pain, caries extent, and caries color with hemostasis achievement during pulp therapy access in primary teeth.
• To identify clinical indicators for predicting pulpal status and guiding treatment decisions.

Main Methods:

• Eighty primary molars with deep caries were assessed for preoperative pain, caries color, and extent.
• Hemostasis at canal orifices post-access cavity preparation was evaluated.
• Statistical analysis included Fisher's exact test, t-test, and kappa statistic.

Main Results:

• Achieving hemostasis was significantly associated with black caries (78.1%) and absence of pain (78.1%).
• Failure to achieve hemostasis was more common with light brown caries (64.3%) and nocturnal pain (64.3%).
• Greater caries extent correlated with the need for pulpectomy over pulpotomy (p=0.024).

Conclusions:

• Caries color, extent, and preoperative pain are valuable clinical indicators for assessing pulpal status in primary teeth.
• These factors can aid clinicians in determining the appropriate pulp therapy (pulpotomy or pulpectomy).