Success Rate and Related Factors of Vitapex Pulpectomy in Primary Teeth: A Retrospective Study

Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth.

This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression.

The Kaplan-Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors.

In total, 647 Vitapex PE teeth from 448 patients (19-121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate.

The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.