Pulpectomy success with iodoform/calcium hydroxide in pediatric primary molars: a retrospective survival analysis

This retrospective cohort study evaluated the clinical success of pulpectomy in pediatric primary molars using iodoform/calcium hydroxide [iodoform/Ca(OH)2] paste, and examined procedural and tooth-related factors associated with treatment outcomes over time.

Records of pediatric patients treated with pulpectomy using iodoform/Ca(OH)2 paste were retrospectively reviewed. Of 1,831 screened records, 167 primary molars that met the inclusion criteria and had a minimum follow-up of 6 months were included in the final analysis. Clinical and radiographic outcomes were assessed longitudinally. Treatment success was analyzed using Kaplan-Meier survival analysis, and factors associated with failure were explored using Cox proportional hazards regression.

Overall clinical success was high, with favorable short- to medium-term outcomes and a gradual decline in survival over time. Immediate placement of stainless-steel crowns was significantly associated with improved treatment survival (P = .046), as was tooth type, with second primary molars showing superior outcomes (P = .024). In contrast, obturation quality and preoperative clinical signs were not significantly associated with treatment failure (P > .05).

Pulpectomy of primary molars using iodoform/Ca(OH)2 paste demonstrates reliable clinical performance in pediatric patients. Procedural and restorative factors, particularly immediate full-coverage restoration, appear to have a greater influence on long-term outcomes than radiographic obturation characteristics, supporting the material's continued use in pediatric endodontic practice.