Analysis of survival and factors associated with failure of primary tooth pulpectomies performed under general anaesthesia in children from South China

BACKGROUND: Pulpectomy is a technique recommended for treatment of irreversible pulp inflammation or necrosis. Treatment-related variables and patient factors may affect the prognosis of pulpectomy. AIM: To investigate the survival and related predictors associated with failure of pulpectomies performed under general anaesthesia for early childhood caries. DESIGN: Dental records of 124 patients, who underwent pulpectomy as part of comprehensive dental treatment under general anaesthesia, were reviewed and assessed. Relapse of pulpitis and periodontal periodontitis were evaluated by clinical examination and periapical film assessment at each follow-up appointment after original treatment. RESULTS: A total of 389 teeth of 124 children were evaluated. By the end of the fourth year, 45% of teeth with pulpitis and 46% of teeth with periapical periodontitis were estimated to relapse; the median (interquartile range) number of years to relapse was 3.5 (3.4-3.8) and 3.0 (1.8-3.0) years, respectively. The follow-up frequency, number of teeth extracted, plaque index, tooth position, type of restoration, pulp status, and quality of root canal filling were observed to have independent effects on relapse. CONCLUSION: Recurrence came earlier in teeth diagnosed with periapical periodontitis than those with pulpitis. Both treatment-related variables and patient factors could affect the prognosis of pulpectomy.