Longitudinal Study Comparing Pulpectomy and Pulpotomy Treatments for Primary Molars of Alaska Native Children.

The purpose of this study was to determine which pulp treatment technique, performed at the Alaska Native Medical Center, is most successful by comparing failure rates of primary molars treated with ferric sulfate (FS) pulpotomy, sodium hypochlorite (SH) pulpotomy or pulpectomy between January 2005 and January 2016. All data were abstracted from the dental records of Alaska Native children aged 2-13 years, retrospectively. Clinical and radiographic failures up to five years after treatment were assessed. Cox proportional hazards models using random effects to account for correlated failure time were adjusted for age, sex, molar tooth position, and visit type. A total of 1,149 procedures in 830 children met the inclusion criteria: 490 pulpectomies, 111 SH Pulpotomies and 548 FS Pulpotomies. Teeth treated with FS pulpotomy had 3.7 times higher risk of radiographic failure (adjusted hazard ratio [aHR]=3.73, 95% confidence interval [CI]= 2.25-6.16), and teeth treated with SH pulpotomy had 2.5 times higher risk of failure (aHR=2.57, 95% CI= 1.17-5.64) than those treated with pulpectomy. The findings from this large cohort study suggest that molar teeth treated with pulpectomies survive significantly longer than those treated with either FS or SH pulpotomies. Randomized trials are warranted to confirm findings. (Pediatr Dent 2019; 41(3):214-20) Received June 14, 2018 | Last Revision January 28, 2019 | Accepted March 14, 2019.