Permanent Versus Temporary Restorations After Emergency Pulpotomies in Primary Molars

Resident’s Name: Jessica Wilson
Program: Lutheran Medical Center - Providence

Article title: Permanent Versus Temporary Restorations After Emergency Pulpotomies in Primary Molars

Author(s): Guelmann et al.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2005. 27:6. 478-481.

Major topic: Restorations Following Emergency Pulpotomies

Overview of method of research: Scientific Article

Purpose:
To determine whether immediate placement of SSC after emergency pulpotomy in primary molars would produce significantly better results than temporary restorations.

Background:
At times due to lack of time, uncooperative behavior from a patient as well as financial limitations SSCs are not placed at the time of an emergency pulpotomy. Previous studies have shown that due to microleakage, emergency pulpotomies temporarily restored with IRM had significantly lower success rate than those restored with SSCs.

Methods:
Retrospective analysis of records of 94 emergency pulpotomies in primary molars was performed at a university pediatric graduate dental clinic. Teeth with pain and caries in close proximity to the pulp were included while those with signs of pulpal necrosis, internal or external resorption, mobility or swelling were not. Treatment was done by pediatric dental residents under attending supervision. RDI and 5 minute formocresol technique were used. The tooth was then either restored with IRM and an SSC or IRM and Ketac Molar at the discretion of the resident and attending. The statistical analysis also included 216 teeth from a previous study conducted with the same methods which were all restored with IRM only. Those receiving temporary restorations were restored with SSCs at the following recall appointment. Clinical success and survival were then determined based on the placement of definitive SSC in the cases where a temporary restoration had been placed and confirmation of the presence of the SSC at following recare appointments. Failure of the pulpotomy was indicated by the need for extraction due to pain, mobility, sinus tract, swelling, resorption or bone destruction.

Findings:
Although not significantly significant, teeth immediately restored with an SSC had higher success rates (86%) compared to those with IRM and Ketac Molar (77%) or just IRM (61%). However, the survival rate for those restored with SSCs immediately was significantly greater (410 days) than temporary restorations (168 and 173 days). Time between emergency visit and definitive respiration placement or recare, age, sex, tooth type and arch were not found to be significant in success versus failure rate.

Key points/Summary:
Immediate placement of SSC after emergency pulpotomies increases the survival rate for the tooth. This technique should be used whenever possible.

Assessment of Article: Although the article demonstrated a good point, it pretty much proved the same thing that was already shown in several other articles.