Pulp Therapy
Matthew J. Finor, DMD, MS
Resident
University of Texas — Houston, Houston, TX
UTHealth School of Dentistry - Houston
Churchville, Pennsylvania, United States
Timothy Kirkpatrick, DDS
UTHealth Houston
Gisela V. V. Bona, DDS, MS
Associate Professor
University of Texas-Houston
HOUSTON, Texas, United States
Bhavani Acharya, DDS
Program Director
UT School of Dentistry at Houston
Houston, Texas, United States
Brett T. Chiquet, DDS, PhD
Associate Professor and Director of Research
UTHealth Houston School of Dentistry
University of Texas School of Dentistry
Houston, Texas, United States
Bhavani Acharya, DDS
Program Director
UT School of Dentistry at Houston
Houston, Texas, United States
Brett T. Chiquet, DDS, PhD
Associate Professor and Director of Research
UTHealth Houston School of Dentistry
University of Texas School of Dentistry
Houston, Texas, United States
Purpose: The purpose of this retrospective study was to compare the clinical and radiographic effectiveness of lesion sterilization tissue regeneration (LSTR) and traditional pulpectomy treatment on primary molars.
Methods: Children, 3 to 10 years old, with at least one primary molar diagnosed with pulpal necrosis or irreversible pulpitis, were included in this study. Teeth were either treated via LSTR or pulpectomy. Patients were followed up at each recall and symptoms of treated teeth were monitored. The molars were followed until exfoliation or extraction occurred.
Results: Fifteen children (Age-Mean(SD)=6.3(1.19), Male=53.3%), twenty-two primary molars (first primary molars=36.3%, maxillary=36.3%) were treated with LSTR. Sufficient follow up for nineteen primary molars available. Twenty-three primary molars (maxillary=82.6%, first primary molar=4.2%) were treated with pulpectomy with sufficient follow up. There was no statistical difference between males versus females, maxillary versus mandibular teeth, or diagnosis (p < 0.05). First molars were treated more with LSTR than pulpectomy (LSTR=7, pulpectomy=1, p=0.013). Pulpectomy treated teeth presented with more symptoms initially, including palpation sensitivity (p=0.03). At 6 months, pulpectomy had a higher failure rate than LSTR (5.26% versus 25%, p=0.18). LSTR treated teeth had a better overall improvement of symptoms compared to pulpectomy (73.68% versus 35%, p=0.08).
Conclusion: At the initial six-month recall, primary teeth treated with LSTR appear to have a better success rate then primary teeth treated with pulpectomies. LSTR teeth are continuing to be monitored for symptoms and failures. It is hypothesized that LSTR will have a greater success rate at one year.