Potential factors affecting the success rate of indirect pulp therapy in primary molars with deep caries: a retrospective study

J Clin Pediatr Dent. 2024 May;48(3):46-51. doi: 10.22514/jocpd.2024.058. Epub 2024 May 3.

Abstract

Indirect pulp therapy (IPT) is a common conservative treatment for deep dental caries. However, the potential risk factors for the prognosis of IPT have not been well studied. This study retrospectively investigated the success rate of IPT in treating primary molars with deep caries and the factors potentially affecting the two-year success rate. A total of 303 primary molars in 202 children (106 boys and 96 girls) were included in this study. These primary molars were identified as having deep caries by clinical and radiographic examinations and were treated with IPT. The factors potentially affecting the IPT success rate were analyzed after two years of follow-up. The results indicated that the two-year IPT success rate was 86% (262/303). The success rate of primary molars with and without stainless steel crowns was 96% (120/125) and 80% (142/178), respectively. Primary molars treated with stainless steel crowns showed a significantly lower risk of failure (hazard ratio (HR) = 0.18, 95% confidence interval (CI): (0.10, 0.34), p = 0.01). There were no significant differences in other factors, including gender (male vs. female), age (preschool vs. school age), cooperation level (Frankl 2 vs. 3 or 4 scales), arch type (maxillary vs. mandibular), tooth type (first vs. second primary molar), or pulp capping material (calcium hydroxide vs. glass ionomer cement). IPT is an effective, conservative treatment modality for primary molars with deep caries. Stainless steel crowns could significantly improve the IPT success rate.

Keywords: Deep caries; Indirect pulp therapy; Potential factors; Primary molar; Stainless steel crown; Success rate.

MeSH terms

  • Child
  • Child, Preschool
  • Crowns*
  • Dental Caries* / therapy
  • Dental Pulp Capping / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Molar*
  • Retrospective Studies
  • Risk Factors
  • Stainless Steel
  • Tooth, Deciduous*
  • Treatment Outcome