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Survival Analysis and Risk Factors of Pulpectomy among Children with Severe Early Childhood Caries Treated under General Anesthesia: A Retrospective Study

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  • Shu-yang He

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
    These authors are contributed equally to this work.)

  • Jin-yi Li

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi’an Jiaotong University, Xi Wu Road No. 98, Xi’an 710041, China
    These authors are contributed equally to this work.)

  • Shan-shan Dai

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi’an Jiaotong University, Xi Wu Road No. 98, Xi’an 710041, China)

  • Yu-hui Yang

    (Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China)

  • Yi-feng Wen

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Department of Endodontics, Affiliated Stomatology Hospital of Xi’an Jiaotong University, Xi’an 710004, China)

  • Qing-yu Guo

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi’an Jiaotong University, Xi Wu Road No. 98, Xi’an 710041, China)

  • Fei Liu

    (Key Laboratory of Shaanxi Province for Craniofacial Precision Medical Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
    Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi’an Jiaotong University, Xi Wu Road No. 98, Xi’an 710041, China)

Abstract

Objectives: This study aims to retrospectively evaluate the survival rate of pulpectomy performed under dental general anesthesia (DGA) through long-term follow-up and to explore the risk factors associated with treatment failure. Methods: The medical records of the children who were diagnosed with S-ECC and received pulpectomy treatment under general anesthesia (GA) from 1 August 2014 to 1 December 2019, in the Stomatological Hospital of Xi’an Jiaotong University, were collected. Two dentistry postgraduates extracted the necessary information and filled in a predesigned excel form. Survival analysis was performed using the Kaplan-Meier method. The shared frailty model was used to explore possible factors affecting the success rate of pulpectomy in primary teeth. Results: A total of 381 children (mean age 3.49 ± 0.90) with S-ECC and 1220 teeth were included in the study, including 590 primary anterior teeth and 630 primary molars. The overall 35-month survival rate was 38.5%, which was 52.9% for anterior teeth and 31.1% for molars. The overall median survival time was 31 months, in which anterior teeth were 35 months and molars were 26 months. The older the children were, the greater the risk of treatment failure (HR 1.56, 95% CI 1.09, 2.24). The risk of pulpectomy failure of primary molars was 1.9 times that of primary anterior teeth (95% CI 1.36, 2.65) and the teeth with abnormal radiological findings before treatment was 1.41 times higher than that of teeth without imaging abnormalities (95% CI 1.74, 3.36). Conclusion: The survival rate of primary tooth pulpectomy is acceptable but decreased gradually with time. The failure rate of pulpectomy in primary molars is higher than that of primary anterior teeth. When the primary caries has extended to the pulp and resulted in a nonvital lesion, pulpectomy could be an option for maximum retention of the primary tooth.

Suggested Citation

  • Shu-yang He & Jin-yi Li & Shan-shan Dai & Yu-hui Yang & Yi-feng Wen & Qing-yu Guo & Fei Liu, 2023. "Survival Analysis and Risk Factors of Pulpectomy among Children with Severe Early Childhood Caries Treated under General Anesthesia: A Retrospective Study," IJERPH, MDPI, vol. 20(2), pages 1-17, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1191-:d:1030298
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    References listed on IDEAS

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    1. Roberto G. Gutierrez, 2002. "Parametric frailty and shared frailty survival models," Stata Journal, StataCorp LP, vol. 2(1), pages 22-44, February.
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