The results of vital pulp therapy for primary molars in children with negative behaviour

Abstract

Relevance. Сhildren's negative behaviour may affect pulpitis treatment results. The study aimed to study the vital pulp therapy effectiveness for chronic fibrous pulpitis treatment in primary molars of children with negative behaviour.Material and methods. The study involved 60 children aged 3-6 years with negative behaviour (according to the Frankl scale). Before the treatment, the children had non-pharmacological psychological behaviour management. One hundred and twenty primary molars were treated for pulpitis using the biological method. Follow-ups assessed the condition of the fillings and the presence/absence of clinical and radiographic signs of complications after 6, 12, 18 and 24 months. Tooth survival rate determined the effectiveness of pulpitis treatment.Results. The after-pulpitis-treatment complication rate where tooth extraction was necessary amounted to 15.0% after six months and 1.7% after 12 months (p<0.001); there were no complications after 18 and 24 months. During the first 12 months, 4.1% of cases required retreatment of pulpitis by pulpotomy. The retreatment rate due to filling defects was 20.8% after six months, and it then significantly decreased to 1.0-3.3% (p < 0,001). The tooth survival rate after pulpitis treatment was 83.3% after 24 months. There were no statistically significant differences between the pulpitis treatment results based on the children’s age, the localization of the carious cavities, and direct or indirect pulp capping.Conclusion. The biological method of chronic fibrous pulpitis treatment in primary molars of children aged 3-6 years with negative behaviour had high 24-month effectiveness at an outpatient dental appointment (with preliminary psychological behaviour management). Most complications developed during the first six months after the treatment, to which dental filling defects contributed.