Prognostic factors for the long-term survival of primary molars following chairside pulpectomy with Vitapex: a retrospective study

Abstract

Abstract Objectives The objective of this study is to evaluate the potential factors that could influence the long-term survival of primary molars after pulpectomy with Vitapex.Materials and Methods A total of 212 primary molars underwent pulpectomy at the Department of Pediatric Dentistry from January 2018 to December 2020 were analyzed in this retrospective study. Kaplan-Meier analyses were utilized to evaluate time until failure. Multivariate Cox regression analysis was conducted to evaluate the clinical factors associated with failures.Results The survival rate was 86.8% at 12 months, declining to 49.5% at 24 months, and further decreasing to 3.3% at 48 months. In the multivariate Cox regression analysis, children aged 5 to 7 had a hazard ratio of 2.10 (P = 0.003), while those aged 7 or older had a significantly higher hazard ratio of 4.40 (P < 0.001) compared to children under 5 years old. Primary molars with a mucosal fistula have a 2.61 times (P = 0.004) higher risk of failure compared to those without this condition .Conclusions The age at initial treatment and the presence of a mucosal fistula before treatment are crucial factors for predicting the outcomes of Vitapex pulpectomy in primary molars and assessing the likelihood of treatment failure.Clinical relevance The apical seal and the extent of apical infection before treatment significantly impact survival rates following pulpectomy of primary molars. Evaluating these variables is crucial for evidence-based clinical decisions.