Evaluation of the reasons for failure in teeth with vital amputation treatment

BMC Oral Health (2023) 23:455 Yildiz et al. BMC Oral Health https://doi.org/10.1186/s12903-023-03171-z Open Access RESEARCH Evaluation of the reasons for failure in teeth with vital amputation treatment Semsettin Yildiz1, M. Sinan Dogan2*   and Mehmet Emin Dogan3 Abstract Aim This study aims to evaluate the primary teeth undergoing amputation due to dental caries or trauma clinically and radiologically. Material and methods The amputation treatment of 90 primary teeth of 58 patients (Female: 20, Male: 38) aged 4–11 years was evaluated clinically and radiologically. Calcium Hydroxide was used for amputation in this study. Composite or amalgam was preferred as filling material in the same session of the patients. Clinical/radiological (Periapical/Panoramic X-ray) examination was performed on the teeth that were unsuccessful in treatment, on the day of the patient’s complaint, and at the end of 1 year in the others. Results According to the clinical and radiological findings of the patients, 14.4% of the boys and 12.3% of the girls were unsuccessful. Amputation in male was a need in the 6–7 age group with a rate of 44.6% at most. Amputation in females was a need in the 8–9 age group with a rate of 52% at most. Conclusion Success in amputation treatment depends on the tooth, the dentist, and the dental material applied. Keywords Deciduous tooth, Vital amputation, Calcium hydroxide Introduction Despite the decreasing prevalence of dental caries today, this disease continues to be one of the critical public health problems affecting children and adults [1]. Tooth decay is a significant health problem that results in pain and reduces the quality of life of children. However, painless and untreated decayed teeth can cause severe dental and systemic problems [2]. The primary purpose of dental caries management is to preserve the tooth’s vitality and prevent tooth hard tissue *Correspondence: M. Sinan Dogan 1 Department of Pediatric Dentistry, Faculty of Dentistry, Fırat University, Elazıg, Turkey 2 Department of Pediatric Dentistry, Faculty of Dentistry, Harran University, Sanlıurfa, Turkey 3 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Harran University, Sanlıurfa, Turkey loss. However, due to the anatomical structure of primary teeth, low mineralization, and high-risk factors, dental caries progresses rapidly [3]. Due to the rapid progression of dental caries in children and a delayed visit to the dentist due to socioeconomic reasons, dental caries affect the pulp. Depending on the size of dental caries and their effect on the pulp, pulp coating (direct or indirect), pulpotomy and pulpectomy are the treatment options [4]. Pulpotomy is a procedure to remove the coronal pulp affected by dental caries or trauma and preserve the vitality of the root pulp. For this purpose, different techniques and materials such as ferric sulfate, glutaraldehyde, Mineral trioxide aggregate (MTA), calcium hydroxide, electrosurgery, and laser therapy are used [5]. Microleakage-free restorations and cavity closure materials are essential for successful treatment in pulpotomy treatment. Because one of the most common causes of failure is the entry of bacteria into the pulp from the salivary environment through the open dentinal tubules. © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Yildiz et al. BMC Oral Health (2023) 23:455 Preventing marginal leakage is essential to vital pulp therapy, as bacterial contamination and infection are significant threats to pulp healing [6]. After pulpotomy, amalgam, glass ionomer, composite, and stainless steel crowns can be used [6, 7]. The restoration to be made is determined according to the amount of tooth tissue remaining after the tooth decay is removed and the time of the tooth falling out [8]. There is a study in the literature evaluating vital pulpotomy failure [9]. However, the filling material used was not evaluated. In this study, the effect of the filling material used after vital pulpotomy on the success of the treatment was investigated. The aim of this study was to evaluate the clinical and radiological success of primary molar amputations with calcium hydroxide according to different restorative materials. The null hypothesis (H0) there is no difference in the success rate of the restorative materials used after amputation. Material and method Amputation was performed on 90 teeth of 58 patients aged 4–11. G-power version 3.1.9.7 was used for power analysis and the sample size was found to be 78 at the 5% error interval and 90% confidence interval. In this study, 90 teeth were included. The criteria for teeth inclusion into the study were as follows; No clinical or radiographic pathological findings; the pulp is opened during caries removal; Patients with bleeding control for 5 min after coronal pulp amputation, teeth within normal limits, and patients without any systemic disease were included in the study. Exclusion criteria; patients with systemic disease, syndrome, noncooperative, patient with lesion cyst, tumor etc. were not included in the study. In the clinical examination performed at the control appointment, Sensitivity to percussion and palpation, spontaneous or causative pain, gingival discoloration, fistula or abscess, pathological mobility were evaluated. Radiolucency in the periapical or furcation region, internal and external pathological root resorption, and expansion of the periodontal ligament were evaluated in the radiological examination. Teeth with any of these clinical and radiological findings were considered to be unsuccessful. All carious tissues were removed under local anesthesia. Coronal pulp tissue was removed using a conventional technique. Bleeding was controlled with moist cotton pellets. A sterile powder of calcium hydroxide mixed with distilled water was applied to the root pulp and gently adapted with a clean cotton pellet to perform Page 2 of 6 calcium hydroxide (...truncated)