Vitapex Pulpectomy of Primary Molars: A Retrospective...
Transcript of Vitapex Pulpectomy of Primary Molars: A Retrospective...
![Page 1: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/1.jpg)
An Evaluation of Pulpectomies Utilizing Vitapex® root canal filling material in
Primary Anteriors and Molars: A Retrospective Study
Steven K. Rayes DDS, MS
![Page 2: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/2.jpg)
Literature Review-History
Pulpectomies have been performed since the 1800’s.
Sweet 1930: “the management of pulpless deciduous teeth is no longer experimental. They respond so promptly to treatment that there is no shadow of a doubt as to the advisability of retaining them”
Gerlach 1932: Utilized Beechwood Creosote and iodine with Gutta percha.
![Page 3: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/3.jpg)
![Page 4: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/4.jpg)
Iodoform Pastes
Walkoff paste (same as KRI paste), 1928
Kri paste: 2.02% parachlorophenol, 4.86% Camphor, 1.22% menthol, 80.8% iodoform.
Maistro paste: same components of KRI with addition of zinc oxide, thymol and lanolin
Vitapex®: Iodoform 40.4%, calcium hydroxide 30.3%, and silicone oil 22.4%
Endoflas: same as Vitapex® + ZOE
![Page 5: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/5.jpg)
![Page 6: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/6.jpg)
Recent Products Metapex-Calcium Hydroxide and Iodoform
RC Fill-Zinc Oxide Eugenol and Iodoform
Endoflas-Zinc Oxide Eugenol, Calcium Hydroxide and Iodoform
Ramar K, Mungara J. Clinical and radiographic evaluation of pulpectomies using three root canal filling materials: An in-vivo study. J Indian Soc Pedod Prev Dent 2010;28:25-9
Studied 96 molars with radiolucency and no mobility in 77 children for 9 months.
Results:Clinical success rate in GROUP I was 100%.Radiographic success rate in GROUP I was 81.1%.Clinical success rate in GROUP II was 96.8%.Radiographic success rate in GROUP II was 72.5%Clinical success rate in GROUP III was 100%Radiographic success rate in GROUP III was
90.32%
![Page 7: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/7.jpg)
![Page 8: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/8.jpg)
![Page 9: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/9.jpg)
New products
Studied 96 molars with radiolucency and no mobility in 77 children for 9 months.
Results: Clinical success rate in RC Fill was100%. Radiographic success rate in RC Fill was 81.1%. Clinical success rate in Metapex was 96.8%. Radiographic success rate in Metapex was 72.5% Clinical success rate in Endoflas was 100% Radiographic success rate in Endoflas was 90.32%
**No statistically significant differences between the groups.
![Page 10: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/10.jpg)
![Page 11: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/11.jpg)
Vitapex®
Vitapex® is produced in Japan.
Comes with a dispensing syringe with adaptable plastic tips for placement.
One study completed in the US by Nurko et al.
Two translated from Japanese studies: Fuchino et al. and Hideki et al.
![Page 12: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/12.jpg)
![Page 13: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/13.jpg)
![Page 14: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/14.jpg)
Concerns….
What if you extrude the apex?
What happens after it resorbs?
(Nurko et al)
Where does it go??
Primary tooth root morphology.
Why is it effective?
(Tchaou et. al /c 21 organisms.)
Effective against black pigmented anaerobes (prevotella, porphyromonas, an Bacteriodes).
![Page 15: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/15.jpg)
Canal Structure of Primary Teeth
![Page 16: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/16.jpg)
Table 1: A summary of the success rates of pulpectomy procedures in primary molars using different filling materials:45, 54, 55 **
Investigator
Year Follow-up (months)
Number of Teeth Examined
Filling Material Success Rate (%)
Rabinowitch 56}.
1953 N/A 1363 Black ZOE 99.5% (calculated)
Gould 36}. 1972 7-26 29 ZOE 82.9% (calculated)
Fuchino T. et al.57}.*
1978 1-19 130 Vitapex® 86.2-97.7%
Rifkin 58}. 1980 12 26 KRI 89.0%
Hideki C et al59}..*
1981 24-54 183 Vitapex® 93.5%
Coll et al.41}.
1985 6-36 33 ZOE 80.5%
Coll et al.41}.
1985 60-82 29 ZOE 86.1%
![Page 17: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/17.jpg)
![Page 18: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/18.jpg)
Garcia-Godoy 32}.
1987
6-24 55 KRI 95.6%
Reyes 60}. 1989
6-24 53 KRI + FC + Ca(OH)2
100.0%
Barr et al.35}.
1991
12-74 62 ZOE + FC 82.3%
Holan et al.34}.
1993
6-48 34 ZOE 65%
Holan et al.34}.
1993
6-48 44 KRI 84%
Coll et al.31}.
1996
20-177 81 ZOE 77.8%
Nurko et al. 6}.
1999
3-22 33 Vitapex® 100%
Fuks et al.17}.
2002
6-52 55 Endoflas 70%
![Page 19: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/19.jpg)
![Page 20: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/20.jpg)
Retrospective Studies-pulpotomy
Clinical Success Radiographic Success
Follow-up Ferric Sulfate Formocresol Ferric Sulfate Formocresol
Period n %
Success n %Success n %
Success n % Success
Burnett & Walker 1->36m 357 93.0% 285 98.2% 45 76% 83 81%
Burnett & Walker Statistically more failures with ferric sulfate than formocresol
At > 36 months formocresol had significantly less failures than ferric sulfate.
Radiographic sample size was very small especially at >36 m
Interradicular radiolucenies were the most common finding for both ferric sulfate and formocresol treated teeth
![Page 21: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/21.jpg)
![Page 22: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/22.jpg)
Literature Review
Nurko et al: 1999
a. Followed 33 teeth for 3 to 22 months treated with Vitapex®
b. Teeth had evidence of infection including
mobility, purulence, and radiographic
radiolucency.
c. Preoperative radiolucency must show a reduction in size or bone regeneration. No signs or symptoms of infection at 6 mo. recall.
d. 100% success rate.
e. Vitapex® that extruded apex resorbed within 2 months.
![Page 23: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/23.jpg)
Resorption of Vitapex®
No damage to permanent tooth
![Page 24: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/24.jpg)
![Page 25: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/25.jpg)
All in the family
![Page 26: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/26.jpg)
Pulpectomy procedures Diagnosis, Diagnosis, Diagnosis!!!
Considerations: medical status, characteristics of pain, radiographic findings, presence/absence of permanent successor, which tooth?, expected time to eruption of permanent successor.
Pulpotomy vs. Pulpectomy?
vitality tests? Percussion? Thermal Stimulus? EPT?
Be Prepared!!
Take a PA to determine working length and Access
Debridement Coronal pulp chamber-round burs and spoon excavators Barbed broaches and #10 files to remove organic material from canals. Sodium Hypochlorite (FULL STRENGTH)
![Page 27: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/27.jpg)
What now??
![Page 28: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/28.jpg)
Pulpectomy Procedures Filing
Filling
a. Dry canals completely…bleeding should be subsided.
b. Cut Vitapex tip as appropriate.
c. Depress plunger and allow vitapex to force the syringe out.
d. Leave a small layer over furcation.
e. Seal with IRM or Temrex.
PLACE AN SSC!!
![Page 29: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/29.jpg)
Things you should just not do…….
![Page 30: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/30.jpg)
Things you should just not do….
Filing toward the furcation area.
Removing tooth structure and pulpal tissue within the canal with a round bur
Performing a pulpotomy without hemostasis (proceed to pulpectomy)
Inserting larger files into canals
Extruding the apex with files
![Page 31: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/31.jpg)
![Page 32: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/32.jpg)
Vitapex Placement
![Page 33: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/33.jpg)
![Page 34: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/34.jpg)
Cases
03/03/00 10/31/00
Resolution of lesion with bone regeneration in
8 months.
![Page 35: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/35.jpg)
Cases
05/30/00 09/10/01
Crown removed, and tooth treated with vitapex®.
![Page 36: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/36.jpg)
Cases
10/07/99 03/23/01
![Page 37: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/37.jpg)
Cases
05/02/00 08/24/01 02/28/02
![Page 38: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/38.jpg)
Cases-marginally restorable
![Page 39: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/39.jpg)
Cases-retreatment
10/12/99 03/30/01
Previously pulpotomy treated tooth, retreated with vitapex pulpectomy.
![Page 40: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/40.jpg)
Pathologic Resorption
06/09/99 02/12/02
Tooth remained long enough for #19 to erupt.
![Page 41: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/41.jpg)
Results
![Page 42: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/42.jpg)
Results
Overall survival success
Follow-up Range .05 to 4.9 years (mean 1.7)
All teeth= 85.5% (21/145)
Teeth without initial radiolucency:
94.81% (4/77)
Teeth with an initial radiolucency:
75.44% (14/57)
![Page 43: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/43.jpg)
![Page 44: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/44.jpg)
Results
Significant Factors in the Analysis:
Presence of Radiolucency (p=.012)
Treatment Location (p=.013)
Restoration Type (p=.003)
Provider Type (p=.027)
![Page 45: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/45.jpg)
Results Significant Factors:
VARIABLE WALD CHI df▪ P-VALUE HR
SQUARE
Restoration Other 8.741 1 .003 4.335
SSC Reference
Provider General DDS 4.887 1 .027 2.704
Type Pediatric DDS Reference
![Page 46: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/46.jpg)
Alaska Native Arts and Crafts
![Page 47: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/47.jpg)
Pulpotomy Comparison
Pulpotomy studies reporting with survival
Analysis:
Rolling et al.- 3-year survival analysis of fc pulpotomies:
1-year 83% (91%), 2-year 78% (88%), 3-year 70% (74%)
Smith et al.- 2-year 79% (88%), 3-year 60-65% (74%)
Casas et al.- 2-year 86% (88%), 30 mo. 25-50% (74%)
![Page 48: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/48.jpg)
Other Considerations
Should be attempted on 2nd primary molars to avoid space loss and distal shoe.
Consider in cases of missing permanent successors.
Consider utilizing apex locator to establish working length.
![Page 49: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/49.jpg)
Cases
Right side treated with pulpectomy, left side treated with extraction…..
![Page 50: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/50.jpg)
Conclusions
![Page 51: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/51.jpg)
CONCLUSIONS
1. The overall success rate of teeth treated with a vitapex pulpectomy was 85.5% with a mean follow-up period of 1.7 years (range .5 to 4.9 years).
2. The overall success rate of teeth treated that had no initial radiolucency was 94.8%.
3. The overall success rate of teeth treated with an initial radiolucency was 75.4%
![Page 52: Vitapex Pulpectomy of Primary Molars: A Retrospective Studyep60.eventpilotadmin.com/doc/clients/AAPD/AAPD2012/library/Rayes.pdf · Primary Anteriors and Molars: A Retrospective Study](https://reader031.fdocuments.in/reader031/viewer/2022012917/5b16c9df7f8b9a6d6d8db642/html5/thumbnails/52.jpg)
Questions?