Analysis of Success Factors Associated with Primary Tooth Pulpectomies Performed Under General Anaesthesia

Background: Pulpectomy is a technique recommended for treatment of irreversible pulp inflammation or necrosis in primary tooth. Treatment-related variables and patient factors may affect the prognosis of pulpectomy. Purpose: To investigate the success rate and related predictors associated with failure of pulpectomies performed under general anaesthesia for primary teeth. Materials and methods: A chart review of patients who underwent pulpectomy as part of comprehensive dental treatment under general anaesthesia in Wang Fang Hospital during 2015 to 2019 was performed. Pretreatment variables, follow up clinical and radiographic records were evaluated. Statistical analysis using SPSS were performed to evaluate the correlation of the variables with the success rate. Results: A total of 144 teeth of 39 children were evaluated. Most of the failure cases were noted in second year. The overall success rate is 92% in first year and 75% in second year. Patient who has more than 16 caries lesions had 4.22 times of hazard ratio than who has less than 16 caries lesions. Teeth with lesion had 2.66 times of hazard ratio than teeth without lesion. The pre-operative clinical symptom and radiographic radiolucency in ante-rior teeth and the size of lesion in posterior teeth significantly affect the success rate of pulpectomy. Conclusions: Both child-related factors and teeth-related factors are associated with the success rate of pulpectomy under general anesthesia. The size of lesion had significant different in posterior teeth.

關鍵字

primary tooth ； pulpectomy ； pulp therapy ； general anesthesia ； success rate

並列摘要

前言：拔髓術是治療乳牙不可逆牙髓炎常用之術式，其成功率受到許多因素的影響。目的：本研究的目的在探討於全身麻醉下進行之乳牙拔髓術其成功率的影響因素。材料與方法：以病歷回顧的方式，評估台北市立萬芳醫院2015至2019年間，於全身麻醉下治療之孩童，具有接受乳牙拔髓術處置。檢視術前各種臨床變項及術後臨床與X光片做評估。根尖片，以統計軟體SAS分析臨床及影像學等變因與成功率的相關性，並分析整體成功率之趨勢。結果：共有39為孩童，144顆牙齒接受拔髓術治療，追蹤時間為6－45個月。第一年的成功率為92%。大部分的失敗出現在第二年。病人具有16個蛀牙疾區以上的，其失敗率為少於16個的4.22倍。前牙術前沒有病灶與成功率有顯著相關；若加入時間因素分析，則不論是前牙或後牙，術前有病灶與成功率皆有顯著相關。另外，前牙部分若術前有腫痛症狀，也與成功率有顯著相關。乳牙拔髓術整體成功率逐年下降。結論：患者與患齒的初始狀態是影響乳牙拔髓術成功率的顯著因素。

並列關鍵字

乳牙；拔髓術；牙髓治療；全身麻醉；成功率

國際替代計量

Analysis of Success Factors Associated with Primary Tooth Pulpectomies Performed Under General Anaesthesia

全文下載

主題瀏覽