Subscribe to RSS
Success Rate and Related Factors of Vitapex Pulpectomy in Primary Teeth: A Retrospective StudyFunding None
Objectives Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth.
Material and Methods This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression.
Statistical Analysis The Kaplan–Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors.
Results In total, 647 Vitapex PE teeth from 448 patients (19–121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate.
Conclusions The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.
Article published online:
05 June 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Kubota K, Golden BE, Penugonda B. Root canal filling materials for primary teeth: a review of the literature. ASDC J Dent Child 1992; 59 (03) 225-227
- 2 Fuks AB, Eidelman E. Pulp therapy in the primary dentition. Curr Opin Dent 1991; 1 (05) 556-563
- 3 Rana MJA, Ehsan HRU, Batool M. Success rate of Vitapex® as an obturating material in primary molars. Pak Oral Dent J 2016; 36 (01) 122-125
- 4 Holan G, Fuks AB. A comparison of pulpectomies using ZOE and KRI paste in primary molars: a retrospective study. Pediatr Dent 1993; 15 (06) 403-407
- 5 Coll JA, Sadrian R. Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition. Pediatr Dent 1996; 18 (01) 57-63
- 6 Mortazavi M, Mesbahi M. Comparison of zinc oxide and eugenol, and Vitapex for root canal treatment of necrotic primary teeth. Int J Paediatr Dent 2004; 14 (06) 417-424
- 7 Ozalp N, Saroğlu I, Sönmez H. Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study. Am J Dent 2005; 18 (06) 347-350
- 8 Trairatvorakul C, Chunlasikaiwan S. Success of pulpectomy with zinc oxide-eugenol vs calcium hydroxide/iodoform paste in primary molars: a clinical study. Pediatr Dent 2008; 30 (04) 303-308
- 9 Al-Ostwani AO, Al-Monaqel BM, Al-Tinawi MK. A clinical and radiographic study of four different root canal fillings in primary molars. J Indian Soc Pedod Prev Dent 2016; 34 (01) 55-59
- 10 Chen X, Liu X, Zhong J. Clinical and radiographic evaluation of pulpectomy in primary teeth: a 18-months clinical randomized controlled trial. Head Face Med 2017; 13 (01) 12
- 11 Sadrian R, Coll JA. A long-term followup on the retention rate of zinc oxide eugenol filler after primary tooth pulpectomy. Pediatr Dent 1993; 15 (04) 249-253
- 12 Spedding RH. Incomplete resorption of resorbable zinc oxide root canal fillings in primary teeth: report of two cases. ASDC J Dent Child 1985; 52 (03) 214-216
- 13 American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth. . In: The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry; 2020: 384-392
- 14 Nurko C, Garcia-Godoy F. Evaluation of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth. J Clin Pediatr Dent 1999; 23 (04) 289-294
- 15 Pramila R, Muthu MS, Deepa G, Farzan JM, Rodrigues SJ. Pulpectomies in primary mandibular molars: a comparison of outcomes using three root filling materials. Int Endod J 2016; 49 (05) 413-421
- 16 Rai R, Shashibhushan KK, Babaji P, Chandrappa PM, Reddy VR, Ambareen Z. Clinical and radiographic evaluation of 3Mix and Vitapex as pulpectomy medicament in primary molars: an in vivo study. Int J Clin Pediatr Dent 2019; 12 (06) 532-537
- 17 Nurko C, Ranly DM, García-Godoy F, Lakshmyya KN. Resorption of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth: a case report. Pediatr Dent 2000; 22 (06) 517-520
- 18 Garcia-Godoy F. Evaluation of an iodoform paste in root canal therapy for infected primary teeth. ASDC J Dent Child 1987; 54 (01) 30-34
- 19 Moskovitz M, Sammara E, Holan G. Success rate of root canal treatment in primary molars. J Dent 2005; 33 (01) 41-47
- 20 Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars. Int J Paediatr Dent 2010; 20 (03) 214-221
- 21 Al-Attiya H, Schmoeckel J, Mourad MS, Splieth CH. One year clinical success of pulpectomy in primary molar s with iodoform-calcium hydroxide paste. Quintessence Int 2021; 52 (06) 528-537
- 22 Duanduan A, Sirimaharaj V, Chompu-inwai P. Retrospective study of pulpectomy with Vitapex® and LSTR with three antibiotics combination (3Mix) for non-vital pulp treatment in primary teeth. CMU J Nat Sci. 2013; 12 (02) 131-139
- 23 Brustolin JP, Mariath AA, Ardenghi TM, Casagrande L. Survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. Braz Dent J 2017; 28 (01) 121-128
- 24 Coll JA, Josell S, Nassof S, Shelton P, Richards MA. An evaluation of pulpal therapy in primary incisors. Pediatr Dent 1988; 10 (03) 178-184
- 25 Primosch RE, Ahmadi A, Setzer B, Guelmann M. A retrospective assessment of zinc oxide-eugenol pulpectomies in vital maxillary primary incisors successfully restored with composite resin crowns. Pediatr Dent 2005; 27 (06) 470-477
- 26 Bahrololoomi Z, Zamaninejad S. Success rate of zinc oxide eugenol in pulpectomy of necrotic primary molars: a retrospective study. JDMT 2015;4(02):
- 27 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 (01) 25-29
- 28 Tabassum S, Khan FR. Failure of endodontic treatment: the usual suspects. Eur J Dent 2016; 10 (01) 144-147
- 29 Hargreaves KM, Berman LH. Cohen's Pathways of the Pulp. Eleventh edition. ed. St. Louis, MO: Elsevier; 2016
- 30 Govindaraju L, Jeevanandan G, Subramanian EMG. Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: a single-blinded randomized controlled trial. Eur J Dent 2017; 11 (03) 376-379
- 31 Gisev N, Bell JS, Chen TF. Interrater agreement and interrater reliability: key concepts, approaches, and applications. Res Social Adm Pharm 2013; 9 (03) 330-338
- 32 Amano M, Agematsu H, Abe S. et al. Three-dimensional analysis of pulp chambers in maxillary second deciduous molars. J Dent 2006; 34 (07) 503-508
- 33 Estrela C, Holland R, Estrela CR, Alencar AH, Sousa-Neto MD, Pécora JD. Characterization of successful root canal treatment. Braz Dent J 2014; 25 (01) 3-11
- 34 Songvejkasem M, Auychai P, Chankanka O, Songsiripradubboon S. Survival rate and associated factors affecting pulpectomy treatment outcome in primary teeth. Clin Exp Dent Res 2021; 7 (06) 978-986
- 35 Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: molecular and histological events. J Oral Sci 2007; 49 (01) 1-12