Effect of tooth position, root canal morphology, and tooth type on the pulpectomy treatment outcomes in primary teeth

Aim: The aim of this study was to evaluate the effect of tooth position, root canal morphology, and tooth type on the success rates of pulpectomy in primary teeth. Methods: This retrospective study collected the data of primary anterior and posterior teeth treated by pulpectomy due to carious pulp exposures from the dental records of two pediatric dentists between 2020 and 2022. Demographic characteristics, clinical data as well as follow-up details were collected. Clinical and radiographic assessments at 6 and 12 months were analyzed. Pulpectomy treatment was considered as an overall failure if the tooth required extraction or retreatment. Categorical data were compared using the Chi-square test and survival analysis was performed using the Kaplan–Meier test. Results: One hundred and eighteen primary teeth (39 anterior teeth and 79 posterior teeth) were included. Overall pulpectomy failure occurred in 10.3% of anterior teeth, in comparison to 3.8% of posterior teeth with no statistically significant difference ( P = 0.162) at 12 months. Radiographic failure occurred in 12.3% of anterior teeth, in comparison to 32.9% of posterior teeth at 12 months with a statistically significant difference ( P = 0.02). Survival rate analysis of anterior teeth versus posterior teeth was not statistically significant ( P = 0.164). Conclusion: The overall success rates and survival rates of anterior teeth treated by pulpectomy were similar to those of posterior teeth. However, the complex root canal morphology of primary molars showed higher radiographic signs of failure.