The survival of vital and non-vital deciduous molar teeth following pulpotomy

Background: There is scant evidence supporting the criteria for establishing the suitability of a deciduous molar for a pulpotomy. Although some criteria, such as patient age, are logical the importance of other factors on tooth survival has not been established. Methods: All pulpotomies performed at 20 school dental clinics over a period of 15 months were reported together with date of birth, gender, tooth treated, presenting signs and symptoms, pulp status and date and method of treatment. Operators performed the treatment according to their usual procedures. Data were analysed statistically using Statview 5.0 (SAS Institute). Results: The outcome of pulpotomy of 465 deciduous teeth in 403 patients was evaluated. The mean age of the patients was 7.4 +/- 0.1 years. Two hundred and seventy-two teeth were vital and 193 were non-vital. One hundred and ninety-six teeth were treated with the one-step formocresol method and 269 with the two-step formocresol method. The age and gender of the patients did not differ between the vital and non-vital groups. There was no influence of mode of treatment on the asymptomatic survival of the teeth in the mouth. The median survival times were significantly longer in vital (32.7 +/- 1.4 months) than non-vital teeth (20.4 +/- 3.0 months; p<0.0001). The only factors significantly influencing the survival of pulpotomized teeth were the age of the patient (p<0.0001), the non-vitality of the pulp (p< 0.0001) and the presence of a radiolucency (p=0.031). Conclusion: Both vital and non-vital teeth were able to survive for extended periods following pulpotomy but the presence of an associated radiolucency or a non-vital pulp at the time of treatment is negatively associated with time of survival.