Survival rate of pulpectomy in primary teeth using Feapex® paste: a clinical study in infants

Abstract

Objective: The aim of this clinical study was to evaluate the survival rate of a new pulpectomy protocol using
2% chlorhexidine digluconate gel and Feapex paste for endodontic treatment in primary teeth. Material and
Methods: A total of 105 pulpectomies were performed in anterior and posterior teeth of 48 infants (1-3 years
old) with high caries experience with irreversible pulpitis or pulp necrosis. All treatments were performed by
dental surgeons with no specialization in Pediatric Dentistry, under local anesthesia and rubberdam isolation.
Manual files were used in conjunction with 2% chlorherixidine gel for root canal instrumentation, and Feapex®
paste was used as a obturation material. The clinical and radiographic outcomes were collected by one trained
independent evaluator with a follow-up period of 24months. Success was determined by the absence of pain,
pathological mobility, pathologic bone rarefaction, pathological root resorption and soft tissue pathology around
the affected tooth Survival of the endodontic treatment was evaluated by estimating survival rates through
Kaplan-Meier curves. Cox Regression analysis with shared fragility were performed to evaluate the association
between the independent variables to endodontic treatment failure (alpha=5%). Results: After 24 months, the
treatment survival was 86% (SE=0.03). Root resorption at baseline was associated with a higher risk of failure
(HR=2.81; CI=1.12-7.08; p=0.027). The survival rate of the endodontic treated teeth due to dental trauma
was 100%, while teeth with dental caries had lower survival rate (85.05%; p<0.001*). Other variables analyzed
included gender, age of the child, tooth position (incisor/molar), restoration type, obturation quality, and
caries experience were not associated with treatment failure (p>0.05). Conclusion: The new protocol using
2% chlorhexidine digluconate and Feapex® presented a high survival rate and can be considered as a suitable
protocol for pulpectomy in primary teeth.Trial Registration: REBEC (RBR-282s2f).
KEYWORDS
Root canal treatment; Primary teeth; Infants; Pulpectomy.