Indirect Pulp Treatment of Primary Posterior Teeth: a Retrospective Study

Purpose: This study was performed to assess retrospectively the clinical and radiographic success of indirect pulp treatment (IPT) on primary posterior teeth, and to compare the influence of caries risk, skills of the operator, and restorative material on the success of IPT.

Methods: A retrospective review of records of patients treated with IPT in the pediatric dental clinic at The University of Michigan, School of Dentistry from July 1993 through July 1999 was completed in January 2000. Two hundred fifty-five records with IPT were reviewed, from which 132 patients met the inclusion criteria, with 187 primary posterior teeth treated with an IPT. The patients were followed clinically and radiographically for a time ranging between 2 weeks to 73 months. Data were analyzed using survival analysis methods.

Results: The success of IPT was 95% (178/187 teeth), with only 9 failures. The 1-year probability of survival of each tooth was estimated to be 96% using an exponential survival model. The use of a base over a calcium hydroxide liner significantly increased the success rate of IPT (P = .0095). The use of a stainless steel crown (SSC) after an IPT was significantly more successful than the use of an amalgam (P=.026). IPT performed on primary first molars failed more frequently than on second primary molars (P = .045). There was no significant difference between maxillary and mandibular primary molars.

Conclusions: Indirect pulp treatment is a successful technique and should be considered as an alternative pulp therapy procedure in deeply carious primary posterior teeth. The use of a base over the liner in addition to a SSC dramatically increases the success of an IPT.