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Caries Color, Extent, and Preoperative Pain as Predictors of Pulp Status in Primary Teeth

Authors Ghaderi F, Jowkar Z, Tadayon A

Received 6 May 2020

Accepted for publication 25 June 2020

Published 3 July 2020 Volume 2020:12 Pages 263—269


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Christopher E. Okunseri

Faezeh Ghaderi,1 Zahra Jowkar,2 Alireza Tadayon3

1Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran; 2Oral and Dental Disease Research Center, Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran; 3Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence: Zahra Jowkar Tel +98-71-36263193
Fax +98-71-36280804

Aim: This study aimed to assess the relationship between preoperative pain status, caries extent, and caries color and the ability to achieve hemostasis at the canal orifices during pulp therapy access in primary teeth.
Study Design: Eighty primary molar teeth with extremely deep caries extending to the pulp (based on bitewing radiography) were investigated in 66 children. The teeth with clear radiographic and clinical signs indicating the involvement of the radicular pulp were excluded. The history of preoperative pain status, the color of dental caries by visual inspection, and the extent of caries lesion measured in bitewing radiographs were recorded. After preparing the access cavities, the hemostasis achievement at the canal orifices was assessed and considered as the final factor in determining the type of treatment (pulpotomy or pulpectomy). The data were analyzed using Fisher’s exact test, the independent t-test, and Cohen’s unweighted kappa statistic. P< 0.05 was considered statistically significant.
Results: Hemostasis was achieved in 78.1% of the teeth with black dental caries, whereas in most of the teeth with light brown dental caries (64.3%), hemostasis was not achieved (p=0.015). The extent of dental caries in the teeth needing pulpotomy was statistically significantly lower than that of those needing pulpectomy (p=0.024). Mesial side dental caries was more related to the irreversible pulpitis compared to the distal one (p=0.01). In 78.1% of the teeth without pain, hemostasis was achieved, and in most of the teeth with nocturnal pain (64.3%), hemostasis did not occur (p=0.034).
Conclusion: The caries color, caries extent, and preoperative pain have the potential to be used as clinical diagnostic tools to determine the pulpal status in primary teeth.

Keywords: caries color, caries extent, hemostasis, pain, pulp treatment

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