Restorative interventions on permanent teeth after vital pulp therapy. A retrospective study on the 12-month success rates

Background: This retrospective study evaluated the 12-month success rates of two different restorative interventions for the management of first permanent molars that have undergone vital pulp therapy (VPT) and correlate the outcome with patient and tooth-related characteristics. Methods: Electronic records of all patients with one first permanent molar treated with VPT and restored at the Department of Pediatric dentistry (NKUA), were retrieved. Data regarding demographic characteristics, type of VPT performed, root developmental stage and type of final restoration were retrieved from patients’ electronic records. Quality of restorations, reason for failure and need for re-treatment at 6 and 12-month post-treatment were evaluated through clinical photos using the Modified United States Public Health Service (USPHS) criteria. Significant correlations were investigated using Fisher’s exact test and associations between development of a default and patient and tooth-related characteristics by multivariate regression analysis. Results: From the 42 molars included, majority were from the upper arch (55%), had undergone pulpotomy (74%) and were sealed with pre-formed metal crowns (PMC) (71%). Success rates were high (>75%) but slightly decreasing with time. PMCs showed overall a more favorable performance, with differences between and within the groups not being significant. Re-treatment was required in eight restorations (19%), with major defaults on marginal adaptation and proximal contact for PMCs and secondary caries and marginal discoloration for adhesive restorations. No significant associations were detected between failure and patient- or tooth-related characteristics (p > 0.05). Conclusions: PMCs and adhesive restorations are good restorative materials of teeth that have undergone VPT, demonstrating an excellent long-term performance and directly affecting the outcome of the pulp therapy.

Vital pulp therapy; Preformed metal crowns; Adhesive restorations; Composite; Onlays; Child; Pediatric patients

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