EFFECTIVENESS OF TREATMENT METHODS USED FOR IRREVERSIBLE PULPITIS IN PRIMARY TEETH: PULPOTOMY AND PULPECTOMY (SYNTHESIS OF EVIDENCE-BASED DATA)

Abstract

Introduction. Given the high prevalence of pathological pulp involvement in primary teeth, variability of diagnostic criteria used, and the absence of unified clinical guidelines for choosing between pulpotomy and pulpectomy in cases of irreversible pulpitis of primary teeth, it is appropriate to synthesize evidence of the highest level to compare the success of these interventions.Objective of the research. To compare the success rates of pulpotomy and pulpectomy procedures for the treatment of irreversible pulpitis in primary teeth in children based on data from systematic reviews.Materials and methods. Study was conducted as targeted analysis of available systematic reviews focused on the comparative evaluation of the success of pulpotomy and pulpectomy procedures for the treatment of irreversible pulpitis of primary teeth in children. A targeted bibliographic search was performed in the international scientometric databases PubMed/MEDLINE, Scopus, and Web of Science Core Collection without restrictions on year of publication. To identify relevant sources, combinations of keywords and MeSH terms were used, including «primary teeth», «deciduous teeth», «irreversible pulpitis», «pulpotomy», «pulpectomy», and «systematic review».Results and discussions. Analysis of the limited number of available systematic reviews and contemporary clinical studies indicated that both pulpotomy and pulpectomy can provide comparably high levels of clinical and radiographic success in the course irreversible pulpitis treatment within primary teeth in the short- and medium-term. Pulpotomy, particularly when modern pulp-capping materials are used, demonstrated consistently high success rates in carefully selected clinical cases that account for baseline conditions and biological feasibility.In contrast, pulpectomy remains the treatment of choice in the presence of extensive coronal destruction, sinus tract formation, or the inability to achieve adequate sealing.Conclusions. Current evidence supports the feasibility of pulpotomy as a sufficiently effective clinical alternative to pulpectomy in endodontic treatment of primary teeth with signs of irreversible pulpitis, provided that baseline clinical conditions do not contraindicate this procedure (e.g., presence of swelling, sinus tract, or critically compromised structural integrity of the tooth). Available data on the cost-effectiveness of pulpotomy and pulpectomy are fragmented and do not allow for a definitive determination of the economic superiority of one approach over the other, as such outcomes are highly dependent on the clinical scenario, materials used, and organization of care.