AIPMED

ANNALS OF IBADAN POSTGRADUATE MEDICINE

ENDODONTIC TREATMENT IN CHILDREN: A FIVE-YEAR RETROSPECTIVE STUDY OF CASES SEEN AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

B.O. Popoola, O.E. Ayebameru and O.M. Olanloye

Department of Child Oral Health, University of Ibadan/University College Hospital, Ibadan.


ABSTRACT

Background: Endodontic treatment aims at preservation of teeth that are pulpally damaged, consequently make the teeth functional on the dental arch.

Objective: This study aimed at determining the prevalence and pattern of endodontic treatment carried out at the Paediatric dental unit of the University College Hospital, Ibadan over a five-year period.

Materials and methods: This was a retrospective study of all patients below 16 years of age treated for various dental problems in our unit between August, 2010 and July, 2015. The records were reviewed and cases with endodontic treatments selected. Data such as age, gender, endodontically treated teeth, reasons for endodontic treatment and type of endodontic treatment given were retrieved from the patients’ dental records.

Results: A total of 3,237 children were seen during the period under review, out of which 312 (9.6%) received endodontic treatment. There were 159 males and 153 females with a mean age of 10.2 ± 3.5. Children aged 10-13 years had the highest frequency of endodontic treatment (36.8%) and this was majorly due to dental trauma, followed by those aged 6-9 years (28.6%) who were treated mainly for dental caries. Root canal therapy was the most prevalent endodontic treatment in permanent teeth (central incisor; 32.7% and first permanent molars; 14.6%) while pulpectomy was the most prevalent endodontic treatment in primary teeth (p = < 0.001).

Conclusion: Dental caries and trauma were the commonest reasons for endodontic treatment in primary and permanent teeth respectively. The prevalence of endodontic treatment in the studied children was 9.6% with highly invasive and multiple visits endodontic treatment type (pulpectomy and root canal therapy) being the most common. There is a need for early presentation of dental conditions so as to reduce complications which require such endodontic treatments.

 

Keywords: Endodontics, Children, Dental caries, Trauma.

Correspondence

Dr. O.E. Ayebameru

Department of Child Oral Health,

University College Hospital,

Ibadan.

E mail: brodashow@yahoo.com


INTRODUCTION

Functional dentition is an important factor in the process of growth and development of the child patient, therefore preservation of both primary and permanent teeth in a functional state is a major task in achieving good oral health in children.1

Many risk factors have been found to affect the health of dental pulp and consequently cause pulpal infection. Of these factors, dental caries, periodontal disease and dental trauma have been generally reported to be the major and the commonest causes of pulp necrosis and periapical periodontitis.2,3,4 In Nigeria, studies have shown that the commonest cause of tooth loss among children is delayed presentation of dental caries and traumatic dental injury.5,6,7 This late presentation and symptomatic visits attitude has made endodontic treatment inevitable among them.

Endodontic treatment is a procedure that is designed to maintain the health of all or part of the pulp when the pulp is diseased or injured, thereby preserving the tooth that would have been otherwise extracted due to pulpal pathology.8 In a study carried out among Danish population, Kirkevang et al.9 reported that endodontic treatment has invariably led to a decline in the tendency amongst dentists to extract diseased teeth. These treatments aim at prevention of progression of infection, preservation of normal periradicular tissues and restoration of the treated tooth to its proper form and function in the dental arch.10

Endodontic treatment comprises pulp capping, pulpotomy, pulpectomy, apexification, root canal therapy and surgical endodontics such as apicectomy, hemisection, root amputation and replantation.2,11

Recently, regenerative endodontics which is based on tissue engineering and root canal revascularization was introduced to overcome the limitations of apicectomy and apexification in the management of immature tooth with open apex and necrotic pulp.12

The prevalence and pattern of endodontic treatment has been studied among many adult populations, irreversible pulpitis due to dental caries was found to be the leading reason for endodontic treatment performed.13-19 A similar study among children population also reported dental caries as the commonest reason for endodontic treatment while other reasons identified were trauma and developmental anomalies such as dens invaginatus.20 However , previous studies among Nigerian children revealed that traumatic dental injuries was the most common reason for endodontic treatment in these children.21-25 Although in contrary, Ajayi et al.2 also reported dental caries as the dominant reason for endodontic treatment among the studied children in Lagos, Nigeria. The University College Hospital, Ibadan, Nigeria is a tertiary hospital that has well - established dental centre with well-equipped paediatric dentistry clinic which serves Ibadan and its environs. This retrospective study had the objective of determining the prevalence and pattern of endodontic treatment performed in the past five years in the Paediatric dentistry unit of the hospital. This will serve as baseline data from which reference can be made on endodontic treatment acceptability among children in our environment.