Estimation of Pulpitis Prevalence in Primary Dentition

Objective: Assessment of distribution of pulpitis in primary dentition on an individual and community scale. Material and Methods: Subject of the study are 67 children with primary dentition and performed minimum one endodontic treatment of a deciduous tooth. Totally 37 girls and 30 boys are included into this research. Child‘s minimal age equals to four and maximum age of participants is six. The research has been carried out at the Faculty of Dental Medicine, Medical University “Prof. Dr. Paraskev Stoyanov”-Varna, in the period 2015-2017. The researchers are specialists at Pediatric Dentistry. Irreversible caries lesions with pulp involvement, categorized as D4, have been investigated through this retrospective study based on medical records of participants. Actual survey data processing package for mathematical and statistical analysis SPSS 20.0 was applied. Results: Approximately half of all the children who have taken part in the research, namely 46, 30 %, are characterized with two endodontic treatment procedures performed. One clinical situation of endodontic therapy concerns 22, 40 % of all the participants. Maximum five teeth affected by pulpitis have been recorded per individual primary dentition. Conclusion: Pulpitis is widely distributed in deciduous teeth.


Introduction
The first half of the 20 th century is marked by intensive development of the conception of the explicit necessity of endodontic treatment of teeth affected by complicated decay processes of pulpitis and periodontitis. There has been going on an incessant process of optimization of X-Ray image diagnostics' methods, techniques of anesthesia administration and therapy approaches [1]. Since the year 1970 there has been a definite tendency of application of a variety of medicines, corresponding to the biological and physiological characteristics of teeth in norm, as well as to the pathological alteration of dental structures in conditions of pulp or periodontium inflammatory or traumatic disintegration [2].
It has been scientifically established that approximately 90% of the patients of child's age, seeking for urgent dental cares, are affected by symptoms of pulp or periodontal diseases [3][4]. The high rate of these noxae correlates with the requirement Pediatric Dentistry specialists to be thoroughly acquainted with the frequency of occurrence and indications of treatment of pulpitis in primary teeth [5][6]. Timely performed diagnostics and efficient therapy have the potential to prevent progression of the disease, related to possible complications. According to the research performed by Rehana YB et al. [7] with typical indications for endodontic treatment are characterized mostly primary teeth with necrotic pulp, namely 47, 5% of all the tested teeth, followed by these with the diagnosis of irreversible pulpitis-42, 5% of all the teeth included in the study. It has been established that 6, 5% of all the deciduous teeth for endodontic treatment were under the impact of traumatic injury of pulp. A ratio of 2, 5% of the total number of the investigated primary teeth have been indicated for endodontic therapy as a consequence of complicated secondary carious lesion. And in only 1% of all the cases the registered cause for endodontic treatment has been ascertained to be chronic hyperplastic pulpitis [7]. In

Objective
The aim of our study is the assessment of distribution of pulpitis in the primary dentition on an individual and community scale.

Material and Methods
Materials Subject of the study are 67 children. The number of girls included is 37 and boys amount to 30 representatives of the research. The average age of all the participants is 5.1 ± 0.8. Child's minimal age equals to 4, maximum age is 6.

Methods
The

Discussion
In the context of our investigation we have established that the average value of the frequency of pulpitis of primary teeth per child equals to 1, 55 ± 0, 93. The number of clinical findings of pulpitis varies from 0 to 8, concerning the age period between 4 and 6 years of age. The results obtained serve as ascertainment of the thesis that pulp inflammation is widely distributed in that age interval. The values definitely confirm the high frequency of caries complications in cases of postponed professional treatment provided by a specialist in the sphere of pediatric dentistry. The results commented are similar to those reported by Yohra et al [11].
Research performed by Rehana B et al. [7] differs from previous studies regarding the role of traumatic injuries as an etiological factor for pulp inflammatory processes. It has been concluded that traumas are not basic indication for endodontic treatment. Traumas are most often related to single clinical cases of emergency [7] and treatment [13] in children with primary dentition. According to other researchers the most frequent established clinical finding related to the need of endodontic therapy is pulp necrotic alteration. Banday N et al [12] represent and support the thesis that the most significant indication for endodontic treatment is irreversible pulpitis in child's age [12].

Conclusions
The average value of the frequency of pulpitis equals to 1, 55 ± 0, 93 per child. The highest relative ratio of conducted endodontic therapy in primary dentition, regarding 46, 27% of all the participants included, amounts to 2 clinical cases of endodontic procedures. An average value of 2, 25 ± 1, 39 endodontic procedures have been registered by a child. Although there is a great variety of prophylactic procedures oriented towards control of tooth decay and its complications, the distribution of pulpitis has still been related to considerable consequences. There is a need to be formulated efficient preventive strategies in the context of health-related educational programs, addressed to dental medicine doctors. The aim is early performed diagnosis and treatment of dental carious lesions, resulting in reduction of the risk for pulp inflammation.