RESEARCH PROPOSAL

DELLOR EWOENAM KWASI TITLE: AN AUDIT OF THE OUTCOMES OF PULPOTOMIES IN CHILDREN ATTENDING THE UNIVERSITY OF GHANA DENTAL SCHOOL (UGDS) CLINIC BETWEEN 2010 AND 2012 INTRODUCTION Carious primary teeth with pulpal involvement or traumatic exposure of pulps of primary teeth that remain vital can be treated by a technique called vital pulpotomy as compared to root canal therapy in adult teeth. The pulp of primary or deciduous teeth, which only have to survive until permanent teeth erupt, and because they have a better blood supply, can sometimes be saved. The treatment involves removal of the coronal pulp, application of medicaments and restoring the tooth to maintain function and arch length until its exfoliation and the eruption of its successor. Primary teeth in children have relatively large pulp spaces and a cavity does not have to get very large before it reaches the pulp chamber. When pulpal tissue is infected and inflamed, it can be removed by a dentist under local anaesthetic. If the soft tissue in the canals is still healthy enough, a special medicated filling can be put into the chamber in an attempt to keep the remaining pulp in the pulp canals alive. The removal of the infected pulp from the chamber is the actual pulpotomy, although the word is often used for the entire process including placement of the medication. First, the decay is removed, and then the pulp chamber is removed usually with a high-speed bur or spoon excavator. A small cotton ball damp with formocresol is placed to fix the pulp stumps and to sterilize the area. After a couple of minutes, the cotton ball is removed and the opening is sealed usually with glass Ionomer cement. Stainless steel crown is sometimes used to restore the tooth. The most common medication used to treat pulpotomized teeth in the University of Ghana Dental School is formocresol. Other methods include Ferric Oxide, mineral trioxide aggregate (MTA), electrosurgery and even lasers. As mentioned earlier, the aim of pulpotomy treatment is to keep the pulp alive for a period of time till it exfoliates. As such factors that lead to failure or success of the treatment should be considered during treatment. These include the inability of the tooth to tolerate the procedure or the medication. Failure to completely remove the decay leading to an abscess formation after the tooth is restored. A filling can be lost if the tooth breaks and the filling is no longer held in place. It is also possible for new decay to start along the edge of a filling that would result in the filling falling out. It is also possible for an improperly placed filling to fail. It is therefore important to determine the success or failure rates of pulpotomies carried out at the UGDS clinic and find out reasons for failed pulpotomies. AIM To assess the outcome of pulpotomies on primary teeth at the University of Ghana Dental School clinic between 2010 and 2012 OBJECTIVES 1. To determine the percentage of pulpotomy failures at the UGDS clinic 2. To determine the leading cause of pulpotomy failures at the UGDS clinic

RESEARCH PROPOSAL

METHODOLOGY Patient folders between 2010 and 2012 will be retrieved from the records office with approval from the relevant authorities. A questionnaire would be designed to record relevant information from the folders without revealing patient names. The questionnaire would include information on the age and sex of the patient, cause of tooth pathology requiring the pulpotomy, the medicaments used, restorative materials used and final treatment done for failed pulpotomies.

TIMETABLE Introduction and Literature Review Methodology Sample Collection Sample Analysis Discussion Recommendations and Conclusion Submission May-June July August September October November December

BUDGET Printing of Questionnaires and Other Letters Contingencies GHC 50.00 GHC50.00

REFERENCES 1. Farooq, N. S., Coll, J. A., Kuwabara, A., & Shelton, P. (2000). Success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth. Pediatric Dentistry. pp 22, 278-286.

2.

The American Academy of Pediatric Dentistry (AAPD). (2009) V 34 /NO 6. Guideline on Pulp Therapy for Primary and Immature Permanent Teeth

3.

Fuks A. B. (2005).Inkham JR, Casamassimo PS, Fields HW Jr, McTigue DJ, Nowak A. Pulp therapy for the primary dentition Pediatric Dentistry: Infancy Through Adolescence. 4th ed. Elsevier Saunders. Pp 375-93