According to a randomized clinical trial, pulpectomy demonstrated enhanced oral health-related quality of life (OHRQoL) and reduced anxiety levels 12 months post-treatment, when compared to tooth extraction. Jenny Abanto et al. sought to evaluate how two approaches for treating primary molars with pulp necrosis (extraction or pulpectomy) affect the OHRQoL in children.

The study enrolled a hundred children between the ages of 3 and 5 years, each having a minimum of 1 necrotic primary molar. They were chosen and randomly assigned to different study groups. Parent proxy reports used Brazilian version of the early childhood oral health impact scale (B-ECOHIS) to assess OHRQoL of volunteers at the beginning of the study and again at 4, 8, and 12 months.

To analyze the differences between the groups in the study, the researchers employed bootstrap linear regression for B-ECOHIS scores, logistic regression for self-reported dental pain, and anxiety scores, with α = 5%. The mean (standard deviation [SD]) B-ECOHIS scores at the start and after 12 months for the pulpectomy group and the extraction group are depicted in Table 1.

Both treatments led to a significant improvement in OHRQoL, but the tooth extraction group exhibited higher scores across the total B-ECOHIS and most domains, depicting a reduced OHRQoL. Additionally, dental extraction was associated with greater anxiety levels in comparison with pulpectomy (odds ratio = 2.52). In comparison with tooth extraction, pulpectomy led to better improvements in OHRQoL scores following 12 months, indicating that it should be the treatment of choice for necrotic primary molars.