Pain and Swelling Related to One-step Pulp Treatment in Children

Objectives: More young children are suffering from early childhood caries and many of them need endodontic treatment at early age. The one-step pulp treatment, gradually applied to adult patients, is doubted by most Chinese pediatric dentists. This study, therefore, was to determine whether postoperative pain and swelling experienced in the recovery period was different for those young children who received both one-step pulp treatment and routine endodontic procedure.

Methods: 40 children of 2- to 8-year-old, with at least two teeth suffering from periradicular periodontitis and having no previous endodontic treatment experience, were selected for the study after informed consent was obtained. The teeth were randomly assigned to two groups. Teeth in group 1 were obturated with Vitapex immediately after instrumentation and debridement for the first visit. Teeth in group 2 were medicated with formocresol pellet after instrumentation and debridement for one week and obturated with the same paste for the second visit. Staff and caregivers blinded to the treatment design made observations of postoperative pain and swelling. Any other adverse effect was recorded.

Results: There was no difference in postoperative swelling, as recorded by the staff and caregivers between the two groups, however, more children complained of transitory postoperative pain for those teeth receiving one-step endodontic therapy, 5/40 compared to 2/40. No other side effect had been reported.

Conclusions: As one-step pulp treatment could save children time without causing postoperative swelling, the transitory postoperative pain could be a notable consideration keeping pediatric dentists from accepting it as an alternative to the routine procedure.