Survival of indirect pulp capping in deeply carious primary molars under local versus general anesthesia: a retrospective cohort study using propensity score matching

This study aimed to evaluate the long-term efficacy of indirect pulp capping performed under general anesthesia or local anesthesia in primary molars with deep caries. It also aimed to investigate factors influencing the success rate. The medical records of children with deeply carious primary molar, who received indirect pulp capping under general anesthesia or local anesthesia from 2022, were screened and collected. Propensity score matching method was used to match the general anesthesia and local anesthesia groups 1:1 based on covariates. Kaplan-Meier survival analysis was conducted and Cox proportional hazards model was applied to analyze the outcomes. Propensity score matching resulted in 120 pairs of matched teeth from 666 teeth meeting inclusion criteria. Subsequently, a total of 14 failures (5.83%) were observed. Kaplan–Meier survival curves and the log-rank test revealed no observable difference in the success rates of indirect pulp capping performed under the two anesthesia methods (adjusted HR: 1.85, 95% CI: 0.62–5.51). In the analysis of the cohort of all teeth, the Cox proportional hazards model showed observable associations between indirect pulp capping and tooth type (HR: 0.34, 95% CI: 0.15–0.77), and restoration technique (HR: 0.48, 95% CI: 0.24–0.97). Age, gender, arch position, decayed tooth surface and anesthesia method had no observable effect on indirect pulp capping success. In this study, the overall survival rate of indirect pulp capping did not decrease observably with time, irrespective of general anesthesia or local anesthesia. Additionally, tooth type and restorative technique are independent prognostic factors for the survival.