الفهرس 
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Abstract
X- Summary
Non-Vital pulp therapy in primary molars has a fundamental role in pediatric dentistry preserving tooth function and dental arch integrity.
Thus, the evaluation of the clinical and radiographic performance of pulpectomy in necrotic primary molars is of paramount importance for the management of dental caries, preservation of teeth until natural exfoliation and preventing space loss and its consequences on the occlusion in the pediatric patient.
The study had two parts:
1. Pulpectomy of necrotic primary molars using rotary files and obturation with Metapex in a single visit and coverage using SSC.
2. Extraction of non- restorable primary molars and placing a band and loop space maintainer
In the Pulpectomy group, radiographic and clinical evaluation were done and followed up in 6, 12 and 18 months. Evaluation of success and failure was done by using the Modified Zurn & Seale Criteria.
In the extraction group, assessment whether the band and loop space maintainer was in place or dislodged was evaluated.
In both groups, pain encountered during the procedures using Wong Baker Faces Scale and time using stop watch at baseline were evaluated. GI assessment and OHrQoL were evaluated at baseline and in follow up period at 6,12 and 18 months.
The study sample comprised 42 children aged (4-7) years, who were admitted to the Pediatric Dentistry and Dental Public Health Clinic, Faculty of Dentistry, Ain-shams University. 21 teeth were eligible for pulpectomy and 21 teeth were eligible for extraction and placement of space maintainer.
In the pulpectomy group, preoperative clinical and radiographic evaluation was done followed by administration of local anesthesia and rubber dam isolation. Access cavity was prepared using high speed round bur and root canals were cleaned and shaped using rotary files mounted in Endo motor with NaOcl irrigation following each file. Paper points were used followed by obturation using Metapex in the canals and a mixture of zinc oxide powder mixed with metapex in the coronal part. Full coverage by SSC was done in the same visit.
In the extraction group, after administration of local anesthesia, alginate impression was taken and sent to the lab, extraction of the tooth was done and then in the next visit band and loop was cemented.
The following is a summary for the results:
1. The pulpectomy group showed radiographic success rates in the follow up periods where 11 cases (52.38%) showed no pathological pathology after 18 months follow up, giving a significant difference p-value<0.001. The only radiographic failures were in the form of 2 cases (9.52%) (internal root resorption) and 8 cases (38.10%) (external root resorption). However the reported radiographic failure, clinical success was in almost all cases, 18 teeth (85.71%) showed no signs or symptoms for pain or infection.
2. Pain assessment between the two groups was (2.29±1.31) for pulpectomy group and (5.24±1.41) for extraction group giving a significant difference p-value<0.001
3. Regarding the gingival heath, there was a significant difference between the two groups, GI for the pulpectomy group at 6 months (1.00±0.26), where it was calculated (1.27±0.22) giving a significance difference p- value=0.004. Significant difference was also found in the 12 and 18 months follow up intervals in favour of the SSC.
4. There was significant difference regarding time between pulpectomy and extraction group, (16.25±1.75) and (8.76±2.21) respectively giving a significant difference p-value<0.001
5. The satisfaction score of the SOHO-5 quality of life questionnaire was in favor of the pulpectomy group in all follow up intervals.