Clinical Findings in 609 Patients with Suspected Endodontic Treatment Failure Following Previous Pulpotec Use: A Case Series from Waddan, Libya

Abstract

Persistent or recurrent symptoms following dental treatment may be associated with residual or recurrent infection, inadequate sealing, recurrent caries, or other endodontic and periodontal conditions. Accurate assessment requires clinical examination and evaluation. To describe the sex distribution and tooth-group distribution of 609 patients presenting with clinical concerns after previous treatment reportedly involving Pulpotec at Elsiraj Dental Clinic, Waddan, Libya, between March 2014 and December 2016, and to investigate the association between sex and tooth group. This descriptive case series used aggregate data from the original clinical report. The dataset included 609 records classified by sex and six tooth groups: upper premolars, lower premolars, upper molars, lower molars, upper anterior teeth, and lower anterior teeth. Frequencies and percentages were calculated. Pearson’s chi-square test was used to assess the association between sex and tooth group, and Cramér’s V was calculated to describe the strength of association. Statistical significance was defined as p < 0.05. Of the 609 records, 358 (58.8%) were female and 251 (41.2%) were male. Upper premolars were the most frequently represented tooth group (194; 31.9%), followed by lower molars (112; 18.4%), upper anterior teeth (111; 18.2%), upper molars (109; 17.9%), lower premolars (61; 10.0%), and lower anterior teeth (22; 3.6%). The association between sex and tooth group was not statistically significant (χ² = 9.26, df = 5, p = 0.099; Cramér’s V = 0.123). The sample contained a higher proportion of females than males, and upper premolars were the most frequently recorded tooth group. No statistically significant association was identified between sex and tooth group. Because the available data did not include a comparison group, a denominator of all teeth originally treated with Pulpotec, or standardized treatment outcomes, the findings cannot establish causation or estimate a treatment-failure rate. All the available data (all teeth) were originally treated with Pulpotec without standardized endodontic treatment, which prevents establishing the cause of endodontic treatment failure.