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Root canal filling materials for endodontic treatment of necrotic primary teeth: a network meta-analysis

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Abstract

Purpose

To investigate the effect of different root canal filling materials on the change of failure of the endodontic treatment of necrotic primary teeth.

Methods

A literature search was carried out in PubMed/MEDLINE, CENTRAL, Scopus databases, and grey literature up to July 2022 selecting randomised clinical trials related to research question. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Root canal filling materials were grouped according to the main component [iodoform (IOD), calcium hydroxide (CAOH), zinc oxide (ZO) or mix (IOD plus CAOH plus ZO) pastes]. Pairwise and network meta-analyses using the mixed treatment comparisons method were performed to compare the number of events (failure) among treatments. Odds ratio and 95% confidence intervals (CI) for calculated. Post-probabilities among treatments were also calculated and interpreted.

Results

From 1186 potentially relevant studies, 17 were selected for full-text analysis, and 7 were included in the meta-analysis, totalizing 263 teeth. In the direct evidence, ZO pastes resulted in a higher chance of failure than IOD pastes (OR 7.07 95% CI 1.02, 62.59). In the indirect evidence, there was no difference between the materials. The IOD pastes presented a high probability (81%) of being the treatment associated to lowest number of failures among all treatments. The CAOH pastes presented the highest probability of being the worst option. Studies showed high bias risk.

Conclusion

There is currently no scientific evidence of the superiority of any one root canal filling material for endodontic treatment of necrotic primary teeth.

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Authors and Affiliations

  1. School of Dentistry, Postgraduate Program in Dentistry, Federal University of Rio Grande Do Sul, Ramiro Barcelos 2492, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil

    D. Pedrotti, P. A. Bottezini, L. Casagrande & T. L. Lenzi

  2. School of Dentistry, Department of Orthodontics and Pediatric Dentistry, University of Sao Paulo, São Paulo, Brazil

    M. M. Braga

Authors
  1. D. Pedrotti
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  2. P. A. Bottezini
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  3. L. Casagrande
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  4. M. M. Braga
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  5. T. L. Lenzi
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Contributions

DP and PAB performed the methodology and wrote the manuscript; LC contributed substantially to discussion and proofread manuscript; MMB performed the statistical evaluation, contributed substantially to discussion, and proofread manuscript; and TLL conceived the idea, contributed substantially to discussion, and proofread manuscript.

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Correspondence to T. L. Lenzi.

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Appendix

Appendix

Search strategies adapted of the PubMed/MEDLINE database for other databases

Database

Search strategy

Scopus

Deciduous tooth OR primary teeth AND pulpectomy AND root canal filling material OR zinc oxide OR calcium hydroxide OR iodoform

CENTRAL

Deciduous tooth AND pulpectomy

ClinicalTrials.gov

Necrotic primary teeth

REBEC

Necrotic primary teeth

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Pedrotti, D., Bottezini, P.A., Casagrande, L. et al. Root canal filling materials for endodontic treatment of necrotic primary teeth: a network meta-analysis. Eur Arch Paediatr Dent 24, 151–166 (2023). https://doi.org/10.1007/s40368-022-00766-y

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