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Awad R, Musa M, Elhoumed M, Liu F, Guo Q. Comparison of Endoflas and Zinc Oxide Eugenol as Root Canal Filling Materials for Pulpectomy in Deciduous Teeth: a Systematic Review and Meta-Analysis. Saudi Dent J 2024; 36:821-829. [PMID: 38883905 PMCID: PMC11178956 DOI: 10.1016/j.sdentj.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 06/18/2024] Open
Abstract
Objectives To evaluate and compare the effectiveness of Endoflas and Zinc Oxide Eugenol (ZOE) as root canal filling materials (RCFMs) for the pulpectomy of deciduous teeth by analyzing multiple clinical and radiographic success and failure follow-ups in previously published studies. Data All clinical studies that investigated the pulpectomy of the deciduous teeth of children aged 3-9 years. Sources The databases used for source identification included MEDLINE (via PubMed), Scopus, Web of Science, and the Cochrane Library. No limitations were imposed on the publication year or language. The selection of studies and extraction of relevant study characteristics were conducted from December 26, 2021, to September 7, 2023. Additionally, the risk of bias (RoB) in the included studies was evaluated by using a RoB instrument (RoB 2). Eligible studies were then combined, and a random-effects model was applied by using the maximum likelihood estimations of log risk ratios and their corresponding 95% confidence intervals. Study selection Of the 3913 records found in the abovementioned databases, nine were eligible for systematic review and eight were eligible for meta-analysis. The studies included 628 pulpectomies of deciduous molar teeth in children. The overall results showed that compared with Endoflas, ZOE was associated with a higher risk ratio for clinical evaluation (LOG[RR] = 0.06, CI 0.03-0.09, p-value 0.001) and radiographic evaluation (LOG[RR] = 0.68, CI 0.35-1.00, p-value 0.001). This association was highly significant at 6- and 9-month follow-ups. Conclusion Compared with ZOE, Endoflas was associated with a lower risk of the clinical and radiographic failure of deciduous teeth pulpectomy and a 6%-6.8% higher risk ratio, especially at 6- and 9-month follow-ups. Clinical significance This study suggests the superiority of Endoflas over ZOE as an RCFM for deciduous teeth.
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Affiliation(s)
- Riham Awad
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Department of Pediatric Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Department of Pediatric Dentistry, Faculty of Dentistry, International University of Africa, 11111 Khartoum, Sudan
| | - Mazen Musa
- Department of Stomatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Department of Orthodontics, Al Tegana Dental Teaching Hospital, Faculty of Dentistry, University of Since and Technology Omdurman, 11111 Khartoum, Sudan
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
- National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania
| | - Fei Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Department of Pediatric Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
| | - Qingyu Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
- Department of Pediatric Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an 710061, China
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Rhaiem M, Elelmi Y, Baaziz A, Chatti M, Maatouk F, Ghedira H. Alternative root canal filling materials to zinc oxide eugenol in primary teeth: a systematic review of the literature. Eur Arch Paediatr Dent 2023; 24:533-547. [PMID: 37803184 DOI: 10.1007/s40368-023-00839-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/26/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE The aim of this review was to compare the currently available root canal filling materials for primary teeth to zinc oxide eugenol (ZOE) to find a suitable alternative. The search question was: which root canal filling materials used in pulpectomy for primary teeth give better clinical and radiographic success rates than ZOE? METHODS A systematic search was conducted using five databases, namely Cochrane central register of controlled trials (CENTRAL), MEDLINE via PubMed, Science Direct, Scopus and EBSCOhost using a selection of "MeSH terms". The "Modified Jadad Scale" was used for the methodology assessment of the included studies. RESULTS Out of 480 articles identified in the initial search, 8 articles met all the inclusion criteria. The results showed that, compared to ZOE, ZOE with calcium hydroxide and iodoform had better clinical and radiographic success rates, a resorption rate similar to that of the roots, faster resorption of extruded particles and a maximum decrease in the size of pre-operative inter-radicular radiolucencies. CONCLUSION Numerous materials, proposed and used by clinicians in root canal filling in primary teeth, can be recommended as alternatives to ZOE. However, none of them could be the ideal material in primary teeth. Thus, more high-quality well-designed randomised clinical trials are required to develop more high-performing materials.
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Affiliation(s)
- M Rhaiem
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia.
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia.
| | - Y Elelmi
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia
| | - A Baaziz
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia
| | - M Chatti
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia
| | - F Maatouk
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia
| | - H Ghedira
- Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia
- Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia
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Castro M, Lima M, Lima C, Moura M, Moura J, Moura L. Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial. Int J Paediatr Dent 2023; 33:335-345. [PMID: 36719000 DOI: 10.1111/ipd.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis. AIM To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis. DESIGN Eighty-eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months. RESULTS At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p = .45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00). CONCLUSION After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis.
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Affiliation(s)
- Marcus Castro
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
| | - Marina Lima
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
| | - Cacilda Lima
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
| | - Marcoeli Moura
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
| | - Joyce Moura
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
| | - Lúcia Moura
- Graduate Program in Dentistry, Federal University of Piauí, Teresina, Brazil
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Irzooqee AF, Al Haidar AHMJ, Abdul-Kareem M. The Effect of Different Obturation Techniques in Primary Teeth on the Apical Microleakage using Endoflas: A Comparative In Vitro Study. Int J Dent 2023; 2023:4982980. [PMID: 37033128 PMCID: PMC10081900 DOI: 10.1155/2023/4982980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
Objectives This study was carried out to quantitatively evaluate and compare the sealing ability of Endoflas by using different obturation techniques. Materials and Methods After 42 extracted primary maxillary incisors and canines were decoronated, their canals were instrumented with K files of size ranging from #15 to #50. In accordance with the obturation technique, the samples were divided into three experimental groups, namely, group I: endodontic pressure syringe, group II: modified disposable syringe, and group III: reamer technique, and two control groups. Dye extraction method was used for leakage evaluation. Data were analyzed using one-way ANOVA and Dunnett's T3 post hoc tests. The level of significance was set at p < 0.05. Results Endodontic pressure syringe had significantly less leakage than the modified disposable syringe and reamer techniques (p < 0.05). Meanwhile, no significant difference was found in the mean leakage between the modified disposable syringe and the reamer techniques. Conclusion Amongst all the techniques used in this study, endodontic pressure syringe could be preferred as an obturation technique in primary teeth when used with Endoflas obturation material because of its potential to provide good apical seal.
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Affiliation(s)
- Alaa Fadhil Irzooqee
- Department of Pediatric and Preventive Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | | | - Maha Abdul-Kareem
- Department of Pediatric and Preventive Dentistry, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq
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Does the use of natural products for endodontic therapy in primary teeth have sufficient evidence for clinical practice? A scoping review. Clin Oral Investig 2022; 26:6043-6060. [DOI: 10.1007/s00784-022-04633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/12/2022] [Indexed: 11/27/2022]
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Silva Junior MF, Wambier LM, Gevert MV, Chibinski ACR. Effectiveness of iodoform-based filling materials in root canal treatment of deciduous teeth: a systematic review and meta-analysis. Biomater Investig Dent 2022; 9:52-74. [PMID: 35615468 PMCID: PMC9126566 DOI: 10.1080/26415275.2022.2060232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction The objective was to review the effectiveness of iodoform-based compared to noniodoform-based filling materials in the root canal treatment of deciduous teeth. Methods This systematic review and meta-analysis used randomized clinical trials with six months or more follow-up. The risk of bias of individual studies and the certainty of the evidence were evaluated (Cochrane risk of bias tool and GRADE, respectively). Results The initial search resulted in 5,127 studies after removal of duplicates. After screening by title and abstract, 34 full-text studies were eligible and 21 remained in the qualitative synthesis and 19 in the meta-analysis. Iodoform-based filling materials resulted in fewer clinical failures when compared to noniodoform-based filling materials at the 6 months (OR = 0.43, 95%CI: 0.19–0.97, p = .04) and 9–12 months (OR = 0.46, 95%CI: 0.23–0.93, p = .03), but not at the 18–30 months follow-up (OR = 1.08, 95%CI: 0.58–2.03, p = .81). When considering radiographic failures, there was no statistical difference between iodoform-based and noniodoform-based filling materials at the 6 months (OR = 0.72, 95%CI: 0.39–1.32, p = .29) and 18–30 months follow-ups (OR = 1.06, 95%CI: 0.51–2.21, p = .87), but fewer radiographic failures were detected at the 9–12 months follow-up (OR = 0.49, 95%CI: 0.29–0.80, p = .005). Conclusion Iodoform-based filling materials showed better clinical and radiographic performance when compared to non-iodoform-based filling materials in the short term, and similar performance in the long term. However, most of the studies exhibited unclear or high risk of bias and the overall certainty of the evidence ranged from low to very low. Therefore, new randomized clinical trials must be accomplished to corroborate this conclusion.
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Affiliation(s)
| | - Leticia Maíra Wambier
- State Universiy of Ponta Grossa, Avenue General Carlos Cavalcanti, Ponta Grossa, Brazil
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Talreja N, N D S, Singla S, Mali S, Agrawal N, Lohiya J. Comparative evaluation of the vertical and horizontal root fracture resistance of primary maxillary incisors obturated with zinc oxide eugenol, vitapex, and endoflas: An in vitro study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_206_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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