Efficacy of an iodoform-based filling material for pulpectomy of primary teeth: A 24-month non-inferiority randomized clinical trial

Comparative Evaluation of the Quality of Obturation Between Three Obturation Techniques in Primary Canines: An In Vitro Study

Aims This study compares three obturation techniques (rotary lentulo spiral, handheld lentulo spiral, and pressure syringe) for the quality of two filling pastes (zinc oxide eugenol (ZOE) paste and Metapex (Meta Biomed Co., Ltd., Chungcheongbuk-do, Korea). Methods and materials Sixty extracted primary canines were instrumented and obturated by filling materials. The obturation techniques were divided into three groups according to different obturation techniques. Obturation quality was evaluated for length, density, and presence of voids by using digital radiography. Results This study showed that the handheld lentulo spiral technique using Metapex and ZOE exhibited more optimal fillings for obturation length. The highest density obturation was achieved using the syringe injection approach with Metapex and ZOE. The highest incidence of both external and internal voids was observed in the group using ZOE with the handheld lentulo spiral technique Conclusions Based on the findings of this study, for both filling materials, the handheld lentulo spiral technique had the greatest number of optimal lengths but there were also more voids.

CONSORT statement adherence and risk of bias in randomized controlled trials on deep caries management: a meta-research

BACKGROUND

Recently, trials have supported changes in deep caries management. However, reporting might lack details, affecting interpretation and implementation. Thus, we aimed to evaluate the adherence to the CONSORT statement and the risk of bias of randomized controlled trials (RCTs) on deep caries management published in pediatric dental journals.

METHODS

We searched PubMed for RCTs in six pediatric dental journals between 2010 and 2022, focusing on deep caries lesion management. Adherence to the CONSORT guideline and the risk of bias were assessed using a modified tool with 19 items; each scored from 0 to 2 (maximum of 38 points), and the Cochrane risk-of-bias (RoB 2) tool. We performed descriptive and regression analyses (α = 5%).

RESULTS

We analyzed 127 RCTs. The mean (standard deviation) CONSORT adherence score was 21.1 (6.7). Notably, 96.1% of the studies received a score of 2 for the "intervention" item, whereas 83.5% scored 0 for the "estimated effect size". The risk of bias assessment revealed that 40.2% of the RCTs were at high risk, 59% were at low risk, and 0.8% were at low risk. RCTs with a high risk of bias had lower CONSORT scores (p<0.001) than those with low or some concerns. RCTs published in journals without the endorsement of the CONSORT statement had lower scores than those in journals with the endorsement of the CONSORT statement. Older RCTs (6-10 years old and more than 10 years old) showed significantly lower CONSORT statement compliance than trials published recently within 5 years.

CONCLUSION

Adherence to the CONSORT was relatively low among the investigated RCTs. Moreover, lower adherence to the CONSORT was associated with a higher risk of bias.

TRIAL REGISTRATION

This study protocol was prospectively registered on the Open Science Framework - DOI ( 10.17605/OSF.IO/V6SYZ ).

Efficacy of antibiotic and iodoform pastes in non-instrumental endodontic treatment of anterior primary teeth-Protocol for a randomized controlled clinical

The maintenance of the deciduous tooth until its physiological exfoliation occurs is one of the main objectives of pediatric dentistry. Endodontic treatment in deciduous teeth resulting from carious or traumatic lesions with pulpal involvement is often necessary and we often find it difficult to perform it, due to the difficult control of the child, the internal anatomy of the root canals, and root resorptions. The non-instrumental endodontic treatment technique (NIET) associated with antimicrobial drugs has advantages such as shorter chair time and less complexity than the conventional technique in which root canal instrumentation is performed. The aim of this study is to carry out a controlled and randomized clinical trial to compare the effectiveness of (NIET) in primary teeth associated with the use of two obturator pastes. One hundred and twenty necrotic deciduous teeth of children aged between 3 and 6 years will be selected; and the teeth will be divided into two groups. In Group 1 and Group 2, root canals will not be instrumented, just irrigated and filled with the respective pastes, antibiotic (CTZ) and iodoform (Guedes-Pinto). Presence of fistula and mobility will be clinically evaluated. The evaluations will be carried out in both groups on the day of treatment and in periods of 1, 3 and 6 months after treatment. For the main outcome, the tooth will be the unit of analysis and the Kaplan-Meier test will be performed to estimate the survival rates of the included teeth. For comparison between the two groups, Student's t test or Mann-Whitney test will be performed, depending on the normality of the data. In addition, Poisson regression analyzes will be carried out, in order to allow the evaluation of the influence of some variables on the results. For all analyses, the significance value will be adjusted to 5%. Trial registration: NCT04587089 in ClinicalTrials.gov. Approval date: May 15, 2023.

Reciprocating instrumentation for endodontic treatment of primary molars: 24-month randomized clinical trial

BACKGROUND

Although reciprocating instrumentation has been extensively studied for permanent teeth, stronger evidence for its use in primary teeth is lacking.

AIM

The aim of this randomized clinical trial was to compare the efficacy of endodontic treatment in primary molars using reciprocating (RECIP) and manual (MAN) instrumentation techniques after 24 months.

DESIGN

Primary molars with indication of endodontic treatment were randomly divided into two groups: MAN and RECIP. Treatments were performed, and root canals were filled with calcium hydroxide and iodoform paste. Teeth were later restored with bulk-fill composite resin and re-evaluated after 6, 12, 18, and 24 months. The primary outcome was the success of the endodontic treatment evaluated by Cox regression analysis adjusted by cluster and success rate after 24 months in the intention-to-treat (ITT) population. Instrumentation time, discomfort, postoperative pain, and quality of root canal filling were also evaluated as secondary endpoints.

RESULTS

A total of 151 primary win 107 children were included, and 137 were followed up for 24 months. Success rate of teeth allocated to the MAN group was 57.3% and 55.3% for RECIP (p = .792); MAN instrumentation, however, was more time-consuming (p = .005).

CONCLUSION

The efficacy of endodontic treatment in primary molars using reciprocating and manual instrumentation is similar after 24 months.

Effect of Vitapex Combined with AH-Plus Paste on Inflammation in Middle-Aged and Elderly Patients with Periodontal-Endodontic Disease

Aims

To investigate the effect of Vitapex combined with AH-plus paste on inflammation in middle-aged and elderly patients with periodontal-endodontic disease.

Materials and Methods

A total of 80 teeth of middle-aged and elderly patients with the periodontal-endodontic disease who were treated in our hospital from June 2020 to June 2021 were selected as the research objects and were divided into comparison group and treatment group with 40 teeth each according to different treatment methods. Among them, the comparison group was filled with zinc oxide clove oil paste gutta-percha, and the treatment group was filled with Vitapex combined with AH-plus paste. The changes in apical cross-section sealing performance, periodontal pocket depth (PD), and gingival index (GI) of the two groups before treatment and after 6 months of follow-up were observed and compared, and X-ray analysis was performed.

Results

There was no significant difference in the level of periodontal indexes and serum inflammatory indexes between the two groups before treatment (P > 0.05). After treatment, the levels of PD, BI, PLI, and GI in the two groups were significantly lower than before treatment (P < 0.05). The differences in IL-6, IL-10, TNF-α, and IL-1β after treatment were significant (P < 0.05). There was no significant difference in the root canal area data of each cross-section between the two groups when the root canal was filled with root filling paste at different positions from the apex (P > 0.05). After root canal filling with root canal paste, the cross-sectional area from different parts of the root canal in the treatment group was significantly smaller than comparison group (P < 0.05). After 6 months of treatment, it was found that CEJ-BD and CEJ-AC in the treatment group were significantly lower than those in the comparison group (P < 0.05).

Conclusion

Vitapex combined with AH-plus paste filling can effectively treat middle-aged and elderly periodontal-endodontic disease, which provides a certain reference for the clinical treatment of middle-aged and elderly periodontal-endodontic disease.