Iodoform Vs Calcium Hydroxide/Zinc Oxide based pastes: 12-month findings of a Randomized Controlled Trial

Abstract

This study evaluated clinical and radiographic twelve-month outcomes of root canal treatments (CT) with smear layer removal, performed in primary teeth, using two different root canal filling materials. Pulpectomy was performed on 27 primary teeth with necrosis or irreversible pulpitis, caused by dental caries or trauma, in 23 children (2-7 years old). A single trained operator performed the CT in a single visit in cases without periapical or interradicular radiolucency (PIR) or in multiple visits in cases with PIR. Participants were selected based on specific inclusion and exclusion criteria, and randomly allocated into two groups: Group 1 (G1)-iodoform paste (iodoform + camphorated parachlorophenol + ointment comprising prednisolone acetate 5.0 mg and rifamycin 1.5 mg); Group 2 (G2)-Calen ® /ZO paste. Treated teeth were restored with composite resin immediately after the root canal filling. The outcomes were evaluated clinically and radiographically according to specific criteria. Two blinded and standardized evaluators assessed the radiographic outcomes. We used descriptive analyses due to the small sample size. CTs were performed due to caries lesions in 70.4% of the cases and due to trauma in 29.6%. Only one tooth of G1 was unsuccessful; hence, pulpectomy performance in both groups was not influenced by the filling material, nor by any other analyzed variable. The level of the root canal filling was better in the Calen ® /ZO group. The clinical and radiographic twelve-month outcomes indicated successful treatment, independently of the root filling material used.

Reliability of Two Methods of Evaluation of the Apical Limit of Obturation of Root Canals of Primary Teeth: A Pilot Study

“…The failure of pulpectomies in this study was not associated with overfilling [5]. However, due to the different factors that may influence clinical and radiographic success, no conclusion could be inferred in relation to the ALO evaluated and the frequency of success.…”

“…Furthermore, the quality of root canal obturation demonstrated a correlation with endodontic failure [7,[12][13][14]. In clinical trials with primary teeth, the evaluation of the quality of obturation was performed only by the visual method [4,5,[15][16][17], so, to our knowledge, this is the first study that has evaluated the limit of obturation of primary canals by use of the digital method. Since there are no similar studies in the literature with this methodology, the comparison with a gold standard method became limited.…”

“…In this pilot study, we evaluated an image database consisted of 27 final radiographs from a previous study [5]. From these, 20 were selected according to the inclusion criteria: periapical radiographs of anterior deciduous teeth with good quality.…”

“…A single operator, specialist and master in Pediatric Dentistry, performed the radiographs immediately after pulpectomy, using the parallelism technique with radiographic positioners (Indusbello, Londrina, PR, Brazil) and the time and temperature processing method. In all patients, the root canal had been filled with iodoform paste (n = 10) or calcium hydroxide paste thickened with zinc oxide (Calen ® /ZO; SS White Artigos Dentários Ltda., Rio de Janeiro, RJ, Brazil) (n = 10) [5]. Radiograph scans (Scanner HP Scanjet G4050, Development Company, Silicon Valley, California, USA) were standardized with a resolution at 300 dpi and 256-grey level.…”

“…The success of endodontic treatment is clinically characterized by the absence of signs or symptoms of infection, including pain, edema, fistula or percussive sensitivity during the preservation of the tooth [2,4,5]. This is also related to precise determination of the root canal length and, consequently, to the apical limit of obturation (ALO).…”