Efficacy of non-instrumental Endodontic treatment in primary teeth: a systematic review of clinical randomized trials.
Anti-bacterial agents
Deciduous
Dental pulp necrosis
Pulpotomy
Root canal therapy
Tooth
Journal
Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575
Informations de publication
Date de publication:
25 Apr 2024
25 Apr 2024
Historique:
received:
25
04
2021
accepted:
04
03
2024
medline:
26
4
2024
pubmed:
26
4
2024
entrez:
25
4
2024
Statut:
epublish
Résumé
Endodontic therapy in pediatric dentistry is a challenging procedure, especially for special needs, uncooperative, and very young patients. A new conservative approach which is the non-instrumental endodontic treatment (NIET) has been developed to simplify the management of primary teeth requiring pulpectomy. This review aimed to compare the efficiency of NIET and conventional endodontic treatment in primary teeth. Electronic databases including MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Scopus without restrictions on publication year or publication language were searched. Only randomized clinical trials reporting clinical and radiographical outcomes of NIET and conventional pulpectomy on primary teeth were considered eligible. Two reviewers extracted the data according to the PRISMA statement and assessed the bias risk using the revised Cochrane risk-of-bias tool and a meta-analysis was performed. From 3322 screened articles, seven articles meeting the inclusion criteria were included. The selected studies included 283 primary molars, of 213 children aged between 3 and 9 years, treated by NIET and conventional pulpectomy, and had follow-up periods ranging from 1 month to tooth exfoliation. Two studies reported good success rates for both the NIET technique and endodontic therapy with no statistically significant difference while three studies showed radiographical significant differences with a low success rate for the NIET technique. Only one study reported better outcomes in the pulpectomy group with statistically significant differences. The quantitative grouping of the included studies showed no significant differences between NIET and conventional endodontic therapy regarding clinical and radiographical success (p value > 0.05). No difference between the NIET technique and the conventional endodontic therapy in primary molars requiring pulpectomy could be confirmed. Results of the present review need to be interpreted with caution since the quality of evidence according to the GRADE was considered as moderate to very low. Therefore, additional clinical trials on the NIET technique are recommended.
Sections du résumé
BACKGROUND
BACKGROUND
Endodontic therapy in pediatric dentistry is a challenging procedure, especially for special needs, uncooperative, and very young patients. A new conservative approach which is the non-instrumental endodontic treatment (NIET) has been developed to simplify the management of primary teeth requiring pulpectomy. This review aimed to compare the efficiency of NIET and conventional endodontic treatment in primary teeth.
METHODS
METHODS
Electronic databases including MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Scopus without restrictions on publication year or publication language were searched. Only randomized clinical trials reporting clinical and radiographical outcomes of NIET and conventional pulpectomy on primary teeth were considered eligible. Two reviewers extracted the data according to the PRISMA statement and assessed the bias risk using the revised Cochrane risk-of-bias tool and a meta-analysis was performed.
RESULTS
RESULTS
From 3322 screened articles, seven articles meeting the inclusion criteria were included. The selected studies included 283 primary molars, of 213 children aged between 3 and 9 years, treated by NIET and conventional pulpectomy, and had follow-up periods ranging from 1 month to tooth exfoliation. Two studies reported good success rates for both the NIET technique and endodontic therapy with no statistically significant difference while three studies showed radiographical significant differences with a low success rate for the NIET technique. Only one study reported better outcomes in the pulpectomy group with statistically significant differences. The quantitative grouping of the included studies showed no significant differences between NIET and conventional endodontic therapy regarding clinical and radiographical success (p value > 0.05).
CONCLUSION
CONCLUSIONS
No difference between the NIET technique and the conventional endodontic therapy in primary molars requiring pulpectomy could be confirmed. Results of the present review need to be interpreted with caution since the quality of evidence according to the GRADE was considered as moderate to very low. Therefore, additional clinical trials on the NIET technique are recommended.
Identifiants
pubmed: 38664717
doi: 10.1186/s13643-024-02505-4
pii: 10.1186/s13643-024-02505-4
doi:
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
112Informations de copyright
© 2024. The Author(s).
Références
Goerig AC, Camp JH. Root canal treatment in primary teeth: a review. Pediatr Dent. 1983;5(1):33–7.
pubmed: 6574437
Carrotte P. Endodontic treatment for children. Br Dent J. 2005;198(1):9–15. https://doi.org/10.1038/sj.bdj.4811946 .
doi: 10.1038/sj.bdj.4811946
pubmed: 15716881
Topaloglu-Ak A, Eden E, Frencken JE. Managing dental caries in children in Turkey–a discussion paper. BMC Oral Health. 2009;9:32. https://doi.org/10.1186/1472-6831-9-32 .
doi: 10.1186/1472-6831-9-32
pubmed: 19939240
pmcid: 2789056
Reyes AD, Reina ES. Root canal treatment in necrotic primary molars. J Pedod. 1989;14(1):36–9.
pubmed: 2637358
Mass E, Zilberman UL. Endodontic treatment of infected primary teeth, using Maisto’s paste. ASDC J Dent Child. 1989;56(2):117–20.
pubmed: 2656788
Shojaeepour R, Khademi M, Joukar S, Borna R. An alternative treatment for non-vital deciduous molars using lesion sterilization and tissue repair: literature review and report of three cases with one-year follow-up. Anat Sci J. 2017;14(2):101–8.
Bolette A, Truong S, Guéders A, Geerts S. The importance of pulp therapy in deciduous teeth. Rev Med Liege. 2016;71(12):567–72.
pubmed: 28387098
Nanda R, Koul M, Srivastava S, Upadhyay V, Dwivedi R. Clinical evaluation of 3 Mix and Other Mix in non-instrumental endodontic treatment of necrosed primary teeth. J Oral Biol Craniofacial Res. 2014;4(2):114–9. https://doi.org/10.1016/j.jobcr.2014.08.003 .
doi: 10.1016/j.jobcr.2014.08.003
Lussi A, Suter B, Fritzsche A, Gygax M, Portmann P. In vivo performance of the new non-instrumentation technology (NIT) for root canal obturation. Int Endod J. 2002;35(4):352–8. https://doi.org/10.1046/j.1365-2591.2002.00484.x .
doi: 10.1046/j.1365-2591.2002.00484.x
pubmed: 12059936
Sain S, Reshmi J, Anandaraj S, George S, Issac JS, John SA. Lesion sterilization and tissue repair-current concepts and practices. Int J Clin Pediatr Dent. 2018;11(5):446–50. https://doi.org/10.5005/jp-journals-10005-1555 .
doi: 10.5005/jp-journals-10005-1555
pubmed: 30787561
pmcid: 6379530
S S, Kanthaswamy C. Lesion sterilization and tissue repair- a review. Res J Pharm Technol. 2017;10(5):1539–42. https://doi.org/10.5958/0974-360X.2017.00271.2 .
doi: 10.5958/0974-360X.2017.00271.2
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097 .
doi: 10.1371/journal.pmed.1000097
pubmed: 19621072
pmcid: 2707599
Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev. 2014;8:CD003220. https://doi.org/10.1002/14651858.CD003220.pub2 .
doi: 10.1002/14651858.CD003220.pub2
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https://doi.org/10.1136/bmj.l4898 .
Risk of bias tools - RoB 2 tool. https://www.riskofbias.info/welcome/rob-2-0-tool . Accessed 9 Aug 2022.
Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars. Int J Paediatr Dent. 2010;20(3):214–21. https://doi.org/10.1111/j.1365-263X.2010.01044.x .
Agarwal M, Das UM, Vishwanath D. A comparative evaluation of noninstrumentation endodontic techniques with conventional ZOE pulpectomy in deciduous molars: an in vivo study. World J Dent. 2012;2(3):187–92. https://doi.org/10.5005/jp-journals-10015-1081 .
doi: 10.5005/jp-journals-10015-1081
Daher A, Viana K, Leles C, Costa L. Ineffectiveness of antibiotic-based pulpotomy for primary molars: a survival analysis. Pesqui Bras Em Odontopediatria E Clínica Integrada. 2015;15:205–15. https://doi.org/10.4034/PBOCI.2015.151.22 .
doi: 10.4034/PBOCI.2015.151.22
Doneria D, Thakur S, Singhal P, Chauhan D. Comparative evaluation of clinical and radiological success of zinc oxide-ozonated oil, modified 3mix-mp antibiotic paste, and vitapex as treatment options in primary molars requiring pulpectomy: an in vivo study. J Indian Soc Pedod Prev Dent. 2017;35(4):346–52. https://doi.org/10.4103/JISPPD.JISPPD_359_16 .
doi: 10.4103/JISPPD.JISPPD_359_16
pubmed: 28914248
Divya DV, Prasad MG, Radhakrishna AN, Sandeep RV, Reddy SP, Kumar KVKS. Triple antibiotic paste versus propolis: a clinical quest for the reliable treatment of periapical lesions in primary molars. Saudi Endod J. 2019;9(1):34. https://doi.org/10.4103/sej.sej_42_18 .
doi: 10.4103/sej.sej_42_18
Zacharczuk GA, Toscano MA, López GE, Ortolani AM. Evaluation of 3Mix-MP and pulpectomies in non-vital primary molars. Acta Odontol Latinoam AOL. 2019;32(1):22–8.
pubmed: 31206571
Boreinstein M, Hedges LV, Higgins JPT, Rothstein HR. How a meta-analysis works. In: Introduction to meta-analysis. John Wiley & Sons, Ltd; 2009. p. 1-7. https://doi.org/10.1002/9780470743386.ch1 .
Shankar K, Ramkumar H, Dhakshinamoorthy S, Paulindraraj S, Jayakaran TG, Bommareddy CS. Comparison of modified triple antibiotic paste in two concentrations for lesion sterilization and tissue repair in primary molars: an in vivo interventional randomized clinical trial. Int J Clin Pediatr Dent. 2021;14(3):388–92. https://doi.org/10.5005/jp-journals-10005-1951 .
doi: 10.5005/jp-journals-10005-1951
pubmed: 34720512
pmcid: 8543998
Grewal N, Sharma N, Chawla S. Comparison of resorption rate of primary teeth treated with alternative lesion sterilization and tissue repair and conventional endodontic treatment: an in vivo randomized clinical trial. J Indian Soc Pedod Prev Dent. 2018;36(3):262–7. https://doi.org/10.4103/JISPPD.JISPPD_140_17 .
doi: 10.4103/JISPPD.JISPPD_140_17
pubmed: 30246747
Eichenbaum IW, Dunn NA. Pulp management in the mixed dentition. J Am Dent Assoc. 1953;47(5):506–15. https://doi.org/10.14219/jada.archive.1953.0205 .
doi: 10.14219/jada.archive.1953.0205
pubmed: 13108494
Navit S, Jaiswal N, Khan SA, et al. Antimicrobial efficacy of contemporary obturating materials used in primary teeth- an in-vitro study. J Clin Diagn Res JCDR. 2016;10(9):ZC09–ZC12. https://doi.org/10.7860/JCDR/2016/21883.8426 .
doi: 10.7860/JCDR/2016/21883.8426
pubmed: 27790570
Jaya AR, Praveen P, Anantharaj A, Venkataraghavan K, Rani PS. In vivo evaluation of lesion sterilization and tissue repair in primary teeth pulp therapy using two antibiotic drug combinations. J Clin Pediatr Dent. 2012;37(2):189–91. https://doi.org/10.17796/jcpd.37.2.e5131jp6m1w33v66 .
doi: 10.17796/jcpd.37.2.e5131jp6m1w33v66
pubmed: 23534328
Hoshino E, Kurihara-Ando N, Sato I, et al. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J. 1996;29(2):125–30. https://doi.org/10.1111/j.1365-2591.1996.tb01173.x .
doi: 10.1111/j.1365-2591.1996.tb01173.x
pubmed: 9206436
Pinky C, Shashibhushan KK, Subbareddy VV. Endodontic treatment of necrosed primary teeth using two different combinations of antibacterial drugs: an in vivo study. J Indian Soc Pedod Prev Dent. 2011;29(2):121–7. https://doi.org/10.4103/0970-4388.84684 .
doi: 10.4103/0970-4388.84684
pubmed: 21911950
Raslan N, Mansour O, Assfoura L. Evaluation of antibiotic mix in Non-instrumentation Endodontic Treatment of necrotic primary molars. Eur J Paediatr Dent. 2017;18(4):285–90. https://doi.org/10.23804/ejpd.2017.18.04.04 .
doi: 10.23804/ejpd.2017.18.04.04
pubmed: 29380613