Long-term outcomes of primary tooth pulpectomy with and without smear layer removal: a randomized split-mouth clinical trial

Pediatr Dent. 2011 Jul-Aug;33(4):316-20.

Abstract

Purpose: The aim of this study was to evaluate, via clinical and radiographic assessment, pulpectomy outcomes performed on primary anterior teeth both with and without a citric acid solution to enhance smear layer removal.

Methods: Patients with a matched pair of primary incisors (split-mouth design) with irreversible pulp changes were selected. A total of 36 teeth (18 children) received pulpectomies and were followed for 36 months. Pulpectomies were performed using sodium hypochlorite and saline solution as canal irrigants; during the last irrigation, the tooth was randomly selected to receive ( Group 1) or not receive (Group 2) the citric acid solution for smear layer removal. The roots were filled with ZOE paste.

Results: Overall pulpectomy success was 90.6%. Cases with smear layer removal were successful 82.3% of the time; those without smear layer removal, 88.2%, and there were no statistical differences (P=1.00).

Conclusion: Pulpectomy with smear layer removal in primary incisors exhibited, after 36 months, a high success rate; however, comparable results were obtained when the smear layer was not removed.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chelating Agents / therapeutic use*
  • Child, Preschool
  • Citric Acid / therapeutic use*
  • Dental Pulp Necrosis / therapy
  • Dental Restoration Failure
  • Female
  • Follow-Up Studies
  • Humans
  • Incisor / pathology
  • Male
  • Pulpectomy / methods*
  • Pulpitis / therapy
  • Root Canal Filling Materials
  • Root Canal Obturation
  • Smear Layer*
  • Tooth, Deciduous
  • Treatment Outcome
  • Zinc Oxide-Eugenol Cement

Substances

  • Chelating Agents
  • Root Canal Filling Materials
  • Zinc Oxide-Eugenol Cement
  • Citric Acid