Clinical and radiographic evaluation of pulpectomy in primary teeth: a 18-months clinical randomized controlled trial

Abstract

Background: To avoid untoward changes when primary teeth are replaced by permanent teeth, resorption of the material used in primary teeth root canal filling should occur at the same rate as root resorption. The Aim of this study was to compare the success rates of a mixed primary root canal filling (MPRCF, ingredients: zinc oxide-eugenol [ZOE], iodoform, calcium hydroxide) to those of ZOE and Vitapex in pulpectomised primary molars.

Methods: One hundred and sixty primary molars from 155 children (average age 5.88 ± 1.27 years) underwent two-visit pulpectomy using one of the three materials. The clinical and radiographic findings at 6, 12 and 18 months were assessed.

Results: At 6 and 12 months, the MPRCF and ZOE success rates were 100%. The Vitapex group showed clinical success rate and radiographic success rate of 100 and 94.5% at 6 months, and 80.4 and 60.7% at 12 months. The 18-month clinical success rates of the MPRCF, ZOE and Vitapex were 96.2, 92.2 and 71.4% and radiographic success rates were 92.5, 88.2 and 53.6%, respectively. There was a statistically significant difference in the success rates between MPRCF and Vitapex and no significant differences between MPRCF and ZOE. More MPRCF were resorbed at same rate with roots than ZOE and Vitapex. Early resorption of root filling resulted in more failure.

Conclusions: The mixture of ZOE, iodoform and calcium hydroxide can be considered an effective root canal filling material in pulp involved primary teeth and had no adverse effect on tooth replacement.

Trial registration: ChiCTR-TRC-14004938 . Registered 13 July 2014.

Keywords: Calcium hydroxide; Iodoform; Primary teeth; Pulpectomy; Zinc Oxide-Eugenol.

Fig. 1

Schematic figure of MPRCF and ZOE. High solubility of calcium hydroxide, strength of chelation was lower and filling mass become porous when contacting with tissue fluid create the favourable resorb ability

Fig. 2

Flowchart of the present clinical study

Fig. 3

Eighteen months follow-up of MPRCF. a Pre–operative radiograph of 54 considered for root canal treatment with MPRCF. b Radiograph taken immediately postoperatively showing adequate filled. c Radiograph 18 months postoperatively showing the fillings were resorbed at the similar rate with palatal root

Fig. 4

Eighteen months follow-up of MPRCF. a, c Pre–operative Radiograph of right and left mandibular first and second primary molar considered for root canal treatment with MPRCF. b, d Radiograph 18 months postoperatively showing the MPRCF fillings were stable and intact

Fig. 5

Twenty-four months follow-up of MPRCF. a Radiograph of 52–64 treated with MPRCF taken 6 months postoperatively. b, c Radiograph taken 18 months postoperatively showing partly resorption of overfilled materials in 62. d Radiograph taken 24 months postoperatively showing intact filling

Fig. 6

Eighteen months follow-up of MPRCF. a Pre–operative radiograph of maxillary first left primary molar of a 3-year-old girl considered for root canal treatment with MPRCF b Radiograph taken 18 months postoperatively showing no resorption of materials in all roots canal

Fig. 7

Twelve months follow-up of ZOE. a Radiograph of 84 treated with ZOE taken immediately postoperatively showing adequate filled. b Radiograph taken 6 months postoperatively showing slower resorption rate of filling material than roots. c Radiograph taken 12 months postoperatively showing remaining of filling material