USE OF IRRIGATING SOLUTIONS IN TOOTH PULPECTOMY DECIDUOUS: LITERATURE REVIEW
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Published:
Jan 7, 2022
Keywords:
pulpectomy, deciduous tooth, root canal irrigants
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Abstract
Cleaning the root canals is a crucial step for the success of endodontic treatment. For this reason, the search for effective irrigation solutions in endodontic therapy of primary teeth is frequent in research and demonstrates the need to find substances with less toxicity and greater efficiency. Therefore, the objective of the present study is to analyze the different irrigation solutions and protocols in the endodontic treatment of primary teeth, in order to build a clinical approach. For this, a literature search was carried out in the databases PubMed/MEDLINE, Cochrane Library, SCIELO, CAPES and VHL Regional Portal using the combination of the terms “deciduous tooth”, “root canal irrigants”, “pulpectomy” and its derivatives , associated with each other by the Boolean operator “AND” and adapted for each database. The searches were carried out from July to August 2020. A total of 192 results were found. After a critical reading, 8 studies were selected. The review included studies that addressed themost common irrigating solutions: sodium hypochlorite, chlorhexidine digluconate, citric acid and ethylenediaminetetraacetic acid (EDTA) in endodontic therapy of primary teeth. EDTA and chlorhexidine digluconate have low toxicity and sodium hypochlorite 1% combined with citric acid 6% has the most successful combination. The association of the two substances proved to be more efficient in cleaning the root canals and removing the smear layer. However, more studies are needed, mainly clinical, to confirm the best irrigation protocol for endodontic treatment of primary teeth.
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Kolling Marquezan, F., Dalcin Manfio, J. C., & Kolling Marquezan, P. (2022). USE OF IRRIGATING SOLUTIONS IN TOOTH PULPECTOMY DECIDUOUS: LITERATURE REVIEW. Naval Dental Jounal, 48(I). Retrieved from http://portaldeperiodicos.marinha.mil.br/index.php/odontoclinica/article/view/1939
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Literature Reviews
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
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26. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod. 2010 Jan;36(1):105-9.
27. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech. 2018 Mar;81(3):275-282.
28. Gandolfi MG, Taddei P, Pondrelli A, Zamparini F, Prati C, Spagnuolo G. Demineralization, Collagen Modification and Remineralization Degree of Human Dentin after EDTA and Citric Acid Treatments. Materials (Basel). 2018 Dec 21;12(1):25.
29. Turk T, Kaval ME, Şen BH. Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study. BMC Oral Health. 2015 Sep 3;15:104.
30. Arguello, K. Visión Actualizada de la Irrigación em Endodocia: Más Allá del NaOCl de Sódio. El Odont.Inv, Venezu ela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014..
32. Götze Gda R, Cunha CB, Primo LS, Maia LC. Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars. Braz Oral Res. 2005 Oct-Dec;19(4):261-6. doi: 10.1590/s1806-83242005000400005. Epub 2006 Feb 14.
33. Hegde RJ, Bapna K. Comparison of removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid and citric acid in primary teeth: A scanning electron microscopic study. Contemp Clin Dent. 2016 Apr-Jun;7(2):216-20.
34. Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand. 2020 Jul;78(5):321-326.
2. Raslan N, Wetzel WE. Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation. Dent Traumatol. 2006 Jun;22(3):145-53.
3. Tewari N, Bansal K, Mathur VP. Dental Trauma in Children: A Quick Overview on Management. Indian J Pediatr. 2019 Nov;86(11):1043-47.
4. Leonardo M, Leonardo R. Tratamento de canais radiculares: avanços tecnológicos de uma endodontia minimamente invasiva e reparadora. 3. ed. São Paulo: Artes Médicas, 2012.
5. da Silva LA, Nelson-Filho P, Faria G, de Souza-Gugelmin MC, Ito IY. Bacterial profile in primary teeth with necrotic pulp and periapical lesions. Braz Dent J. 2006;17(2):144-8.
6. Kaur R. Review article irrigating solutions in Pediatric Dentistry: literature review and update. J AdvMed Dental Scienc, Haryana. 2014;2(2):104-115.
7. Ito IY, Junior FM, Paula-Silva FW, Da Silva LA, Leonardo MR, Nelson-Filho P. Microbial culture and checkerboard DNA-DNA hybridization assessment of bacteria in root canals of primary teeth pre- and post-endodontic therapy with a calcium hydroxide/chlorhexidine paste. Int J Paediatr Dent. 2011 Sep;21(5):353-60.
8. Alacam A. The effect of various irrigants on the adaptation of paste filling in primary teeth. J Clin Pediatr Dent. 1992 Summer;16(4):243-6.
9. Barcelos R, Tannure PN, Gleiser R, Luiz RR, Primo LG. The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized, and controlled clinical trial evaluation. Int J Paediatr Dent. 2012 Sep;22(5):369-81.
10. Pintor AV, Dos Santos MR, Ferreira DM, Barcelos R, Primo LG, Maia LC. Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review. J Clin Pediatr Dent. 2016 Winter;40(1):1-7.
11. Valdez-Gonzalez C, Mendez-Gonzalez V, Torre-Delgadillo G, Flores-Reyes H, Gaitan-Fonseca C, Pozos-Guillen AJ. Effectiveness of oxidative potential water as an irrigant in pulpectomized primary teeth. J Clin Pediatr Dent. 2012 Fall;37(1):31-5.
12. Jolly M, Singh N, Rathore M, Tandon S, Banerjee M. Propolis and commonly used intracanal irrigants: comparative evaluation of antimicrobial potential. J Clin Pediatr Dent. 2013 Spring;37(3):243-9.
13. Tulsani SG, Chikkanarasaiah N, Bethur S. An in vivo comparison of antimicrobial efficacy of sodium hypochlorite and Biopure MTAD™ against enterococcus faecalis in primary teeth: A qPCR study. J Clin Pediatr Dent. 2014 Fall;39(1):30-4.
14. Ruiz-Esparza CL, Garrocho-Rangel A, Gonzalez-Amaro AM, Flores-Reyes H, Pozos-Guillen AJ. Reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigant in pulpectomized primary teeth: a preliminary report. J Clin Pediatr Dent. 2011 Spring;35(3):265-70.
15. Barcelos R.Efetividade de substâncias químicas auxiliares na desinfecção e
saneamento de canais radiculares de dentes decíduos. In: Reunião Anual da SBPqO, 20, 2003, Águas de Lindoia. Pesquisa Odontológica Brasileira. Anais. São Paulo: SBPqO, 2003.7:229
16. Botton G, Pires CW, Cadoná FC, Machado AK, Azzolin VF, Cruz IB, Sagrillo MR, Praetzel JR. Toxicity of irrigating solutions and pharmacological associations used in pulpectomy of primary teeth. Int Endod J. 2016 Aug;49(8):746-54.
17. Lopes, H., Siqueira, J., Endodontia: Biologia e Técnica. 2ª. ed. Rio de Janeiro: Ed. Med Guanabara Koogan S. A, 2004, p. 245.
18. Hargreaves K., Cohen S..Caminhos da Polpa. 11. ed. Rio de Janeiro: Elsevier, 2017
19. Estrela C, Estrela CR, Decurcio DA, Hollanda AC, Silva JA. Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Int Endod J. 2007 Feb;40(2):85-93.
20. Michelotto M. Clorexidina na terapia endodôntica, Revista Sul-Brasileira de Odontologia, Brasil, 2008;5(1):77-89.
21. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
22. Darda S, Madria K, Jamenis R, Heda A, Khanna A, Sardar L. An in-vitro evaluation of effect of EDTAC on root dentin with respect to time. J Int Oral Health. 2014 Apr;6(2):22-7.
23. Güzel C, Uzunoglu E, Dogan Buzoglu H. Effect of Low-surface Tension EDTA Solutions on the Bond Strength of Resin-based Sealer to Young and Old Root Canal Dentin. J Endod. 2018 Mar;44(3):485-488.
24. Plotino G. New Technologies to Improve Root Canal Disinfection. Bra Dent J. 2016:27(1):3-8.
25. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):84-9.
26. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod. 2010 Jan;36(1):105-9.
27. Machado R, Garcia LDFR, da Silva Neto UX, Cruz Filho AMD, Silva RG, Vansan LP. Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration. Microsc Res Tech. 2018 Mar;81(3):275-282.
28. Gandolfi MG, Taddei P, Pondrelli A, Zamparini F, Prati C, Spagnuolo G. Demineralization, Collagen Modification and Remineralization Degree of Human Dentin after EDTA and Citric Acid Treatments. Materials (Basel). 2018 Dec 21;12(1):25.
29. Turk T, Kaval ME, Şen BH. Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study. BMC Oral Health. 2015 Sep 3;15:104.
30. Arguello, K. Visión Actualizada de la Irrigación em Endodocia: Más Allá del NaOCl de Sódio. El Odont.Inv, Venezu ela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014..
32. Götze Gda R, Cunha CB, Primo LS, Maia LC. Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars. Braz Oral Res. 2005 Oct-Dec;19(4):261-6. doi: 10.1590/s1806-83242005000400005. Epub 2006 Feb 14.
33. Hegde RJ, Bapna K. Comparison of removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid and citric acid in primary teeth: A scanning electron microscopic study. Contemp Clin Dent. 2016 Apr-Jun;7(2):216-20.
34. Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand. 2020 Jul;78(5):321-326.