Use of Irrigating Solutions in Pulpectomy of Deciduous Teeth: Literature Review Uso de Soluções Irrigadoras na Pulpectomia de Dentes Decíduos: Revisão de Literatura
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Published:
May 12, 2021
Keywords:
Pulpectomy, Deciduous tooth, Root Canal Irrigators
Main Article Content
Abstract
Cleaning of root canals is a crucial step for a successful endodontic treatment. For this reason, the search for effective irrigating solutions in endodontic therapy of deciduous teeth is frequent in research and it demonstrates the need to find substances with lower toxicity and greater efficiency. Thus, this study aims to analyze the different irrigating solutions and protocols in the endodontic treatment of deciduous teeth, in order to build a clinical approach. For this, a literature search was performed in the Databases PubMed/ MEDLINE, Cochrane Library, SCIELO, Portal de Periódicos CAPES and VHL using the combination of the terms “deciduous tooth,” “root canal irrigants,” “pulpectomy” and their 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. In total, 192 results were found. After a critical reading, eight studies were selected. The review included studies addressing the most common irrigating solutions: sodium hypochlorite, chlorhexidine digluconate, citric acid, and ethylenediaminetetraacetic acid (EDTA) in endodontic therapy of deciduous teeth. EDTA and chlorhexidine digluconate have low toxicity and the 1% sodium hypochlorite combined with 6% citric acid have the most prosperous combination. The association of these two substances proved to be more efficient in cleaning root canals and removing the smear layer. However, more studies are necessary, mainly clinical ones, to confirm the best irrigating protocol for the endodontic treatment of deciduous teeth.
Article Details
How to Cite
Use of Irrigating Solutions in Pulpectomy of Deciduous Teeth: Literature Review: Uso de Soluções Irrigadoras na Pulpectomia de Dentes Decíduos: Revisão de Literatura. (2021). Naval Dental Jounal, 48(I), 33-40. https://doi.org/10.29327/25149.48.1-4
Section
Literature Reviews
How to Cite
Use of Irrigating Solutions in Pulpectomy of Deciduous Teeth: Literature Review: Uso de Soluções Irrigadoras na Pulpectomia de Dentes Decíduos: Revisão de Literatura. (2021). Naval Dental Jounal, 48(I), 33-40. https://doi.org/10.29327/25149.48.1-4
References
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M, Lopez A, et al. Global burden of oral conditions in 1990-
2010: a systematic analysis. J Dent Res. 2013 Jul;92(7):592-7.
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 DNADNA
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, et al. 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, SilvaJA. 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 Lowsurface
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, et al. 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, Venezuela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006
May;32(5):389-98.
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.
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 microleakagmicroleakage in primary teeth. Acta
Odontol Scand. 2020 Jul;78(5):321-326.
M, Lopez A, et al. Global burden of oral conditions in 1990-
2010: a systematic analysis. J Dent Res. 2013 Jul;92(7):592-7.
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 DNADNA
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, et al. 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, SilvaJA. 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 Lowsurface
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, et al. 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, Venezuela,2019.
31. Zehnder M. Root canal irrigants. J Endod. 2006
May;32(5):389-98.
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.
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 microleakagmicroleakage in primary teeth. Acta
Odontol Scand. 2020 Jul;78(5):321-326.