Pulpectomies with Smear Layer Removal in Primary Anterior Teeth – Five Years of Follow Up

Patricia Nivoloni TANNURE, Roberta BARCELOS, Gabriela GÖTZE, Camilla AZEVEDO, Rogerio GLEISER, Laura Guimarães PRIMO

Abstract


Objective: To evaluate the efficacy de pulpectomies with removal of smear layer in primary anterior teeth and the clinical conditions of the permanent successors after five years of clinical and radiographic follow up.
Method: Clinically healthy children aged 3 to 5 years requiring root canal treatment in anterior teeth due to caries and/or dentoalveolar trauma were selected. The chemomechanical preparation consisted of instrumentation with K files and 1.0% sodium hypochlorite and final irrigation with 6.0% citric acid for removal of smear layer. The canals were filled with ZOE and all teeth were restored with photoactivated composite resin. Clinical and/or radiographic evaluation was carried out in the first month and then successively during six months up to five years posttreatment or up to eruption of the permanent successor.
Results: The success rate was 91.5%. After five years of follow up, 38 permanent successors (80.9%) had erupted. From these, 5 (10.6%) teeth erupted ectopically and five (10.6%) presented enamel opacities. There was no association between treatment outcome (success or failure) and certain factors, such as pulpal alteration, pulpal diagnosis, presence of periapical lesion and apical limit of obturation.
Conclusion: After five years of follow up, the pulpectomies in primary anterior teeth with removal of smear layer presented a high success rate, suggesting that the use of citric acid was favorable to the therapy. There was a small number of enamel opacities and ectopic eruptions of the permanent successors. Based on the obtained results, it is recommended the development of new clinical studies, especially controlled and randomized trials, using the same protocol and including molars, in order to confirm the effectiveness of smear layer removal in the pulpectomies of primary teeth.

Keywords


pulpectomia; dente decíduo; lama dentinária; ácido cítrico



DOI: http://dx.doi.org/10.4034/pboci.v11i2.931

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