Pulpectomies with Iodoform Versus Calcium Hydroxide-Based Paste: A Preliminary Randomised Controlled Clinical Trial


  • Maysa Lannes Duarte
  • Marina Siqueira
  • Daniele Vieira Cassol
  • Angela Scarparo
  • Laura Guimarães Primo
  • Roberta Barcelos


Pulpectomy, Tooth, Deciduous, Root Canal Filling Materials, Clinical Trial


Objective: To compare clinical and radiographical pulpectomy outcomes in primary teeth filled with different pastes. Material and Methods: The sample included thirty-eight teeth indicated for pulpectomy due to irreversible pulp inflammation or necrosis from thirty patients (2 to 9 years old). The first appointment comprised chemomechanical preparation (2.5% sodium hypochlorite), smear layer removal (6% citric acid), intracanal dressing and temporary restoration. Seven days later, teeth were randomly assigned to filling with iodoform (IP) or calcium hydroxide with zinc oxide (CHZO) based pastes and temporarily restored. Final restoration (composite resin) occurred at the 3rd appointment. Data from baseline, 6 and 12 months were analysed using descriptive and inferential statistics (p≤0.05). Results: The overall frequency of success was 63.6% (n=21), with no significant difference between groups (IP=62.5% n=10; CHZO=64.7% n=11, p=0.59). Multiradicular teeth, overfilled canals and teeth whose coronal restoration have been lost were significantly associated with failure (p=0.01, p=0.04 and p<0.001, respectively). Conclusion: After 12 months, both pastes showed similar outcomes and can be used as good options for pulpectomies in primary teeth. Moreover, tooth location, extent of the root canal filling, and integrity of final restoration during the follow-up influenced the outcome of pulpectomies.


Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2018; 5(5):CD003220. https://doi.org/10.1002/14651858.CD003220.pub3

Najjar RS, Alamoudi NM, El-Housseiny AA, Al Tuwirqi AA, Sabbagh HJ. A comparison of calcium hydroxide/iodoform paste and zinc oxide eugenol as root filling materials for pulpectomy in primary teeth: a systematic review and meta-analysis. Clin Exp Dent Res 2019; 5(3):294-310. https://doi.org/10.1002/cre2.173

Silva Junior MF, Wambier LM, Gevert MV, Chibinski ACR. Effectiveness of iodoform-based filling materials in root canal treatment of deciduous teeth: a systematic review and meta-analysis. Biomater Investig Dent 2022; 9(1):52-74. https://doi.org/10.1080/26415275.2022.2060232

Pinto DN, de Sousa DL, Araujo RB, Moreira-Neto JJS, Araújo RBR, Moreira-Neto JJS. Eighteen-month clinical and radiographic evaluation of two root canal-filling materials in primary teeth with pulp necrosis secondary to trauma. Dent Traumatol 2011; 27(3):221-4. https://doi.org/10.1111/j.1600-9657.2011.00978.x

Segato RA, Pucinelli CM, Ferreira DC, Daldegan Ade R, Silva RS, Nelson-Filho P, et al. Physicochemical properties of root canal filling materials for primary teeth. Braz Dent J 2016; 27(2):196-201. https://doi.org/10.1590/0103-6440201600206

Cerqueira DF, Mello-Moura AC, Santos EM, Guedes-Pinto AC. Cytotoxicity, histopathological, microbiological and clinical aspects of an endodontic iodoform-based paste used in pediatric dentistry: a review. J Clin Pediatr Dent 2008; 32(2):105-10. https://doi.org/10.17796/jcpd.32.2.k1wx5571h2w85430

Marques RPS, Moura-Netto C, Oliveira NM, Bresolin CR, Mello-Moura ACV, Mendes FM, et al. Physicochemical properties and filling capacity of an experimental iodoform-based paste in primary teeth. Braz Oral Res 2020; 34:1-8. https://doi.org/10.1590/1807-3107bor-2020.vol34.0089

Queiroz AM, Nelson-Filho P, Silva LA, Assed S, Silva RA, Ito IY. Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ. Braz Dent J 2009; 20(4):290-6. https://doi.org/10.1590/s0103-64402009000400005

Moness AM, Khattab NN, Waly NG. Evaluation of three root canal filling materials for primary teeth (in vivo and in vitro study). Egypt Dent J 2012; 59:1-13.

Mani SA, Chawla HS, Tewari A, Goyal A. Evaluation of calcium hydroxide and zinc oxide eugenol as root canal filling materials in primary teeth. ASDC J Dent Child 2000; 67(2):83,142-7.

Queiroz AM, Assed S, Consolaro A, Nelson-Filho P, Leonardo MR, Silva RA, et al. Subcutaneous connective tissue response to primary root canal filling materials. Braz Dent J 2011; 22(3):203-11. https://doi.org/10.1590/S0103-64402011000300005

Pilownic KJ, Gomes APN, Wang ZJ, Almeida LHS, Romano AR, Shen Y, et al. Physicochemical and biological evaluation of endodontic filling materials for primary teeth. Braz Dent J 2017; 28(5):578-86. https://doi.org/10.1590/0103-6440201701573

Cassol DV, Duarte ML, Pintor AVB, Barcelos R, Primo LG. Iodoform vs calcium hydroxide/zinc oxide based pastes: 12-month findings of a randomized controlled trial. Braz Oral Res 2019; 33(e002):1-10. https://doi.org/10.1590/1807-3107bor-2019

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; 22(5):369-81. https://doi.org/10.1111/j.1365-263X.2011.01210.x

Hackshaw A. Small studies: strengths and limitations. Eur Respir J 2008; 32(5):1141-3. https://doi.org/10.1183/09031936.00136408

Finucane D, Kinirons MJ. External inflammatory and replacement resorption of luxated, and avulsed replanted permanent incisors: a review and case presentation. Dent Traumatol 2003; 19(3):170-4. https://doi.org/10.1034/j.1600-9657.2003.00154.x

Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent 2019; 29(3):238-48. https://doi.org/10.1111/ipd.12484

Coll J, Sadrian R. Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition. Pediatr Dent 1996; 18(1):57-63.

Poornima P, Subba Reddy VV. Comparison of digital radiography, decalcification, and histologic sectioning in the detection of accessory canals in furcation areas of human primary molars. J Indian Soc Pedod Prev Dent 2008; 26(2):49-52. https://doi.org/10.4103/0970-4388.41615

Silva LA, Leonardo MR, Oliveira DS, Silva RA, Queiroz AM, Hernández PG, et al. Histopathological evaluation of root canal filling materials for primary teeth. Braz Dent J 2010; 21(1):38-45. https://doi.org/10.1590/S0103-64402010000100006

Sari S, Okte Z. Success rate of Sealapex in root canal treatment for primary teeth: 3-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105(4):e93-96.

Moskovitz M, Sammara E, Holan G. Success rate of root canal treatment in primary molars. J Dent 2005; 33(1):41-7. https://doi.org/10.1016/j.tripleo.2007.12.014

Olegário IC, Bresolin CR, Pássaro AL, de Araujo MP, Hesse D, Mendes FM, et al. Stainless steel crown vs bulk fill composites for the restoration of primary molars post-pulpectomy: 1-year survival and acceptance results of a randomized clinical trial. Int J Paediatr Dent 2022; 32(1):11-21. https://doi.org/10.1111/ipd.12785

Pinto Gdos S, Oliveira LJ, Romano AR, Schardosim LR, Bonow ML, Pacce M, et al. Longevity of posterior restorations in primary teeth: Results from a paediatric dental clinic. J Dent 2014; 42(10):1248-54. https://doi.org/10.1016/j.jdent.2014.08.005

Campagna P, Pinto LT, Lenzi TL, Ardenghi TM, De Oliveira Rocha R, Oliveira MDM. Survival and associated risk factors of composite restorations in children with early childhood caries: a clinical retrospective study. Pediatr Dent 2018; 40(3):210-4.

Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011; 37(7):895-902. https://doi.org/10.1016/j.joen.2011.04.002

Chisini LA, Collares K, Cademartori MG, de Oliveira LJC, Conde MCM, Demarco FF, et al. Restorations in primary teeth: a systematic review on survival and reasons for failures. Int J Paediatr Dent 2018; 28(2):123-39. https://doi.org/10.1111/ipd.12346

Şermet Elbay Ü, Tosun G. Effect of endodontic sealers on bond strength of restorative systems to primary tooth pulp chamber. J Dent Sci 2017; 12(2):112-20. https://doi.org/10.1016/j.jds.2016.06.003

Di Francescantonio M, Nurrohman H, Takagaki T, Nikaido T, Tagami J, Giannini M. Sodium hypochlorite effects on dentin bond strength and acid-base resistant zone formation by adhesive systems. Brazilian J Oral Sci 2015; 14(4):334-40. https://doi.org/10.1590/1677-3225v14n4a15

American Academy of Pediatric Dentistry (AAPD). Pulp Therapy for Primary and Immature Permanent Teeth. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2021:399-407.

Coll JA, Dhar V, Vargas K, Chen CY, Crystal YO, AlShamali S, et al. Use of non-vital pulp therapies in primary teeth. Pediatr Dent 2020; 42(5):337-49.

Chen X, Liu X, Zhong J. Clinical and radiographic evaluation of pulpectomy in primary teeth: a 18-months clinical randomized controlled trial. Head Face Med 2017; 13(1):1-10. https://doi.org/10.1186/s13005-017-0145-1

Amin M, Nouri MR, Hulland S, ElSalhy M, Azarpazhooh A. Success rate of treatments provided for early childhood caries under general anesthesia: a retrospective cohort study. Pediatr Dent 2016; 38(4):317-24.

Songvejkasem M, Auychai P, Chankanka O, Songsiripradubboon S. Survival rate and associated factors affecting pulpectomy treatment outcome in primary teeth. Clin Exp Dent Res 2021; 7(6):978-86. https://doi.org/10.1002/cre2.473




How to Cite

Duarte, M. L., Siqueira, M., Cassol, D. V., Scarparo, A., Primo, L. G., & Barcelos, R. (2023). Pulpectomies with Iodoform Versus Calcium Hydroxide-Based Paste: A Preliminary Randomised Controlled Clinical Trial. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 23, e220119. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/2480



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