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The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized, and
Roberta Barcelos1, Patricia Nivoloni Tannure, Rogerio Gleiser
1Department of Specific Formation, School of Dentistry, Federal Fluminense University (UFF), Nova Friburgo, Brazil. rbarcelos@vm.uff.br
Background:
The effect of smear layer (SL) removal on primary tooth pulpectomy outcome has not been well elucidated.
Aim:
To determine the effect of SL removal on primary tooth pulpectomy outcome.
Methods:
This is a double-blind, randomized, and controlled clinical trial. Forty-eight patients were randomly divided into SL removal (G1 = 40 teeth) or smear layer nonremoval (G2 = 42 teeth) groups. Following the chemomechanical preparation with K-files and 2.5% sodium hypochlorite (NaOCl), teeth were irrigated with either 6% citric acid and 0.9% physiologic solution (G1) or only 0.9% physiologic solution (G2). Camphorated paramonochlorophenol was used as intracanal medication. At the second appointment, 1 week after, root canals were filled with zinc oxide-eugenol paste. Clinical and radiographical baseline criteria were stipulated equally for both groups.
Results:
The success rate (G1 = 91.2%; G2 = 70.0%) was statistically different (P = 0.04) between the groups. In G2, the outcome was affected significantly by pulpal necrosis (P = 0.02), pre-operatory symptoms (P = 0.02), and periapical/inter-radicular radiolucency (P = 0.04).
Conclusion:
The pulpectomy outcome was improved by smear layer removal. The outcome for teeth with pulpal necrosis, pre-operatory symptoms, or periapical/inter-radicular radiolucency was significantly improved by removal of the smear layer.
