Is calcium hydroxide more effective than formocresol or camphor phenol as intracanal disinfectants in acute pulpitis...

Data sources Cochrane Library, PubMed, Ovid, ScienceDirect, Wiley, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang and VIP Database for Chinese Technical Periodicals (VIP) databases were searched for articles dating from January 2000 to July 2018. Studies in languages other than English or Chinese were excluded.Study selection Randomised controlled trials comparing the clinical effectiveness of calcium hydroxide to formocresol or camphor phenol in acute pulpitis of deciduous teeth requiring root canal treatment were included. The primary outcome was clinical effectiveness while the secondary outcome was incidence of endodontic inter-appointment emergencies.Data extraction and synthesis Two authors independently screened titles and abstracts of all studies identified through the search and reviewed full articles against established inclusion/exclusion criteria. Any disagreements between the authors were resolved by consensus or by consulting relevant experts. Risk of bias assessment was carried out using the Cochrane collaboration tool. Clinical effectiveness and incidence of inter-appointment endodontic emergencies were expressed as odds ratio and 95% CI. Heterogeneity was assessed using Q-test and I2 measurement. Appropriate models were used for meta-analysis based on heterogeneity.Results A total of 16 randomised trials informed the meta-analysis. Clinical effectiveness of calcium hydroxide was compared to formocresol in 12 studies and pooled data indicate that calcium hydroxide was significantly better in terms of clinical effectiveness (OR = 3.37; 95% CI 2.54 to 4.48), and was associated with significantly decreased inter-appointment emergency visits (OR = 0.26; 95% CI 0.16 to 0.42) . Calcium hydroxide was compared to camphor phenol in seven studies and was shown to be significantly superior in its clinical effectiveness (OR = 5.50; 95% CI 3.36 to 8.98).Conclusions Limited available evidence suggest calcium hydroixide was superior to formocresol and camphor phenol as intracanal medicaments in the management of acute pulpitis in deciduous teeth.