Flare-ups in Primary Teeth Before, During, and After Pulpectomy: A Systematic Review and Meta-analysis.

Area of Science:

• Pediatric Dentistry
• Endodontics
• Systematic Review and Meta-analysis

Background:

• Pain and fear associated with root canal procedures are significant concerns for child patients and dentists.
• Understanding pain prevalence during pulpectomy is crucial for managing patient anxiety and treatment outcomes.

Purpose of the Study:

• To systematically review and meta-analyze the prevalence and severity of flare-ups before, during, and after pulpectomy in children.
• To assess pain experiences at different stages of the pulpectomy procedure in pediatric patients.

Main Methods:

• A comprehensive search of Medline/PubMed, Cochrane, and EBSCOhost databases was conducted, supplemented by hand searches.
• Three articles met the inclusion criteria for the systematic review and meta-analysis.
• Data on flare-ups at pretreatment, during treatment, and posttreatment phases were extracted and analyzed.

Main Results:

• Pretreatment flare-ups were reported in 51.2% of cases.
• During treatment, the prevalence of flare-ups decreased to 19.8%.
• No flare-ups were observed in the posttreatment phase, indicating a 100% success rate.

Conclusions:

• Pulpectomy-associated flare-ups in primary teeth are most prevalent before the procedure.
• Pain and flare-up incidence significantly diminish during and after the pulpectomy procedure.
• The findings highlight the importance of managing pretreatment pain and anxiety in pediatric endodontics.