Effectiveness of different obturation materials in primary teeth: A network meta-analysis

Area of Science:

• Pediatric Dentistry
• Endodontics
• Materials Science

Background:

• Selecting an ideal obturation material is critical for successful pulpectomy in primary teeth.
• Current literature lacks definitive evidence on the optimal material choice.

Purpose of the Study:

• To assess the effectiveness of various obturation materials used in primary teeth pulpectomy via Network Meta-Analysis (NMA).

Main Methods:

• A systematic search identified eligible Randomized Controlled Trials (RCTs).
• Data synthesis used a Bayesian random-effects model with Odds Ratios (ORs) calculated.
• Risk of bias and certainty of evidence were evaluated using Cochrane RoB 2 and GRADE approaches.

Main Results:

• The NMA included 47 studies with over 1608 patients and 19 obturation material combinations.
• Zinc oxide eugenol (ZOE), calcium hydroxide (CH), and iodoform-based paste (Endoflas) showed favorable effect estimates (OR ≈ 0.35).
• Overall certainty of evidence was low to very low due to methodological limitations and small sample sizes.

Conclusions:

• The combination of ZOE, CH, and iodoform-based paste (Endoflas) is a potential obturation material option for primary teeth.
• This recommendation is based on limited evidence, highlighting the need for further high-quality research.