Pulp therapy in primary teeth with irreversible pulpitis or necrosis: a literature review

Abstract

For many professionals, pulpectomy in primary teeth is a challenging procedure due to the technical difficulty and complexity of the root canals. In addition, there is a wide variety of techniques and materials available. This review aims to summarize and compare the scientific evidence on pulpectomy in primary teeth. The bibliographic search was performed in the PubMed database in August 2022 and updated in June 2023. Two reviewers independently assessed studies according to the following inclusion criteria: systematic reviews with or without meta-analysis, published in the last 10 years. The certainty of the evidence (GRADE) was taken from the original article. Disagreements were resolved by a third reviewer. Two hundred and thirty-six studies were retrieved. After reading, 31 studies were evaluated for eligibility and 25 systematic reviews were included. The studies were developed in 11 countries, with Brazil (n=7) and India (n=6) accounting for most studies. The year of publication varied between 2014 and 2023, with the years 2021 (n=8) and 2022 (n=5) having the largest number of studies. The certainty of the evidence of most of the studies was which moderate to very low. This review concluded that there is still insufficient evidence to determine which of the different techniques and materials are most effective, leaving it up to the clinician to choose the clinical protocol to be used.