Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis
ObjectivesThis study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth.Materials and MethodsElectronic-databases searching for published and grey literature and manual searching were conducted. Only randomi...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Academy of Conservative Dentistry
2020-08-01
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| Series: | Restorative Dentistry & Endodontics |
| Subjects: | |
| Online Access: | http://rde.ac/upload/pdf/rde-45-e26.pdf |
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| Summary: | ObjectivesThis study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth.Materials and MethodsElectronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsSixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1–14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate.ConclusionMost comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.Trial RegistrationPROSPERO database Identifier: CRD42016041953 |
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| ISSN: | 2234-7658 2234-7666 |