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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| Format: | Article |
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Korean Academy of Conservative Dentistry
2020-08-01
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| Series: | Restorative Dentistry & Endodontics |
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| Online Access: | http://rde.ac/upload/pdf/rde-45-e26.pdf |
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| author | Ahmed Mohamed Ibrahim Siza Yacoub Zakhary Suzan Abdul Wanees Amin |
| author_facet | Ahmed Mohamed Ibrahim Siza Yacoub Zakhary Suzan Abdul Wanees Amin |
| author_sort | Ahmed Mohamed Ibrahim |
| collection | DOAJ |
| description | 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 |
| format | Article |
| id | doaj-art-b831e5fa6e6e4ef4891d38159420c7e2 |
| institution | Kabale University |
| issn | 2234-7658 2234-7666 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | Korean Academy of Conservative Dentistry |
| record_format | Article |
| series | Restorative Dentistry & Endodontics |
| spelling | doaj-art-b831e5fa6e6e4ef4891d38159420c7e22025-08-20T03:30:40ZengKorean Academy of Conservative DentistryRestorative Dentistry & Endodontics2234-76582234-76662020-08-01453e2610.5395/rde.2020.45.e26908Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysisAhmed Mohamed Ibrahim0Siza Yacoub Zakhary1Suzan Abdul Wanees Amin2Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, EgyptDepartment of Endodontics, Faculty of Dentistry, Cairo University, Cairo, EgyptDepartment of Endodontics, Faculty of Dentistry, Cairo University, Cairo, EgyptObjectivesThis 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: CRD42016041953http://rde.ac/upload/pdf/rde-45-e26.pdfcalcium hydroxideintracanal medicationmeta-analysisnon-vital pulpsystematic review |
| spellingShingle | Ahmed Mohamed Ibrahim Siza Yacoub Zakhary Suzan Abdul Wanees Amin Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis Restorative Dentistry & Endodontics calcium hydroxide intracanal medication meta-analysis non-vital pulp systematic review |
| title | Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis |
| title_full | Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis |
| title_fullStr | Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis |
| title_full_unstemmed | Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis |
| title_short | Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis |
| title_sort | calcium hydroxide intracanal medication effects on pain and flare up a systematic review and meta analysis |
| topic | calcium hydroxide intracanal medication meta-analysis non-vital pulp systematic review |
| url | http://rde.ac/upload/pdf/rde-45-e26.pdf |
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