Primary tooth pulpectomy overfilling by different placement techniques: A systematic review and meta-analysis

This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth.

A systematic search was undertaken by searching Pubmed/MEDLINE and Scopus for English language peer-reviewed articles published until February 2018 that reported overfilling of primary tooth pulpectomy. Two reviewers independently screened and identified studies against the selection criteria and independently collected the data using a specially designed data extraction form. Overfilling rate was the primary summary measure. The weighted pooled overfilling rates were estimated by random-effects meta-analysis.

Twenty clinical and 4 in-vitro studies satisfied the eligibility criteria. In the clinical studies, the pooled overfilling rate for Zinc-Oxide Eugenol was 23.3% with Lentulo mounted in handpiece, 22.7% with Lentulo, and 17% with plugger techniques. The pooled overfilling rate for Calcium hydroxide-based materials was 16.7% with Lentulo mounted in handpiece, 14.7% with Lentulo, 19.6% with provided syringe, and 25.7% with plugger techniques. In the in-vitro studies, neither individual overfilling rates nor two by two comparisons were subjected to meta-analysis because of the inadequate number of studies.

The lowest overfilling rate in the clinical studies was with plugger and hand-held Lentulo techniques for ZOE and calcium hydroxide-based materials, respectively.