Eighteen‐month clinical and radiographic evaluation of two root canal‐filling materials in primary teeth with pulp necrosis secondary to trauma

Abstract – Aim: This study compared clinically and radiographically the use of zinc oxide and eugenol cement (ZOE) and a commercial calcium hydroxide and polyethylene glycol‐based paste (Calen^®) thickened with zinc oxide as root canal‐filling materials for primary teeth with pulp necrosis secondary to trauma within 18 months of follow up. Material and methods: Eligible patients of both genders aged 2 years and 6 months to 5 years and 10 months who had been referred for dental treatment at a pediatric dental trauma service and presented at least one anterior primary tooth (central and/or lateral incisor) with pulp necrosis secondary to traumatic injury were selected. Twenty‐six children (n = 31 teeth) with mean age of 3.4 years met the inclusion criteria and were enrolled after parental written consent. The root canals were instrumented and filled with either ZOE (group I; n = 15 teeth) or Calen^® paste composition: 2.5 g calcium hydroxide, 0.5 g zinc oxide, 0.05 g colophony, and 1.75 ml polyethylene glycol 400 (vehicle)] thickened with zinc oxide (Calen^®/ZO; group II; n = 16 teeth). ZO was added to the Calen^® paste for slowing paste resorption, which should ideally occur simultaneously with the physiologic resorption of primary tooth roots. Clinical success after 18 months of follow up was considered as absence of pain, tooth mobility or fistula, and radiographic success as the partial or total remission of apical periodontitis, absence of pathological root resorption or presence of new bone formation. Results: Eighteen months after treatment, the teeth obturated with ZOE and Calen^®/ZO presented statistically similar (Fisher’s exact test; P > 0.05) success rates of 93.3% and 87.5%, respectively. Conclusion: Our results showed the clinical and radiographic outcomes for Calen^®/ZO to be equal to those for ZOE after 18 months, suggesting that both materials can be indicated for obturating primary teeth with pulp necrosis after trauma.