Hipoclorito de sódio na pulpotomia de dentes decíduos: uma revisão sistemática e meta-análise

Abstract

Rationale/Objectives: Pulpotomy is a conservative pulp therapy that aims to maintain the vitality of the pulp without the need for more radical procedures such as pulpectomy or extraction. The aim of this review was to provide a synthesis of the literature evaluating the clinical and radiographic efficacy of the use of sodium hypochlorite (NaOCl) in pulpotomy of primary teeth and to compare it with other materials used for this procedure. Methodology: Bibliographic searches were performed in Medline via PubMed, Medline via Ovid, Scopus, Lilacs, Embase, Cochrane Library and Web of Sciences. The gray literature search was also performed on Google Scholar, OpenGray, National Institute for Health and Care Excellence (NICE), and ProQuest. Randomized clinical trials, non-randomized clinical trials, and cohort studies in which pulpotomy in primary teeth with sodium hypochlorite was compared with pulpotomy in primary teeth with other materials were included. No restrictions were placed on language or publication date when searching electronic databases. Data were grouped and analyzed descriptively. Qualitative assessment was performed according to the Cochrane risk of bias tool. Rob-2 was used for randomized clinical trials, ROBINS-I for non-randomized clinical trials and the Newcastle-Ottawa Scale for cohort studies. In the RevMan software, meta-analyses were performed incorporating methodologically homogeneous studies. Dichotomous outcomes were used and included clinical and radiographic success. The I2 was used to calculate the heterogeneity of the studies. Results were given in odds ratio and confidence interval. Results: A total of 2654 studies were initially identified through electronic searches. After discarding duplicates and reading the titles and abstracts of the selected articles, 19 studies were considered for reading the full text. After reading the full text, 14 studies met the eligibility criteria. Twelve articles were included in the metaanalysis. Regarding clinical and radiographic successes, there was no significant difference between pulpotomy with NaOCl and pulpotomy with formocresol, ferric sulfate, MTA and saline solution. Most randomized controlled trials had methodological problems that led to a classification of medium risk of bias. All non-randomized clinical trials were classified as having high risk of bias. As for the cohort studies, all two studies were considered to have strong evidence. Conclusion: The results of this study show that NaOCl does not differ from other drugs such as formocresol, ferric sulfate, MTA and saline solution, in the clinical and radiographic success of pulpotomy in primary teeth