Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis.

Autor:	Ibrahim AM; Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt., Zakhary SY; Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt., Amin SAW; Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Restorative dentistry & endodontics [Restor Dent Endod] 2020 May 22; Vol. 45 (3), pp. e26. Date of Electronic Publication: 2020 May 22 (Print Publication: 2020).
DOI:	10.5395/rde.2020.45.e26
Abstrakt:	Objectives: This 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 Methods: Electronic-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). Results: Sixteen 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. Conclusion: Most 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 Registration: PROSPERO database Identifier: CRD42016041953. Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported. (Copyright © 2020. The Korean Academy of Conservative Dentistry.)
Databáze:	MEDLINE
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