Comparison of Endoflas and Zinc Oxide Eugenol as Root Canal Filling Materials for Pulpectomy in Deciduous Teeth: a Systematic Review and Meta-Analysis.

ABSTRACT

Objectives: To evaluate and compare the effectiveness of Endoflas and Zinc Oxide Eugenol (ZOE) as root canal filling materials (RCFMs) for the pulpectomy of deciduous teeth by analyzing multiple clinical and radiographic success and failure follow-ups in previously published studies. Data All clinical studies that investigated the pulpectomy of the deciduous teeth of children aged 3-9 years. Sources The databases used for source identification included MEDLINE (via PubMed), Scopus, Web of Science, and the Cochrane Library. No limitations were imposed on the publication year or language. The selection of studies and extraction of relevant study characteristics were conducted from December 26, 2021, to September 7, 2023. Additionally, the risk of bias (RoB) in the included studies was evaluated by using a RoB instrument (RoB 2). Eligible studies were then combined, and a random-effects model was applied by using the maximum likelihood estimations of log risk ratios and their corresponding 95% confidence intervals. Study selection Of the 3913 records found in the abovementioned databases, nine were eligible for systematic review and eight were eligible for meta-analysis. The studies included 628 pulpectomies of deciduous molar teeth in children. The overall results showed that compared with Endoflas, ZOE was associated with a higher risk ratio for clinical evaluation (LOG[RR] = 0.06, CI 0.03-0.09, p-value 0.001) and radiographic evaluation (LOG[RR] = 0.68, CI 0.35-1.00, p-value 0.001). This association was highly significant at 6- and 9-month follow-ups. Conclusion: Compared with ZOE, Endoflas was associated with a lower risk of the clinical and radiographic failure of deciduous teeth pulpectomy and a 6%-6.8% higher risk ratio, especially at 6- and 9-month follow-ups. Clinical significance: This study suggests the superiority of Endoflas over ZOE as an RCFM for deciduous teeth.