Correlation Analysis Of Different Root Canal Filling Materials On Apical Periodontitis Of Deciduous Teeth

Background:Deciduous apical periodontitis is one of the common clinical diseases in pediatirc dentistry.It is mainly caused by the timely treatment of pulp infection,which leads to the destruction of the periapical root and root bifurcation,and even the early loss of deciduous teeth.Root canal treatment is the most common treatment for deciduous apical periodontitis.Because of the characteristics of deciduous root canal and physiological absorption,the clinical and imaging effects and antibacterial properties of root canal filling materials.Associated with the ability to promote tissue healing.At present,the most widely used root canal filling materials are zinc oxide clove oil,calcium hydroxide,iodoform paste,antibiotic paste,and biological material preparation.Based on this study,the above root canal filling materials were studied to provide a statistical basis for the clinical selection of appropriate root canal filling materials as filling drugs for apical periodontitis.Objective:To evaluate the clinical and radiographic effectiveness of different intracanal filling materials employed in human primary molar pulpectomies,investigate the presence of selective microorganisms in primary root canal infections of deciduous teeth with periapical pathosis,compare three different commonly used for filling the root canals of primary teeth for antimicrobial efficacy against some of the microorganisms commonly found in periapical periodontitis,in order to provide a theoretical and statistical basis for the clinical selection of appropriate root canal filling materials.Methods:1.Electronic searches were conductedin PubMed,Web of Science,Embase and Cochrane databases according to the search strategy,and randomized controlled trials that met the inclusion criteria were obtained.The risk of bias was assessed used the Cochrane risk of bias tool,and forest plots were drawn with Reviewer Manager 5.3.2.A total of 80 root canal samples were obtained from patients with apical periodontitis.The DNA extracted from the sample was amplified by using specific primers for the 16 S rRNA gene of Ef,Pg and Fn,and qualitative analysis was performed to evaluate the specificity of the microorganism in different stages of apical periodontitis.3.In this experimental in vitro study three root canal filling materials and distilled water were tested for antimicrobial efficacy against Enterococcus faecalis,Porphyromonas gingivalis and Fusobacterium nucleatum using the slip diffusion method.Comparing the diameter of theinhibition zone(mm),and statistical analysis was performed using SPSS24.0 software.Results:1.A total of 15 articles were eligible for inclusion in the systematic review;of these,9 studies were included in the meta-analysis.Five studies compared ZOE with iodoform-based paste(Vitapex and Metapex)and illustrated significant differences(P<0.05).In addition,ZOE compared with CH,Vitapex,Metapex and Endoflas and Endoflas compared with Metapex were not significantly different(P>0.05).2.Among the 80 samples,16 samples were found in the P2 phase.The detection rates of Ef,Pg and Fn in the three bacteria were not significantly different in the P2 group(P > 0.05).There were 20 samples in P3 and 44 samples in P4,the detection rate of Ef in these two groups was higher than that of Pg and Fn,and the difference was statistically significant(P <0.05).There were no statistical differences of the detection rate of Pg and Fn in the P3 and P4 groups.3.Triple antibiotic paste showed the strongest antibacterial potential against the three bacteria in the root canal of primary teeth with periapical periodontitis,followed by Vitapex,ApexCal,the results were statistically significant(P<0.05);distilled water was non-inhibitory against these bacteria.Enterococcus faecalis was most sensitive to the three drug reactions,followed by Porphyromonas gingivalis and Fusobacteriumnucleatum,the results were statistically significant(P < 0.05).Conclusions:1.Iodoform-based paste had a higher overall success rate than ZOE in primary molar pulpectomies.Iodoform-based paste may be recommended as a good substitution for ZOE.More studies with sufficient evidence are required to obtain a meta-analysis to comprehensively assess the potency of TAP and other materials for primary molar pulpectomies.2.In the P2 and P3,it is recommended to use a root canal filling material with better anti-Ef effect;in the P2,there is no difference in the ability of the root canal filling material to resist Ef,Pg and Fn.3.Triple antibiotic paste is the most recommended root canal filling material for the treatment of apical periodontitis in primary teeth.