Clinical and radiographic success of lesion sterilization and tissue repair in primary teeth: a systematic review and meta-analysis.

Abstract

Research evaluating the clinical and radiographic outcomes of lesion sterilization and tissue repair (LSTR), particularly in terms of mobility, pain, sinus tract, fistula, swelling, root resorption, and interradicular radiolucency is yet to be conducted. This systematic review aimed to assess the clinical and radiographic success of LSTR using three antibacterial drug combinations-"three Mix" (3MIX)-and compare their success rates with those of conventional pulpectomy and pulpotomy in treating primary teeth. Additionally, the review sought to determine which antibiotic combination is most effective in LSTR in primary teeth.  A comprehensive search strategy was applied across three electronic databases: PubMed, Scopus, and King Abdulaziz Digital Library. Two independent reviewers screened 536 titles and 70 abstracts, ultimately selecting 14 articles based on the predefined inclusion criteria. Clinical and radiographic outcomes were evaluated at 6, 12, and 18-month follow-up intervals. The Cochrane's risk of bias tool was used to assess the quality of randomized trials, and the Newcastle-Ottawa Scale was used to assess the methodological quality of non-randomized trials. A total of 14 clinical studies were included in the review. Only two studies compared LSTR to MTA pulpotomy. The composition of 3MIX and other antibacterial mixtures used in LSTR varied significantly, though consistent clinical and radiographic success was observed across the studies. All studies demonstrated relatively high success rates for 3MIX antibiotic paste, both clinically and radiographically. No significant differences were found between the success rates of 3MIX, Vitapex, zinc oxide eugenol, and other 3MIX combinations in pulpectomy of primary teeth. At the 12-month follow-up, the meta-analysis found no significant difference in clinical and radiographic success rates between 3MIX and conventional pulpotomy and pulpectomy. 3MIX may be effective for primary teeth pulpectomy, especially when conventional pulpectomy treatments are not suitable in young, uncooperative children.