Does the use of natural products for endodontic therapy in primary teeth have sufficient evidence for clinical practice? A scoping review.

Abstract

The use of natural products for pulp therapy has experienced a remarkable advancement in recent years. The aim was to provide a critical appraisal of the safety and efficacy of natural products for endodontic therapy in primary teeth and verify whether their uses in clinical practice have sufficient evidence. Two reviewers searched ten databases (Cochrane, DOSS, Embase, Google Scholar, LILACS, OpenGrey, Proquest, PubMed, Scopus, and Web of Science) until January 2022, identifying references that evaluated the safety and efficacy of the use of natural products for endodontic therapy in primary teeth. Cohort, randomized, and non-randomized clinical trials were included. A total of 3583 references were initially identified. From the 63 studies retrieved for full-text reading, 37 fulfilled the selection criteria and were included in the qualitative analysis. The studies investigated 19 natural products for pulpotomy medicament, irrigating solution, intracanal medication, and root canal filling material. Most studies showed similar efficacy of natural products and their control groups; however, many methodological biases and concerns about the safety and efficacy of natural products were identified, questioning their clinical applicability. The included studies provided insufficient evidence to support safe and effective clinical application of natural products for endodontic therapy in primary teeth. Future well-designed studies with representative samples are needed to support the use of natural products for endodontic therapy in primary teeth. The use of natural products for endodontic therapy in primary teeth requires caution by clinicians, due to the insufficient available evidence.