Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses.

Abstract

To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth. Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE. Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6months (RR = 0.99, 95% CI, 0.94-1.04, p= 0.67; I2= 0%), 12months (RR = 0.97, 95% CI, 0.90-1.04, p= 0.34; I2= 0%), and 18months (RR = 0.89, 95% CI, 0.77-1.04, p= 0.14; I2= 0%) and radiographic findings at 6months (RR = 0.91, 95% CI, 0.78-1.06, p= 0.23; I2= 9%), 12months (RR = 0.87, 95% CI, 0.65-1.18, p= 0.38; I2= 64%), and 18months (RR = 0.84, 95% CI, 0.69-1.02, p= 0.08; I2= 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low. No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low. The present meta-analyses could not demonstrate the superiority of one treatment over the other.