Department of Specific Formation, School of Dentistry, Federal Fluminense University (UFF), Nova Friburgo, Brazil.
Int J Paediatr Dent. 2012 Sep;22(5):369-81. doi: 10.1111/j.1365-263X.2011.01210.x. Epub 2011 Dec 29.
The effect of smear layer (SL) removal on primary tooth pulpectomy outcome has not been well elucidated.
To determine the effect of SL removal on primary tooth pulpectomy outcome.
This is a double-blind, randomized, and controlled clinical trial. Forty-eight patients were randomly divided into SL removal (G1 = 40 teeth) or smear layer nonremoval (G2 = 42 teeth) groups. Following the chemomechanical preparation with K-files and 2.5% sodium hypochlorite (NaOCl), teeth were irrigated with either 6% citric acid and 0.9% physiologic solution (G1) or only 0.9% physiologic solution (G2). Camphorated paramonochlorophenol was used as intracanal medication. At the second appointment, 1 week after, root canals were filled with zinc oxide-eugenol paste. Clinical and radiographical baseline criteria were stipulated equally for both groups.
The success rate (G1 = 91.2%; G2 = 70.0%) was statistically different (P = 0.04) between the groups. In G2, the outcome was affected significantly by pulpal necrosis (P = 0.02), pre-operatory symptoms (P = 0.02), and periapical/inter-radicular radiolucency (P = 0.04).
The pulpectomy outcome was improved by smear layer removal. The outcome for teeth with pulpal necrosis, pre-operatory symptoms, or periapical/inter-radicular radiolucency was significantly improved by removal of the smear layer.
清除玷污层（SL）对乳牙髓腔治疗效果的影响尚未得到充分阐明。
确定清除玷污层对乳牙髓腔治疗效果的影响。
这是一项双盲、随机、对照的临床试验。将 48 名患者随机分为清除玷污层（G1=40 颗牙）或保留玷污层（G2=42 颗牙）两组。使用 K 锉和 2.5%次氯酸钠（NaOCl）进行化学机械预备后，G1 组用 6%柠檬酸和 0.9%生理盐水冲洗，G2 组仅用 0.9%生理盐水冲洗。樟脑对氯酚作为根管内用药。在第二次就诊时，即治疗后 1 周，用氧化锌丁香酚糊剂进行根管充填。两组的临床和影像学基线标准相等。
G1 组（91.2%）和 G2 组（70.0%）的成功率有统计学差异（P=0.04）。在 G2 组中，牙髓坏死（P=0.02）、术前症状（P=0.02）和根尖/根管周围放射透影（P=0.04）显著影响治疗效果。
清除玷污层可改善牙髓腔治疗效果。对于有牙髓坏死、术前症状或根尖/根管周围放射透影的牙齿，清除玷污层可显著改善治疗效果。
