title: Long-term outcomes of primary tooth pulpectomy with and without smear layer removal: a randomized split-mouth clinical trial.
abstract: OBJECTIVE
  The aim of this study was to evaluate, via clinical and radiographic assessment, pulpectomy outcomes performed on primary anterior teeth both with and without a citric acid solution to enhance smear layer removal.
  
  
  METHODS
  Patients with a matched pair of primary incisors (split-mouth design) with irreversible pulp changes were selected. A total of 36 teeth (18 children) received pulpectomies and were followed for 36 months. Pulpectomies were performed using sodium hypochlorite and saline solution as canal irrigants; during the last irrigation, the tooth was randomly selected to receive ( Group 1) or not receive (Group 2) the citric acid solution for smear layer removal. The roots were filled with ZOE paste.
  
  
  RESULTS
  Overall pulpectomy success was 90.6%. Cases with smear layer removal were successful 82.3% of the time; those without smear layer removal, 88.2%, and there were no statistical differences (P=1.00).
  
  
  CONCLUSIONS
  Pulpectomy with smear layer removal in primary incisors exhibited, after 36 months, a high success rate; however, comparable results were obtained when the smear layer was not removed.
authors: Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Patricia Nivoloni
authors: PN
authors: Tannure
authors: Camilla Pontes
authors: CP
authors: Azevedo
authors: Roberta
authors: R
authors: Barcelos
authors: Rogerio
authors: R
authors: Gleiser
authors: Laura Guimarães
authors: LG
authors: Primo
mesh_terms: D002614:Chelating Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D019343:Citric Acid / Q000627:therapeutic use*; D003790:Dental Pulp Necrosis / Q000628:therapy; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D011670:Pulpectomy / Q000379:methods*; D011671:Pulpitis / Q000628:therapy; D012387:Root Canal Filling Materials; D012389:Root Canal Obturation; D016369:Smear Layer; D014094:Tooth, Deciduous; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement
chemical_list: D002614:Chelating Agents; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; D019343:Citric Acid