Comparative Evaluation of 1% Sodium Hypochlorite vs Other Intracanal Irrigants during Pulpectomy of Primary Teeth: A Systematic Review

Aim: The aim of this systematic review was to compare the clinical effectiveness of 1% sodium hypochlorite (NaOCl) solution with other commonly used irrigants during pulpectomy. Materials and methods: An extensive search was conducted in PubMed, Cochrane, LILACS, Google Scholar, and ScienceDirect until December 2022 in order to identify randomized controlled trials and clinical trials that evaluated the use of 1% NaOCl irrigation in primary molars. Only those trials that met the inclusion criteria were selected for the review. Two independent reviewers were involved in the process of selecting studies, extracting data, and evaluating bias using the Cochrane Collaboration tool and the risk of bias assessment tool 2.0 (RoB 2) to determine the level of bias in the included studies. Results: The systematic review analyzed four articles that met the inclusion criteria, comparing 1% NaOCl irrigation with other commonly used irrigation solutions. The evaluated factors include clinical success, radiographic success over a 1-year period, quality of obturation, and reduction in bacterial count. In clinical success evaluations, 1% NaOCl demonstrated no failures after 12 months of follow-up. Radiographs revealed minimal root resorption in the 1% NaOCl group, indicating its effectiveness. In the obturation quality test, the 1% NaOCl group had more voids. In bacterial count reduction comparisons, 1% NaOCl was equally effective as other irrigants compared. Conclusion: Based on the studies evaluated and the limitations of this review, it is possible to conclude that irrigation with 1% NaOCl is as effective as other irrigation solutions evaluated in the included studies. Clinical significance: The usage of 1% NaOCl irrigation may reduce tissue irritation. This presents a safer alternative by potentially improving patient comfort and treatment efficacy in pediatric dentistry.