Efficacy of Calcium Hydroxide in the Endodontic Treatment of Primary Teeth: Six Years of Follow-up

Objective: The aim of this work was to evaluate, clinically and radiographically, the efficacy of calcium hydroxide in the endodontic treatment of primary teeth with pulp necrosis associated or not with periapical or interadicular lesions. Method: The test group comprised 33 primary teeth, being 17 anterior teeth and 16 posterior teeth, from 31 children aged 1 to 11 years. The control group consisted of 33 homologous teeth to those treated endodontically and their permanent successors. The patients were treated by two previously calibrated experienced professionals. Endodontic access cavities were made and the chemomechanical preparation was performed under copious irrigation with 1% sodium hypochlorite. When a two-appointment root canal therapy was necessary (teeth with necrotic pulps associated with periapical and/or interadicular lesion), a calcium hydroxide and saline paste was used as an intracanal dressing for 30 days. After this period, the root canals were filled with L&C® calcium hydroxide-based cement. Posttreatment periodic controls were carried out during a follow up period of 72 months until the exfoliation of the primary teeth and eruption of the permanent successor. Results: Adequate outcomes were obtained in 32 out of the 33 teeth evaluated in the test group, i.e., 97% of the treated teeth did not present clinical or radiographic evidence of periapical or interadicular radiolucencies. Comparison between the test and control groups revealed similar results with respect to the stage and pattern of physiological root resorption of the primary teeth, as well as the development and eruption of the permanent successors in both groups. These results indicate endodontic success and demonstrate the efficacy of the employed treatment protocol. Conclusion: Calcium hydroxide is effective in the endodontic treatment of primary teeth, requiring no combination with other antimicrobial agents.