Cytotoxicity, Histopathological, Microbiological and Clinical Aspects of an Endodontic Iodoform-Based Paste Used in Pediatric Dentistry: A Review

This review aims at describing and comparing materials commonly used in root canal therapy, the cytotoxicity,histopathological, microbiological and clinical aspects of a iodoform-based paste (Guedes-Pinto Paste-GPP) used in endodontic treatment of primary teeth. GPP has shown excellent biocompatibility to pulp fibroblasts and mild inflammatory reactions, having been well-tolerated by the periapical and connective tissues. Moreover, GPP bactericidal and bacteriostatic effects against many oral microorganisms were also demonstrated. Regarding clinical trials, the GPP technique has achieved success rates when considering clinical and radiographic examinations. In the face of all the above mentioned results, this paper would like to propose the use of this endodontic material as a root canal filling for primary teeth.

review, pulpectomy, primary teeth, iodoform, camphorated parachlorophenol

1. Kopel HM. Root canal therapy for primary teeth. J Mich State Dent Assoc, 52: 28–33, 1970.

2. Rifiklin A. A simple, effective, safe technique for the root canal treat-ment of abscessed primary teeth. ASDC J Dent Child, 47: 435–441, 1980.

3. Mass E & Zilberman UL. Endodontic treatment of infected primary teeth, using Maisto’s paste. ASDC J Dent Child, 56: 117–120, 1989.

4. Kubota K, Golden BE, Penugonda B. Root canal filling materials for primary teeth: a review of the literature. ASDC J Dent Child, 58: 225–227, 1992.

5. Fuks AB. Pulp therapy for the primary and young permanent dentitions. Dent Clinics of North America, 3: 571– 596, 2000.

6. Guedes-Pinto Ac, Paiva Jg, Bozzola JR. Tratamento endodôntico de dentes decíduos com polpa mortificada. Rev Assoc Paul Cir Dent, 35: 240–45, 1981.

7. Santos EM. Análise da citotoxicidade in vitro de fármacos utilizados na terapia endodôntica de dentes decíduos: estudo comparativo da ação da pasta Guedes-Pinto, formocresol, glutaraldeído e ácido fosfórico sobre cultura de fibroblastos. Master Thesis, São Paulo, 1998.

8. Lopes-Marotti NR. Analysis of cytotoxicity in vitro of Guedes-Pinto’s paste in different storage conditions and post-preparation times on cul-ture of NIH-3T3 fibroblasts. PhD Thesis, São Paulo, 2003. Available at: http://dedalus.usp.br:4500/ALEPH/POR/FOT/FOT/FO/FIND-ACC/0054658

9. Michel JA, Guedes-Pinto AC, Araújo VC. Estudo histopatológico da reação de subcutâneo de camundongos submetidos à ação da pasta Guedes-Pinto utilizada na terapia de dentes decíduos com polpa morti-ficada. Rev Fac Odontol São Paulo, 23: 65–72, 1980.

10. Lujan VAP, Fazzi R, Guedes-Pinto AC, Araújo VC. Histopatologia de la pulpa de dientes de ratones sometidos a la accion de medicamentos uti-lizados en las terapias pulpares de dientes deciduos humanos. Rev Estomatológia, 2: 45–52, 1992.

11. Chedid RR, Guedes-Pinto, AC, Araujo VC. Reação da polpa ao trata-mento endodôntico de decíduos: estudo histopatológico da reação da polpa de ratos submetidos à ação de pastas e medicamentos utilizados na terapia pulpar de dentes decíduos. RGO, 40: 25–28, 1992.

12. Waterhouse PJ, Nunn JH, Whitworth JM, Soames JV. Primary molar pulp therapy-histological evaluation of failure. Int J Paediatr Dent, 10: 313–21, 2000.

13. Faraco-Junior IM & Percinoto C. Avaliação de duas técnicas de pulpec-tomias em dentes decíduos. Rev Assoc Paul Cir Dent 52: 400-04, 1998.

14. Souza CJA, Lacativa AM, Pascon EA, Loyola AM. Avaliação histológ-ica da resposta óssea à pasta Guedes-Pinto: estudo experimental em cobaias. Braz Oral Res, 14: 131 (abstract B188), 2000.

15. Santos EM. Action of the Guedes Pinto’s paste and of calcium hydrox-ide: histophatologic evaluation of the reaction of the subcutaneous of mice and of the activity quimiotatic in vitro of macrophages. PhD The-sis, São Paulo, 2002. Available at: http://dedalus.usp.br:4500/ALEPH/POR/FOT/FOT/FO/FULL/1279494

16. Santos EM, Nakiri JH, Borges MAC, Bussadori SK, Guedes-Pinto AC. Avaliação da biocompatibilidade in vivo e da capacidade reparacional in vitro da pasta Guedes-Pinto armazenada. Braz Oral Res, 20: 286 (abstract Pc158), 2006.

17. Ranly DM & Garcia-Godoy F. Current and potential pulp therapies for primary and young permanent teeth. Journal Dent 28: 153–161, 2000.

18. Bonow MLM, Guedes Pinto AC; Bammann LL. Antimicrobial activity of drugs used in pulp therapy of deciduous teeth. Braz Endod J, 1: 44–8, 1996.

19. Gomes AM, Fonseca L, Guedes-Pinto AC. Avaliação microbiológica do preparo biomecânico e de uma pasta obturadora de canais de dentes decíduos necrosados. Rev Odontoped, 5: 93–101, 1997.

20. Silva CM, Candelária LFA, Bombana AC. Estudo comparativo da ação antimicrobiana entre cinco pastas de obturação de canais radiculares de dentes decíduos. J Bras Odontoped Odontol Bebê, 5: 502–510, 2002.

21. Wen-Shiun T, Been-Foo T, Glenn EM, Coll JA. In vitro inhibition of bacteria from root canals of primary teeth by various dental materials. Pediatr Dent, 17: 351–55, 1995.

22. Reddy S, Ramakrishna Y. Evaluation of antimicrobial efficacy of various root canal filling materials used in primary teeth: a microbiological study. J Clin Pediatr Dent, 31: 193–8, 2007. 23. Tchaou WS, Turng BF, Minah GE, et al. In vitro inhibition of bacteria from root canals of primary teeth by various dental materials. Pediatr Dent, 17: 351–5, 1995.

24. Tchaou WS, Turng BF, Minah GE, et al. Inhibition of pure cultures of oral bacteria by root canal filling materials. Pediatr Dent, 18: 444–9, 1996.

25. Pabla T, Gulati MS, Mohan U. Evaluation of antimicrobial efficacy of various root canal filling materials for primary teeth. J Indian Soc Pedod Prev Dent, 15: 134–40, 1997.

26. Praetzel JR, Guedes-Pinto AC, Weiss R, Friedrich RSC. Atividade antimicrobiana da pasta Guedes-Pinto armazenada sob condições diversas. Braz Oral Res, 17: 117, 2003.

27. Massa VTDM, Brun SC, Oliveira RS et al. Avaliação da atividade antimicrobiana da pasta Guedes-Pinto, em diferentes tempos de armazenagem. Braz Oral Res, 20: 132 (abstract Ic099), 2006.

28. Rifiklin A. A. The root canal treatment of abscessed primary teeth. A three to four-year follow-up. ASDC J Dent Child, 49 :428–31, 1982.

29. Garcia-Godoy F. Evaluation of an iodoform paste in root canal therapy for infected primary teeth. ASDC J Dent Child, 54: 30–4, 1987.

30. Wright KJ, Barbosa SV, Araki K, Spangberg LS. In vitro antimicrobial and cytotoxic effects of Kri 1 paste and zinc oxide-eugenol used in primary tooth pulpectomies. Pediatr Dent, 16: 102–106, 1994.

31. Srinivasan V, Patchett CL, Waterhouse PJ. Is there life after Buckley’s Formocresol? Part I – A narrative review of alternative interventions and materials. Int J Paediatr Dent, 16: 117–127, 2006.

32. Mani SA, Chawla HS, Tewari A, Goyal A. Evaluation of a calcium hydroxide and zinc oxide eugenol as root canal filling materials in primary teeth. ASDC J Dent Child, 67: 142–147, 2000.

33. Holan G, Fuks AB. A comparison of pulpectomies using ZOE and KRI paste in primary molars: a retrospective study. Pediat Dent, 15: 403–407, 1993.

34. Nurko C and& Garcia-Godoy F. Evaluation of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth. J Clin Pediatr Dent, 23: 289–94, 1999.

35. Mortazavi M, Mesbahi M. Comparison of zinc oxide and eugenol, and Vitapex for root canal treatment of necrotic primary teeth. Int J Paediatr Dent, 14: 417–24, 2004.

36. Bengston AL, Bengston NG, Guedes-Pinto AC. Polpotomia em dentes decíduos com o emprego da pasta Guedes-Pinto - Observação clínica e radiográfica. Rev Odontoped, 1: 5–13, 1992.

37. Bengston AL & Bengston NG. Nova conduta nas pulpectomias de dentes decíduos. Avaliação clínico-radiográfica do uso da pasta Guedes-Pinto. RGO, 42: 7–11, 1994.

38. Puppin-Rontani RMP, Peters CF, Worliczeck AT. Tratamento endodôntico de dentes decíduos com necrose pulpar. Rev Assoc Paul Cir Dent, 48: 1235–8, 1994.

39. Araújo OMB, Pereira, MM, Pereira ES, Villamarin JC. Pulpotomias em dentes decíduos com emprego de formocresol diluído a 1/5 com a pasta Guedes-Pinto modificada – Observação clínica e radiográfica. Rev Odontoped, 4: 75–80, 1995.

40. Castro MM. Observações clínico-radiográficas de molares permanentes jovens submetidos à pulpotomia e tratados com Pasta Guedes-Pinto. Rev Odontol Universidade Santo Amaro, 3: 80–3, 1998.

41. Ortega KL, Rezende NPM, Araújo NS, Magalhães MHCG. Effect of a topical antimicrobial paste on healing after extraction of molars in HIV positive patients: Randomised controlled clinical trial. Br J Oral Maxillofacial Surg, 45: 27–9, 2007 (Epub 2006 Feb 17).

42. Downloaded from http://meridian.allenpress.com/jcpd/article-pdf/32/2/105/1749510/jcpd_32_2_k1wx5571h2w85430.pdf by Bharati Vidyapeeth Dental College & Hospital user on 25 American Academy of Pediatric Dentistry. Guideline on Pulp Therapy for Primary and Young Permanent Teeth. Pediatr Dent, 26: 115–9, 2004.

43. Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA & Moffat MA. UK National Clinical Guidelines in Paediatric Dentistry: Pulp therapy for primary molars. Int J Paediatr Dent, 7: 267–68, 1997.

44. Kramer PF, Faraco Junior IM, Feldens CA. Current status of pulp therapy in the Brazilian Universities – Pulpotomy and Pulpectomy Technique in deciduous teeth. J Bras Odontoped e Odontol Bebe, 3: 222–29, 2000.

45. Brusco EHC, Perussolo B, Scapin HLC, Ferreira SLM. Procedimentos e substâncias empregados por faculdades de odontologia brasileiras na terapia endodôntica de dentes decíduos pulpectomizados. J Bras Odontopediatr Odontol Bebê, 5: 35–46, 2002.