Clinical and Radiographic Outcomes of Different Root Canal Obturation Materials in Primary Teeth: A Retrospective Observational Study

Introduction: Pulpectomy is commonly performed to retain the primary teeth affected by irreversible pulpal disease or necrosis.The choice of root canal filling material may influence treatment outcomes, although the comparative clinical evidence remains inconsistent.This study aimed to compare the clinical and radiographic outcomes of three root canal filling materials used for pulpectomy of primary molars.Materials and methods: This retrospective observational study reviewed the records of children who underwent pulpectomy of the primary molars.Forty-five eligible cases of pulpectomy (per patient, one primary molar tooth) were included and categorized into three groups of 15, according to the material used: zinc oxide eugenol (ZOE), Metapex, and Endoflas.Clinical and radiographic outcomes were assessed at 12 months of follow-up.The obturation quality and adverse radiographic findings were also evaluated.Statistical analysis was performed using the chi-square test, effect-size estimation, and binary logistic regression.Results: Clinical success was observed in 10 (66.7%), 13 (86.7%),and 14 (93.3%)teeth in the ZOE, Metapex, and Endoflas groups, respectively (p = 0.013).Radiographic success was observed in nine (60.0%), 12 (80.0%),and 13 (86.7%)teeth, respectively (p = 0.044).Overall success was achieved in eight (53.3%),11 (73.3%), and 12 (80.0%)teeth, respectively (p = 0.030).Optimal obturation was more frequent with Metapex and Endoflas than ZOE (p = 0.025).Pathological root resorption and persistent/new radiolucency were also significantly more frequent with ZOE treatment.In the regression analysis, Metapex and Endoflas were associated with greater odds of overall success than ZOE.Conclusion: Within the limitations of this retrospective study, Metapex and Endoflas were associated with more favorable clinical and radiographic outcomes than ZOE.Further prospective studies are required to confirm these findings.