Clinical and Radiographic Failure of Non-surgical Endodontic Treatment and Retreatment Using Single-cone Technique with Calcium Silicate-Based Sealers: A Systematic Review and Meta-Analysis
Journal of Endodontics
Published:March 26, 2024DOI:https://doi.org/10.1016/j.joen.2024.03.007
ABSTRACT
Introduction
This systematic review and meta-analysis aimed to evaluate the clinical and radiographic
failure of non-surgical endodontic treatment and retreatment for mature permanent
teeth with or without apical periodontitis using the single-cone (SC) obturation technique
with calcium silicate-based bio-ceramic (CSBC) sealers and to compare these failure
rates to other sealer materials and obturation techniques.
Methods
A comprehensive search was conducted using MEDLINE (PubMed), Embase, Cochrane Library,
Scopus, Web of Science, and gray literature up to March 2023. Two reviewers assessed
the eligibility of the included studies. Eligible studies were critically appraised
for risk of bias and quality of evidence. Subsequently, a meta-analysis of pooled
data was conducted utilizing the RevMan software (P< 0.05) to evaluate the failure
rate of non-surgical root canal therapy using CSBC sealers and SC obturation procedures.
Separately, another analysis was conducted to compare those results with the outcome
of non-surgical root canal therapy using alternative obturation materials and methods.
Results
5 studies were included. The pooled failure rate for non-surgical endodontic treatment and retreatment combined using CSBC sealers and SC obturation technique was 6.8% [95% confidence
interval (CI)= (3%-12%), I2 = 46%]. A second analysis was conducted on the three included clinical trials to
compare the outcomes of the intervention (CSBC sealers and SC obturation technique)
and control groups (other sealers and other obturation techniques). This analysis
found no significant difference between the two groups regarding clinical and radiographic
failure of endodontic treatment and retreatment [Risk ratio=0.71, 95% CI = (0.33,1.51), I2 = 0]. This difference was also not statistically significant when the failure rate
of primary root canal treatment and retreatment were separately analyzed [Combined
Risk ratio of primary root canal treatment=0.94, 95% CI = (0.46,1.93), I2= 0%; Combined Risk ratio of retreatment=0.21, 95% CI = (0.001, 75.46), I2= 0%].
Conclusions
The overall results of this systematic review and meta-analysis demonstrate that the
SC obturation technique with CSBC sealer provides similar results compared to other
obturation materials and techniques in facilitating the healing of apical periodontitis.
Comments