Abstract
Background
Apical periodontitis (AP) is an inflammatory disease of the apical periodontium as a sequelae of pulp death. It is managed by disinfection and filling of the root canal space.
Objectives
The aim of this systematic review was to investigate whether obturation techniques and materials used for root canal filling led to management of AP.
Methods
A systematic review protocol was written following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist and registered on the international prospective register of systematic reviews (PROSPERO; CRD42021260275) including two population, intervention, comparison, outcome and time (PICOT) for the research questions querying the effectiveness of obturation techniques (PICOT 1) and materials (PICOT 2) for the management of AP. Electronic searches were conducted on Pubmed, ScienceDirect, Scopus and Embase search engines. Searches on International Endodontic Journal, Journal of Endodontics, Clinical Oral Investigations, Journal of Dental Research and Journal of Dentistry websites were also conducted, until May 2021. Both primary ( tooth survival) and secondary outcomes were evaluated. The risk of bias was assessed by Cochrane RoB2 for the randomized trails and ROBINS-I for the non-randomized.
Results
The search strategy identified 1652 studies, with 1600 excluded on title and abstract screening, leaving 52 studies for full text screening. In total 10 studies met the inclusion criteria. The obturation technique and materials used did not affect the outcome of AP. Vertical compaction resulted in faster resolution of periapical lesions and the oral health related quality of life of patients treated with lateral condensation exhibited poorer outcomes compared to single matched cone after 6 months recall.
Discussion
The inclusion and exclusion criteria used for this systematic review enabled the capture of all the literature available on the effect of obturation techniques and materials on outcome of AP. The data was heterogenous and a number of articles investigating obturation techniques had no information on the materials and techniques used as they looked at quality of fill.
Conclusions
Included studies did not find any difference between different procedures (PICOT 1) and materials (PICOT 2). The risk of bias was high thus the findings should be interpreted with caution.
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