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Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis

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Abstract

Objectives

Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)2] or antibiotics.

Materials and methods

We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case–control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type.

Results

Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15–0.45,\({I}^{2}\)=92.6%), 46.5% with Ca(OH)2 vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH)2 group (46.5%, 95% CI: 0.17–0.68,\({I}^{2}=80.9\)%) than in the antibiotic group (10%, 95% CI: − 0.04–0.43,\({I}^{2}=82.1\)%).

Conclusions

Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH)2 paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification.

Clinical relevance

This study highlights the significant association between complete calcification and Ca(OH)2 paste.

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Author information

Authors and Affiliations

  1. Department of Endodontics, College of Dentistry, Qassim University, Qassim, P. O. Box: 1162, Saudi Arabia

    Waleed Almutairi

  2. Department of Endodontics, Eastern Riyadh Dental Center, Second Health Cluster in Riyadh, Ministry of Health, Riyadh, Saudi Arabia

    Yousef Al-Dahman

  3. Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, Al Majmaah, Saudi Arabia

    Faisal Alnassar

  4. Department of Statistic, Faculty of Science, Tabuk University, Tabuk, Saudi Arabia

    Olayan Albalawi

Authors
  1. Waleed Almutairi
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  2. Yousef Al-Dahman
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  3. Faisal Alnassar
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  4. Olayan Albalawi
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Contributions

The authors confirm contribution to the paper as follows: Waleed Almutairi: conceptualization, methodology, investigation, writing—reviewing and editing. Yousef Al-Dahman: methodology, investigation, writing—original draft preparation. Faisal Alnassar: methodology, investigation, software. Olayan Albalawi: methodology, formal analysis, writing—reviewing and editing.

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Correspondence to Waleed Almutairi.

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Almutairi, W., Al-Dahman, Y., Alnassar, F. et al. Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis. Clin Oral Invest 26, 3333–3342 (2022). https://doi.org/10.1007/s00784-021-04333-5

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