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Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis

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Abstract

Aim

To evaluate the influence of root canal filling quality on periapical lesion status using cone-beam computed tomography (CBCT).

Materials and Methods

The bibliographic search was conducted in electronic databases of PubMed, Embase, Scopus, and Web of Science without restrictions related to the year of publication and language. Inclusion criteria were prospective or retrospective cohort studies that followed periapical pathosis for, at least, 1 year. Three reviewers independently evaluated the eligibility for inclusion, extracted data, and assessed the risk of bias. The quality of the studies was based on the Newcastle–Ottawa Scale. This meta-analysis was performed to evaluate the quality of treatment by the homogeneity and apical extension of the filling.

Results

Of the 1179 studies initially recovered, six cohort studies were included, out of which four were considered with a low risk of bias. The results showed that the absence of gaps in the filling reduced the chance of unhealed periapical lesions by 2.39 times (RR = 2.39; 95% CI: 1.62–3.53; p < 0.00001; I2 = 55%). An apical filling extension of 0–2 mm below the apex also contributed significantly to the absence of unhealed periapical lesions (RR = 1.49; 95% CI: 1.15–1.94; p = 0.003; I2 = 2%).

Conclusion

The homogeneity and apical extension of the filling influenced the presence of unhealed periapical lesions in endodontically treated teeth evaluated using CBCT.

Clinical relevance

Apical extension of the filling ranging between 0 and 2 mm short of the apical foramen and the homogeneity of the filling without gaps are directly related to the success rate of root canal treatment.

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Acknowledgements

The authors gratefully acknowledge financial support received from Coordination for the Improvement of Higher Education Personnel, CAPES Brazil, nº 33002029032P4 and São Paulo Research Foundation, FAPESP, nº 2018/14450-1.

Funding

The work was supported by Coordination for the Improvement of Higher Education Personnel, CAPES Brazil, nº 33002029032P4 and by São Paulo Research Foundation, FAPESP, nº 2018/14450–1.

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Authors and Affiliations

  1. Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil

    Guilherme Nilson Alves dos Santos, Vitor Luís Ribeiro, Laís Lima Pelozo, Amanda Pelegrin Candemil, Fabiane Carneiro Lopes-Olhê, Jardel Francisco Mazzi-Chaves & Manoel Damião Sousa-Neto

  2. Department of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil

    André Luis Faria-e-Silva

  3. Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil

    Matheus L Oliveira

Authors
  1. Guilherme Nilson Alves dos Santos
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  2. André Luis Faria-e-Silva
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  3. Vitor Luís Ribeiro
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  4. Laís Lima Pelozo
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  5. Amanda Pelegrin Candemil
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  6. Matheus L Oliveira
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  7. Fabiane Carneiro Lopes-Olhê
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  8. Jardel Francisco Mazzi-Chaves
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  9. Manoel Damião Sousa-Neto
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Contributions

Guilherme N. Alves dos Santos: Conceptualization; methodology; data curation; formal analysis; investigation; writing, original draft; project administration. André L. F. Silva, Vitor L. Ribeiro, Laís L. Pelozo and Amanda P. Candemil: Data curation, formal analysis, investigation, writing—review and editing. Matheus L. Oliveira and Fabiane C. Lopes: Visualization, investigation, writing—review and editing. Jardel F. Mazzi-Chaves and Manoel D. Sousa-Neto: Conceptualization; methodology; visualization; investigation; writing, review and editing; supervision; project administration.

Corresponding author

Correspondence to Manoel Damião Sousa-Neto.

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Alves dos Santos, G.N., Faria-e-Silva, A.L., Ribeiro, V.L. et al. Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis. Clin Oral Invest 26, 5105–5116 (2022). https://doi.org/10.1007/s00784-022-04558-y

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