Uncertain Decision-Making in Primary Root Canal Treatment

Area of Science:

• Endodontics
• Dental Public Health

Background:

• Primary root canal interventions are crucial for preserving natural teeth.
• Assessing the success and survivability of these treatments is vital for patient care.

Purpose of the Study:

• To systematically review existing literature comparing the success and survivability of primary root canal interventions.
• To identify gaps in evidence regarding specific treatment modalities.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searches of MEDLINE and Cochrane Oral Health Library up to June 2016, augmented by handsearching.
• Quality assessment of included systematic reviews using the Revised Assessment of Multiple Systematic Reviews (RAMSTAR) protocol.

Main Results:

• Only nine systematic reviews met the inclusion criteria.
• Included reviews lacked sufficient or statistically significant evidence to support specific primary root canal interventions.
• Key treatment aspects like dental files, instrumentation techniques, and obturation materials/techniques were not adequately assessed in systematic reviews.

Conclusions:

• The current evidence base for primary root canal interventions is insufficient, leading to significant uncertainty for dental practitioners.
• This evidence gap poses potential healthcare risks to patients undergoing root canal treatment.
• Development of decision-making tools for uncertain situations is essential to support dentists and patients.