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Comparison between immediate and delayed post space preparations: a systematic review and meta-analysis.

Alexandre Henrique Dos Reis-Prado1, Lucas Guimarães Abreu2, Warley Luciano Fonseca Tavares1

  • 1Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Clinical Oral Investigations
|January 8, 2021
PubMed
Summary

Delayed post space preparation increases apical leakage. Immediate preparation is the safer clinical choice to prevent leakage and ensure better apical sealing in endodontic treatments.

Keywords:
Dental leakageEndodontically treated teethEndodonticsMeta-analysisProsthodonticsSystematic review

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Area of Science:

  • Endodontics
  • Restorative Dentistry
  • Dental Materials

Background:

  • Post space preparation is crucial for restoring endodontically treated teeth.
  • The timing of post space preparation (immediate vs. delayed) may impact the integrity of the apical seal.

Purpose of the Study:

  • To systematically review and meta-analyze studies comparing immediate and delayed post space preparation regarding apical sealing.
  • To evaluate the influence of preparation timing on apical leakage, bacterial penetration, voids, and post-bond strength.

Main Methods:

  • Systematic literature search of PubMed/Medline, Cochrane Library, and other databases until February 2020.
  • Inclusion of in vitro studies comparing immediate and delayed post space preparation effects on apical filling and post adhesion.
  • Risk of bias assessment and meta-analysis of relevant studies.

Main Results:

  • Meta-analysis of three studies revealed significantly higher apical leakage with delayed post space preparation (MD = 0.41 mm, CI = 0.24-0.59, p < 0.001).
  • While some studies indicated more leakage with delayed preparation, others found no significant difference in leakage, bacterial penetration, voids, or post-bond strength.
  • Subgroup analyses were performed for resin-based and zinc oxide-eugenol-based sealers.

Conclusions:

  • Delayed post space preparation appears to negatively affect apical sealing, increasing apical leakage.
  • Immediate post space preparation is suggested as a safer clinical approach to prevent apical leakage.
  • Further research is needed to fully elucidate the impact of preparation timing on other parameters like bond strength.