Effectiveness of tricalcium silicate-based cements: Systematic review and meta-analysis

Area of Science:

• Biomaterials Science
• Endodontics
• Dental Materials

Background:

• Tricalcium silicate-based cements offer benefits like biocompatibility and biomineralization induction for dental applications.
• Effective root canal obturation is crucial for long-term endodontic treatment success, requiring excellent sealing and penetration.
• Bioceramic sealers are increasingly used in endodontics due to their favorable properties.

Purpose of the Study:

• To evaluate and compare the sealing ability of tricalcium silicate-based sealers using warm versus cold obturation techniques.
• To assess the intratubular penetration of tricalcium silicate-based sealers with warm and cold obturation methods.
• To synthesize existing evidence through a meta-analysis on the efficacy of different obturation techniques for bioceramic sealers.

Main Methods:

• A systematic electronic literature search was performed in PubMed, Scopus, and Web of Science databases.
• Studies published up to February 2023 focusing on endodontically treated teeth, bioceramics, and sealing capacity were included.
• A meta-analysis was conducted on selected studies, analyzing data for sealing capacity and intratubular penetration.

Main Results:

• The meta-analysis included 10 studies, with 4 addressing intratubular penetration, 4 sealing capacity, and 2 both.
• Warm obturation showed a standardized mean difference (SMD) of 2.34 for intratubular penetration, indicating significantly greater penetration (p=0.032).
• For sealing capacity, warm obturation yielded an SMD of -1.31, demonstrating a superior trend (p=0.081) compared to cold techniques.

Conclusions:

• The warm obturation technique significantly enhances intratubular penetration of tricalcium silicate-based sealers.
• Warm obturation demonstrated a superior sealing capacity compared to cold techniques, approaching statistical significance.
• Warm obturation techniques appear more effective for root canal sealing and achieving better penetration with bioceramic sealers.