The Use of Bioceramics in Retrograde Apicectomy: A Systematic Review of Clinical Applications and Outcomes

This systematic review investigates the clinical use of bioceramic materials in retrograde apicectomy, a surgical endodontic procedure aimed at managing persistent periapical pathology. The review follows the PRISMA 2020 guidelines and is registered in PROSPERO (CRD420251022135). Comprehensive searches were conducted in PubMed, Scopus, and Web of Science from January 2000 to December 2024. Studies were included if they were human clinical trials evaluating bioceramic materials in retrograde apicectomies with a minimum follow-up of 6 months. Data extraction included sample size, material type, healing outcomes, and complications. Nineteen studies met the inclusion criteria. Findings indicated that bioceramics demonstrated superior sealing ability, biocompatibility, and osteoconductive properties compared to traditional materials such as amalgam or IRM. The analysis highlights the effectiveness of mineral trioxide aggregate (MTA) and newer formulations such as bioceramic putty and premixed hydraulic silicate cements. Bioceramics are positioned as a promising standard in apical surgery, though further long-term controlled studies are warranted.