Effect of Obturation Techniques on the Quality of Root Canal Fillings: A Systematic Review and Meta-analysis of Studies.

INTRODUCTION

The current study aimed to compare the quality of root canal obturation performed with cold lateral condensation with other obturation techniques.

MATERIALS AND METHODS

Diverse Search was conducted using six electronic/academic databases following PICOS (i.e. population, intervention, control, outcomes, and study design) strategy: (P) Extracted mature permanent teeth; (I) Obturation techniques except for cold lateral condensation; (C) Cold lateral condensation tyechnique; (O) Quality of root canal obturation; and (S) studies assessing parameters using micro-computed tomography. The statistical method used for the meta-analyses was the "inverse variance DerSimonian-Laird test". The heterogeneity data was calculated using the T2, Cochran Q test, and I2 statistics.

RESULTS

Fifteen studies were included for the final analysis; one had a low risk of bias, eight a moderate risk, and six a high risk of bias. Ten studies were selected for meta-analyses; three studies comparing cold lateral condensation with carrier-based gutta-percha techniques [=0.96; mean difference (MD)=-0.02; confidence interval (CI): (-0.77, 0.73); I2=21%]; three comparing cold lateral condensation with single-cone techniques [=0.75; MD=-0.39; CI: (-2.77, 1.99); I2=92%]; two comparing cold lateral condensation and thermo-plasticized injectable techniques [=0.37; MD=5.91; CI: (-7.13,18.94); I2=99%]; and five comparing cold lateral condensation with warm vertical condensation techniques [<0.0001; MD=5.29; CI=(2.84, 7.74); I2=92%]. The overall effect reported significant results [=0.0003; MD=2.69; CI=(1.23, 4.16); I2=96%]; favoring fewer voids and gaps for the other used obturation techniques.

CONCLUSIONS

Cold lateral condensation and single-cone techniques presented no statistical differences. Nonetheless, Warm vertical condensation technique had better results compared to cold lateral condensation.