Department of Medical Record Management Center, the First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
Office of Scientific Research Management, School of Public Health, China Medical University, Shenyang, 110122, China.
BMC Oral Health. 2024 Nov 27;24(1):1439. doi: 10.1186/s12903-024-05111-x.
This study conducted a thorough assessment of vertical root fracture (VRF) resistance of endodontically treated teeth filled with various canal-filling systems and techniques through frequentist network meta-analysis (NMA).
A systematic literature search was performed to retrieve relevant publications using PubMed, Embase, ScienceDirect, Web of Science, and Cochrane Library databases. The retrieval time range was from Jan 2000 to Sep 2023. The literature selection and data extraction were independently conducted by two investigators. Eligible studies were critically appraised for risk of bias and quality of evidence. Subsequently, we used the 'network' package in Stata/MP 17.0 software to compare the VRF resistance of roots treated with different obturating systems or techniques.
Forty-eight trials involving 2724 single-canal roots were included in the NMA. The surface under the cumulative ranking curves indicated that Resilon/Epiphany (80.8%), although outdated, provided the highest VRF resistance among all obturating systems. This was followed by GP/iRootSP (55.5%), GP/MTA-Plus (47.9%), GP/AH-Plus (47.4%), GP/AH-26 (45.9%), and GP/ZOE (12.3%). The roots filled with Resilon/Epiphany showed better VRF resistance as compared to those filled with gutta-percha/AH-Plus (SMD = 0.77, 95%CI 0.10 to 1.45) and gutta-percha/zinc oxide eugenol (SMD = 1.64, 95%CI 0.47 to 2.80). The single cone technique (SCT) group displayed the highest VRF resistance, and roots filled with all techniques, except Thermafil, outperformed the positive control group.
Resilon/Epiphany demonstrated the greatest root strength among all six obturating systems, followed by GP/iRootSP and GP/MTA-Plus, which are calcium silicate-based systems. In contrast, the gutta-percha/zinc-oxide eugenol system exhibited the weakest performance. All canal-filling techniques, particularly the SCT, strengthen endodontically treated roots, except for the Thermafil technique. Further well-designed clinical trials with large sample sizes are essential for validation.
本研究通过频率网络荟萃分析（NMA）对使用不同根管充填系统和技术进行根管治疗的牙齿的垂直根裂（VRF）阻力进行了全面评估。
使用 PubMed、Embase、ScienceDirect、Web of Science 和 Cochrane Library 数据库进行系统文献检索，检索时间范围为 2000 年 1 月至 2023 年 9 月。由两名研究者独立进行文献筛选和数据提取。对合格研究进行偏倚风险和证据质量的批判性评价。随后，我们使用 Stata/MP 17.0 软件中的“网络”包比较不同充填料系统或技术治疗的根的 VRF 阻力。
纳入的 NMA 包括 48 项试验，共涉及 2724 个单根管根。累积排序曲线下面积表明，虽然 Resilon/Epiphany（80.8%）已经过时，但在所有充填料系统中提供了最高的 VRF 阻力。其次是 GP/iRootSP（55.5%）、GP/MTA-Plus（47.9%）、GP/AH-Plus（47.4%）、GP/AH-26（45.9%）和 GP/ZOE（12.3%）。与使用牙胶/AH-Plus（SMD=0.77，95%CI 0.10 至 1.45）和牙胶/氧化锌丁香酚（SMD=1.64，95%CI 0.47 至 2.80）相比，用 Resilon/Epiphany 填充的根显示出更好的 VRF 阻力。单尖技术（SCT）组显示出最高的 VRF 阻力，除了 Thermafil 技术外，所有技术填充的根都优于阳性对照组。
在所有六种充填料系统中，Resilon/Epiphany 表现出最强的根强度，其次是钙硅酸钠基系统的 GP/iRootSP 和 GP/MTA-Plus。相比之下，牙胶/氧化锌丁香酚系统表现出最弱的性能。所有根管充填技术，特别是 SCT，除了 Thermafil 技术外，都能增强根管治疗后的根，除了 Thermafil 技术外，所有技术填充的根都优于阳性对照组。需要进一步进行设计良好的、具有大样本量的临床试验来验证。
