Elmsmari Firas, Elsayed Yousef, Aboubakr Abdelrahman, Kaafarani Mahdi, Nour Osama, Pawar Ajinkya M
Department of Clinical Sciences, College of Dentistry, Ajman University, University Street Al Jerf 1, Ajman, 346, United Arab Emirates.
Center of Medical and Bio-Allied Health Sciences Research, Ajman University, University Street Al Jerf 1, Ajman, 346, United Arab Emirates.
J Oral Biol Craniofac Res. 2025 Nov-Dec;15(6):1422-1432. doi: 10.1016/j.jobcr.2025.08.031. Epub 2025 Sep 2.
Bioceramic sealers, known for their bioactivity and biocompatibility, offer a promising alternative to traditional resin-based sealers. However, clinical evaluations are lacking. This systematic review and meta-analysis compared the clinical and radiographic outcomes of bioceramic single-cone obturation with those of conventional treatment and sealers.
We conducted a systematic search of PubMed, ScienceDirect, and the Cochrane Library for randomized controlled trials (RCTs) published up to March 2024. Our review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (). Included studies compared bioceramic single-cone obturation with conventional obturation in permanent teeth with a follow-up of ≥6 months. Risk of bias was assessed using the second version of the Cochrane Risk of Bias tool (RoB 2.0). A random-effects meta-analysis was performed to calculate pooled success rates, odds ratios (ORs), and 95 % confidence intervals (CIs). Heterogeneity and publication bias were assessed via I statistics and Egger's test.
Three RCTs involving 259 participants met inclusion criteria. The success rates for the bioceramic group were 88.7 %, 87.1 %, and 92.0 % at 6, 12, and 18 months, respectively, while those for the controls were 76.4 %, 76.4 %, and 90.7 %, respectively. Three studies reported higher success rates in the bioceramic groups than in the controls, although between-group differences were not statistically significant (overall OR range 1.12-2.09; p > 0.05). We observed moderate heterogeneity at the early follow-ups and negligible heterogeneity at the 18-month follow-ups.
Single-cone obturation with bioceramic sealers may result in small but clinically relevant advantages; however, more high-quality RCTs with longer-term follow-up are needed.
生物陶瓷封闭剂以其生物活性和生物相容性而闻名，为传统树脂基封闭剂提供了一种有前景的替代方案。然而，缺乏临床评估。本系统评价和荟萃分析比较了生物陶瓷单尖充填与传统治疗及封闭剂的临床和影像学结果。
我们对PubMed、ScienceDirect和Cochrane图书馆进行了系统检索，以查找截至2024年3月发表的随机对照试验（RCT）。我们的综述方案已在国际前瞻性系统评价注册库（PROSPERO）中注册（）。纳入的研究比较了生物陶瓷单尖充填与恒牙常规充填，随访时间≥6个月。使用Cochrane偏倚风险工具第二版（RoB 2.0）评估偏倚风险。进行随机效应荟萃分析以计算合并成功率、比值比（OR）和95%置信区间（CI）。通过I统计量和Egger检验评估异质性和发表偏倚。
三项涉及259名参与者的RCT符合纳入标准。生物陶瓷组在6个月、12个月和18个月时的成功率分别为88.7%、87.1%和92.0%，而对照组的成功率分别为76.4%、76.4%和90.7%。三项研究报告生物陶瓷组的成功率高于对照组，尽管组间差异无统计学意义（总体OR范围为1.12 - 2.09；p>0.05）。我们在早期随访中观察到中度异质性，在18个月随访中异质性可忽略不计。
使用生物陶瓷封闭剂进行单尖充填可能会带来虽小但具有临床意义的优势；然而，需要更多高质量、长期随访的RCT。
