Abstract
BackgroundThis systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment.MethodsKeywords of “(core carrier OR Thermafil) OR (cold lateral condensation OR lateral condensation) OR (warm vertical condensation OR vertical condensation) AND (obturation OR root canal filling) AND clinical study” were searched for all obtainable publications up to year 2017 in the databases of PubMed, ScienceDirect, EMBASE, Scopus and Web of Science. The success rate, short-term postoperative pain, overfilling and adaptation of core-carrier obturation from clinical studies were selected. Reviews, laboratory studies, animal studies and irrelevant reports were excluded.Results1349 relevant articles were identified with 149 duplicated articles removed and 1173 irrelevant articles were excluded after screening. The titles and abstracts of the 19 identified articles were screened in the systematic review. The full texts of remaining articles were retrieved with data extracted for meta-analysis on the success rate, postoperative pain, overfilling and adaptation of obturation. The pooled success rate of core-carrier obturation was 83% (95% CI: 69%-91%). The pooled incidence of 1-day and 7-day short-term postoperative pain were 35% (95% CI: 15%-62%) and 6% (95% CI: 1-35%). The pooled proportion of teeth with overfilling and adequate adaptation of the obturation material were 31% (95% CI: 18%-50%) and 85% (95% CI: 75%-91%), respectively.ConclusionsThe success rate of endodontic treatment using core-carrier obturation was 83%. Short-term postoperative pain was not uncommon (24%). Most teeth (85%) had adequate adaptation using core-carrier obturation material, but a considerable amount of teeth (31%) had overfilling.
Highlights
This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment
This review primarily aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment, most studies used cold lateral condensation to compare core-carrier obturation
Among these 19 studies, 11 papers reported the treatment success [1, 15, 19, 20, 25,26,27,28,29,30,31], eight papers reported short-term postoperative pain [17, 19, 25, 27, 28, 32,33,34], 11 papers reported overfilling [15, 17, 19, 20, 25, 27, 30, 35,36,37,38] and seven papers reported the adequate adaptation of root canal filling [15, 20, 25, 30, 35, 37, 38]
Summary
This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment. The outcome of endodontic treatments does not rely on a proper disinfection process only, and on tight-sealed fillings of the canals as barriers to prevent re-infection. Root filling material is necessary to obturate the root canal in fluid tight seal 3-dimensionally on the main canal as well as the accessory canals. Since the introduction by Bowman in 1867, Gutta-percha has been the most commonly used solid core endodontic obturation material worldwide [1]. The root canal was packed with this non-plastising gutta-percha in cold lateral compaction, which was gradually moved towards a thermoplastising rubber-like material aimed at increasing root canal adaptability [2]. One of the disadvantages of the cold lateral condensation technique is that gutta-percha cones do not adapt properly to canal walls, in the presence of irregularities
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