Effectiveness in the removal of bioceramic sealers versus conventional sealers: systematic review and meta-analysis

Abstract

This study aimed to carry out a systematic review to evaluate the effectiveness in removing bioceramic sealers compared to conventional sealers commonly used, evaluated through the percentage of remaining material. The electronic search was carried out in the following databases: MEDLINE (PubMed), Embase, Web of Science, Scopus, Cochrane Library, and in gray literature, at the Brazilian Digital Library of Theses and Dissertations (BDTD).  Two independent researchers conducted the survey to identify the studies, without restrictions on year and language of publication, using the PICO strategy until the month of August 2020. A total of 80 titles were retrieved in the initial search, however, only 9 studies were included for the qualitative synthesis and 5 studies were included in the quantitative synthesis. The descriptive results indicated that the average time taken to remove the filling material was longer for bioceramics by approximately 67% of the studies that evaluated this condition, and with regard to the establishment of patency, no difference was detected between the sealers. It could be observed that bioceramic sealers presented a lower amount of remaining material than conventional sealers (p = 0.01) both in the overall analysis and in the analysis of subgroups. The removal of conventional sealer proved to be inferior to bioceramic sealers, with greater amounts of material remaining in the root canals after endodontic retreatment. The use of bioceramic sealers has gained space in the endodontic practice. However, it is not yet known whether these sealers affect the removal of root canal fillings during retreatments.