Dislodgment Resistance of Bioceramic and Epoxy Sealers: A Systematic Review and Meta-analysis

Emmanuel João Nogueira Leal Silva; Antonio Canabarro; Márcia Rejane Thomas Canabarro Andrade; Daniele Moreira Cavalcante; Oscar Von Stetten; Tatiana Kelly da Silva Fidalgo; Gustavo De-Deus

doi:10.1016/j.jebdp.2019.04.004

Dislodgment Resistance of Bioceramic and Epoxy Sealers: A Systematic Review and Meta-analysis

J Evid Based Dent Pract. 2019 Sep;19(3):221-235. doi: 10.1016/j.jebdp.2019.04.004. Epub 2019 Apr 18.

Authors

Emmanuel João Nogueira Leal Silva¹, Antonio Canabarro², Márcia Rejane Thomas Canabarro Andrade³, Daniele Moreira Cavalcante⁴, Oscar Von Stetten⁵, Tatiana Kelly da Silva Fidalgo⁶, Gustavo De-Deus⁴

Affiliations

¹ Department of Endodontics, School of Dentistry-Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil; Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil; Department of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil. Electronic address: nogueiraemmanuel@hotmail.com.
² Department of Periodontology, Veiga de Almeida University (UVA), Rio de Janeiro, RJ, Brazil.
³ Department of Paediatric Dentistry, Fluminense Federal University (UFF), Nova Fibrurgo, RJ, Brazil.
⁴ Department of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
⁵ Private Practice Limited to Endodontics, Stuttgart, Germany.
⁶ Department of Preventive and Community Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.

PMID: 31732099
DOI: 10.1016/j.jebdp.2019.04.004

Abstract

Objectives: The aim of the present systematic review was to evaluate if epoxy resin-based root canal sealers present superior push-out bond strength compared to calcium silicate-based root canal sealers.

Methods: The inclusion criteria consisted of in vitro studies that compared the push-out bond strength of epoxy resin-based and calcium silicate-based sealers. A systematic search was performed in the following databases for articles published until February 2018: PubMed, ScienceDirect, Scopus, Web of Science, and OpenGrey. The quality assessment and data extraction of the selected articles were performed. A meta-analysis of the pooled data and the subgroups according to the root thirds was carried out using the RevMan software (P < .05).

Results: The search resulted in 2292 studies. After the duplicate studies were removed and the title and abstract were read, 20 studies were selected and 17 were considered as having a low risk of bias. The pooled meta-analysis comparing epoxy resin-based (n = 467) and paste-to-paste calcium silicate-based root canal sealers (n = 467) demonstrated higher mean push-out bond strength values (P < .001) for the epoxy resin-based root canal sealers; the heterogeneity among studies was 85% (I²). The comparisons between epoxy resin-based (n = 358) and premixed ready-to-use calcium silicate-based root canal sealers (n = 358) also demonstrated a significant difference between the sealers (P < .05), with an I² of 95%. The subgroup analysis showed that only in the middle third, were increased bond strength values for epoxy resin-based sealer observed (P < .001), with an I² of 94%.

Conclusions: The epoxy resin-based sealer demonstratedhigher push-out bond strength than paste-to-paste calcium silicate-based root canal sealer regardless of the root third assessed. In addition, the epoxy resin-based sealer exhibited increased push-out bond strength in comparison with premixed ready-to-use calcium silicate-based root canal sealer when evaluating the middle third.

Keywords: Dental cements; Endosequence; MTA; Push-out bond strength; Root canal sealers; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Calcium Compounds
Dental Bonding*
Dentin
Epoxy Resins
Humans
Materials Testing
Root Canal Filling Materials*

Substances

Calcium Compounds
Epoxy Resins
Root Canal Filling Materials