Impact of the Quality of Coronal Restoration versus the Quality of Root Canal Fillings on Success of Root Canal Treatment: A Systematic Review and Meta-analysis

By Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, Pashley DH, Tay FR.

Date: 11/2011
Journal: JOE

Purpose: To determine whether the quality of a coronal restoration or the quality of a root canal filling has a greater impact on the outcome of root canal treatment

PICO: in adult patients who have had nonsurgical root canal treatment, does the presence of an adequate root filling and an inadequate coronal restoration compared with the presence of an inadequate root filling and an adequate coronal restoration result in a worse clinical outcome?

Materials and Methods:

•Electronic literature search was conducted using terms ‘‘coronal restoration,’’ ‘‘root canal,’’ ‘‘periapical status,’’ and ‘‘quality’’ and were reviewed by 3 investigator. 132 initially included and final N = 9

•Data were collected based on predetermined criteria, Percentages of teeth without apical periodontitis were recorded for each category: Adequate root canal treatment (AE), inadequate root canal treatment (IE), adequate restoration (AR), and inadequate restoration (IR). -Data for 3 comparisons (AR/AE vs AR/IE, AR/AE vs IR/AE, and IR/AE vs AR/IE) were analyzed using meta-analysis for odds ratios.

Odds ratios greater than 1 indicate that patients in the first treatment group (eg, AR/AE) had lower odds of apical periodontitis; ORs less than 1 indicate that patients in the second treatment group (eg, AR/IE) had lower odds.

Most highlighted Results:

AR/AE versus AR/IE (OR = 2.734)

AR/AE versus IR/AE (OR = 2.808)

IR/AE versus AR/IE (OR = 1.039)

Clinical significance:

Having adequate endodontic treatment and adequate restoration is the goal