Clinical studies on core-carrier obturation: a systematic review and meta-analysis

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.

Microscopic and Chemical Assessments of the Filling Ability in Oval-Shaped Root Canals Using Two Different Carrier-Based Filling Techniques

“…The presence of the plastic carrier in a Thermafil obturator could make a retreatment and/or the postspace preparation a difficult task. 25 26 What's more, the clinicians who lack the basic principles for use Thermafil obturator could perform a root canal filling with a naked plastic carrier in the last millimeter of the canal.…”

“…First, the clinicians, who lack of the basic principles for use Thermafil obturator, could perform a root canal filling with a naked plastic carrier in the last millimeter of the canal. 25 26 Second, the preparation of the postspace, if necessary, in a canal filled with a Thermafil obturator could be very difficult and could cause a postoperative perforation as result of a lack of attention or experience on the part of the clinician. Third, the retreatment management in a tooth filled with a Thermafil obturator could be very difficult for a general practitioner.…”

Influence of endodontic procedure on postoperative pain: Evidence from systematic reviews

“…In meta-analysis Peng et al 24 investigated outcome of root canal filling with warm gutta-percha (thermomechanical compaction, thermoplasticized injectable gutta-percha obturation, ultrasonic condensation of gutta-percha, and solid-core carry insertion technique) in comparison to cold lateral condensation, and found that incidence of postoperative pain was similar between the two groups, although the overextension was seen more frequent in the former technique. The results of systematic review and metaanalysis of Wong et al 25 indicate that postoperative pain of core-carrier obturation was comparable with that of cold lateral condensation in day 1 and 7 days after intervention. Moreover, no significant difference in the technical quality of root canal filling (overfilling or adequate adaptation) was found between techniques.…”

Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis

“…15 Obturation techniques that use thermoplasticized gutta-percha have become more frequent because they result in homogeneous fillings and satisfactory sealing against marginal infiltration, 16 but may favor apical extrusion of filling material. 17,18 The filling material when in contact with the periodontal tissues through the apical foramen can potentially modify the healing process in the periodontium 19 and interfere with the occurrence of postoperative pain. 4 The intensity of inflammatory reactions in the apical region depends on several factors, one of these being the composition of the sealer.…”