Outcomes reporting in systematic reviews on non‐surgical root canal treatment: A scoping review for the development of a core outcome set

Abstract

Background: Studies related to non-surgical root canal treatment are amongst the most frequently performed clinical studies in endodontics. However, heterogeneity in reporting outcomes and lack of standardization is a significant challenge to evidence synthesis and guideline development. Objectives:The aims of the present scoping review were to (a) identify outcomes reported in systematic reviews evaluating non-surgical root canal treatment; (b) identify how and when the reported outcomes were measured; (c) assess possible selective reporting bias in the included studies. The information obtained in this study should inform the development of a core outcome set (COS) for non-surgical root canal treatment.Methodology: Structured literature searches were performed to identify systematic reviews on non-surgical root canal treatments published in English between January 1990 and December 2020. Two reviewers undertook study selection and data extraction. Outcomes were categorized according to a healthcare taxonomy into five core areas (survival, clinical/physiological changes, life impact, resource use, and adverse events). The outcome measurement tools and length of follow-up were recorded. Results: Seventy-five systematic reviews were included, of which 40 included metaanalyses. Most reviews reported on physiological and clinical outcomes, primarily pain and/or radiographic assessment of periapical status, and a variety of measurement tools and scales were used. Few reviews focused on tooth survival, life impact, resources, and adverse events. The heterogeneity amongst the reviews was large on all parameters. Less than 40% of the reviews assessed the risk of selective reporting.Discussion: Overall aims of the included reviews were highly heterogenic; thus, outcomes and how they were measured also varied considerably. Patient-centred outcomes and the use of resources were rarely reported on.Conclusions: Most studies reported on physiological and clinical outcomes, in particular pain and/or radiographic healing. Measurement tools, scales, thresholds, and follow-up periods varied greatly within each outcome, making comparison across OUTCOMES IN NON-SURGICAL ROOT CANAL TREATMENT First author Year Country of corresponding author Journal name Aim /Research question Outcomes Metaanalysis (Y/N) Aminoshariae, A. 2020 USA Clinical Oral Investigations To evaluate the relationship between CVD and outcomes in endodontic treatment.

Post-Operative Quality of Life after Single-Visit Root Canal Treatment Employing Three Different Instrumentation Techniques—An Institutional Randomized Clinical Trial

“…However, their study findings revealed that K files and ProTaper Next found mild continuous pain in both groups, but the duration of pain was longer for hand instrumentation [ 11 ]. Research has suggested that compared to rotary devices, NiTi reciprocating single-file systems may be associated with more severe post-operative discomfort [ 5 , 15 ]. Moreover, a meta-analysis of 42 studies in randomized clinical trials by Hou et al concluded that the use of reciprocating instruments is associated with a higher incidence of post-endodontic pain than the use of rotary instruments [ 13 ].…”

The importance of establishing a core outcome set for endodontic clinical trials and outcomes studies

“…The relevance of a clinical trial is directly related to its outcomes, but most trials in Dentistry are focused on outcomes that are important to clinicians, but not to the patients (Fleming et al, 2016). An evaluation of Endodontic trials, highlights that treatment outcome is based on clinician perception of success in the form of clinical and radiographic evidence of absence of apical periodontitis (Kirkevang et al, 2022), but whether this is the most important outcome for patients is not clear.…”

Outcomes reporting in systematic reviews on revitalization: A scoping review for the development of a core outcome set

“…endodontics, immature teeth, outcomes, regenerative endodontic, revitalization canal treatment (Kirkevang et al, 2022). A recent expert review provided critical analysis of research methods on revitalization procedure (Galler et al, 2022) and covered a range of aspects including subject recruitment, study design, diagnosis, treatment parameters and outcomes.…”

“…The aim of the systematic review process is to identify outcomes reported in all clinical studies in humans in order to generate list of outcomes that are to be categorized according to health intervention taxonomy (Dodd et al, 2018 ) for validation via a subsequent Delphi process and consensus meeting. The process has been completed for VPT (Cushley et al, 2022 ), surgical endodontics (Shah et al, 2022 ) and non‐surgical root canal treatment (Kirkevang et al, 2022 ). A recent expert review provided critical analysis of research methods on revitalization procedure (Galler et al, 2022 ) and covered a range of aspects including subject recruitment, study design, diagnosis, treatment parameters and outcomes.…”