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

Abstract

Introduction Thorough cleaning and shaping of root canals are essential for periapical healing. Restoration of endodontically-treated teeth is also required for them to function and prevent coronal leakage. This study compared the impact of the quality of root canal treatment versus the quality of coronal restoration in treatment outcomes. Methods Literature search was conducted using the search terms “coronal restoration”, “root canal”, “periapical status” and “quality”. Articles that evaluated the effect of the quality of root filling and coronal restoration or both on the success of root canal treatment were selected. Nine articles were identified and were reviewed by three investigators. Data were collected based on pre-determined 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), Inadequate Restoration (IR). Data were analyzed using meta-analysis for odds ratios (ORs). Results After adjusting for significant covariates to reduce heterogeneity, the results were combined to obtain pooled estimates of the common OR for the comparison of AR/AE vs AR/IE (OR 2.734; 95% CI 2.61–2.88; p<0.001) and AR/AE vs IR/AE (OR 2.808; 95% CI 2.64–2.97; p<0.001). Conclusion On the basis of the current best available evidence, the odds for healing of apical periodontitis increase with both adequate root canal treatment and adequate restorative treatment. Although poorer clinical outcomes may be expected with adequate root filling-inadequate coronal restoration and inadequate root filling-adequate coronal restoration, there is no significant difference in the odds of healing between these two combinations.

Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers

“…Final restoration and use of dental dam isolation have also been shown to have a significant impact on the long-term outcomes of endodontic treatment, but these factors cannot be adequately derived from claims data. 5,17,18,24 Despite the limitations of this study, the high long-term survival rates of endodontically treated teeth reconfirm the predictability of endodontic treatment provided by the dental health system as a whole. One-year, 5-year, and 10-year survival rates of 96%, 92%, and 86%, respectively, represent survival rates similar to those of previous studies.…”

Fracture strength, failure type and Weibull characteristics of lithium disilicate and multiphase resin composite endocrowns under axial and lateral forces

“…Hence, their retention to the tooth is achieved through both macro-and micro-mechanical means. Endocrowns restore the anatomy, seal the root canal opening, preventing bacterial recolonization all of which eventually affect the long-term prognosis of a tooth following endodontic treatment [2].…”

“…Hence, their retention to the tooth is achieved through both macro-and micro-mechanical means. Endocrowns restore the anatomy, seal the root canal opening, preventing bacterial recolonization all of which eventually affect the long-term prognosis of a tooth following endodontic treatment [2].Finite element analysis, mathematical modelling and static loading tests from in vitro studies suggest that molar teeth restored by endocrowns could withstand physiological chewing forces without fracture or debonding [3][4][5]. They seem to be potentially more resistant to failure than molars restored with glass fiber reinforced composite posts [3][4][5].…”

Evaluation of Apical Contamination in Teeth with Prefabricated Posts Fixed with Different Dental Cements

“…Endodontically treated teeth should therefore be restored as soon as possible, preserving the antisepsis of the pulp cavity, considering that in addition to the technical quality of the endodontic treatment, adequate coronal restoration is correlated to high periapical success rates [1][2][3][4][5][6][7][8]23]. So, it seems reasonable to think that the combination of good endodontic treatment followed by efficient cementing of the pin / restoration set may delay or hinder the access of contaminants from the oral cavity to the periapical region, possibly increasing the success rate of the dental treatment.…”

“…Endodontically treated teeth should therefore be restored as soon as possible to preserve the antisepsis of the pulp cavity obtained, since the technical quality of the endodontic treatment and adequate coronal restoration are correlated with high success rates [1][2][3][4][5][6][7][8].…”