Does quality of the final restoration or root canal filling have greatest impact on final outcome?

iStock_000013123590XSmall root canal x-ray

This review looked whether the quality of the final restoration or the quality of the root canal filling had the greatest impact on the outcome of the root canal filling.

Medline, Embase, the Cochrane Library, the Wiley online database, four journals; (Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, and Endodontics and Dental Traumatology) and the references of all relevant articles were searched. There were no language restrictions. 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 3 investigators. 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 were analyzed using meta-analysis for odds ratios (ORs).

They found:

  • AR/AE versus AR/IE (OR = 2.734;  95%CI, 2.61–2.88; P < .001)
  • AR/AE versus IR/AE (OR =2.808;  95% CI, 2.64-2.97; P < .001)

They concluded:

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.

Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, Pashley DH, Tay FR. 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. J Endod. 2011 Jul;37(7):895-902. Epub 2

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –