Non-Cochrane · intervention · PM41555359
Sealing ability and marginal adaptation of premixed versus manually mixed bioceramic root-end filling materials: a systematic review and meta-analysis.
Hattab Ayham, Al-Tayyan Mouhammad, Hajeer Osama · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-07722-y
Findings
Population Extracted human teeth or standardized dentin models with root-end cavities (in vitro)
2 findings
| Premixed (ready-to-use) bioceramic root-end filling materials | Manually mixed (powder-liquid) bioceramic root-end filling materials | Sealing ability (leakage) Not specified · Laboratory · Overall | SMD -0.12 [-0.46, 0.22] Low Downgraded: risk of bias, imprecision, inconsistency, indirectness 8 studies |
| Premixed (ready-to-use) bioceramic root-end filling materials | Manually mixed (powder-liquid) bioceramic root-end filling materials | Marginal adaptation (interfacial gap width, SEM) Not specified · Laboratory · Overall | MD -1.84 [-3.20, -0.49] Moderate Downgraded: risk of bias, imprecision, inconsistency 6 studies |
Included primary studies 18
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Agrafioti 2020 matched by author and year (probable) | NR | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Agrafioti 2020 Comparative analysis of torque and apical force to assess the cutting behaviour of ProTaper Next and ProTaper Universal endodontic… PMID:31087492 | 2020 | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Arvelaiz 2022 matched by author and year (probable) | NR | this review only | Sealing ability (leakage) | not extracted yet |
| Bago 2022 matched by author and year (probable) | NR | this review only | Sealing ability (leakage) | not extracted yet |
| Bago 2022 Sealing Ability of Bioactive Root-End Filling Materials in Retro Cavities Prepared with Er,Cr:YSGG Laser and Ultrasonic Techniques. PMID:35877365 | 2022 | this review only | Sealing ability (leakage) | not extracted yet |
| Isola 2022 matched by author and year (probable) | NR | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Isola 2022 Oral Fluorescein Angiography with Ultra-Wide-Field Scanning Laser Ophthalmoscopy in Pediatric Patients Precis: Oral Fluorescein… PMID:36143067 | 2022 | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Kim 2015 Interfacial characteristics of Biodentine and MTA with dentine in simulated body fluid. PMID:25478890 | 2015 | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Leal 2011 matched by author and year (probable) | NR | this review only | Sealing ability (leakage); Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Leal 2011 Comparison of the root-end seal provided by bioceramic repair cements and White MTA. PMID:21375542 | 2011 | this review only | Sealing ability (leakage); Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Rencher 2021 matched by author and year (probable) | NR | this review only | Sealing ability (leakage) | not extracted yet |
| Rencher 2021 Comparison of the sealing ability of various bioceramic materials for endodontic surgery. PMID:34513641 | 2021 | this review only | Sealing ability (leakage) | not extracted yet |
| Sagsen 2012 matched by author and year (probable) | NR | this review only | Sealing ability (leakage) | not extracted yet |
| Sahebi 2010 matched by author and year (probable) | NR | this review only | Sealing ability (leakage); Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Sahebi 2010 Obituary: Ake Möller, 1916-2009. PMID:20666764 | 2010 | this review only | Sealing ability (leakage); Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Shokouhinejad 2011 matched by author and year (probable) | NR | this review only | Sealing ability (leakage) | not extracted yet |
| Shokouhinejad 2014 matched by author and year (probable) | NR | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
| Shokouhinejad 2014 Marginal adaptation of new bioceramic materials and mineral trioxide aggregate: a scanning electron microscopy study. PMID:24688585 | 2014 | this review only | Marginal adaptation (interfacial gap width, SEM) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Extracted human teeth or standardized dentin models prepared for root-end cavity filling | Extracted human teeth or dentin models (n=12 studies) |
| Intervention | Premixed ready-to-use bioceramic root-end filling materials (putty or paste) | Premixed bioceramics: EndoSequence BC RRM, BC RRM Fast-Set Putty, TotalFill RRM (n=12) |
| Comparison | Manually mixed powder-liquid bioceramic materials prepared chairside | Manually mixed: ProRoot MTA, MTA Angelus, Biodentine (n=12) |
| Outcomes | Sealing ability (primary); marginal adaptation by SEM gap measurement (secondary) | Sealing ability (n=8); marginal adaptation (n=6) |
| Study designs | In vitro or ex vivo laboratory studies | In vitro studies (n=12) |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Partial Yes | RCT: N/A · NRSI: Partial Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | RCT: N/A · NRSI: No | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |