Assessment of Treatment Outcomes with Complete Orthograde Obturation with Bioceramic Materials: A Scoping Review

Abstract

Aim: Bioceramic sealers are being used as obturation materials as they are known for hard tissue induction and facilitating periapical healing. Based on some in vitro studies, one can hypothesize that mineral trioxide aggregate (MTA) and biodentine used as the sole obturating material could reinforce the tooth and provide a better sealability than an MTA/biodentine apical plug with gutta-percha obturation. However, there are not many high-quality studies regarding outcomes of complete MTA/biodentine obturations compared with traditional obturation methods. The aim of this review is to organize findings of clinical outcomes and the quality of complete obturation of root canals from various in vitro studies and to identify the gaps in research done in this area. Methods: The preferred reporting items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews guidelines were followed to conduct a thorough literature search in June 2024 across PubMed, Google Scholar, Scopus, Science Direct, and Scielo. The research question was formulated using PICO: population: permanent dentition in adults or children; intervention: orthograde monoblock obturation; comparator: traditional orthograde root canal filling methods; outcome: success defined by asymptomatic, functional tooth, and radiographic evidence of healing. Results: Out of 511 initially identified studies, 474 studies did not meet initial eligibility criteria for inclusion, and only 37 studies were selected. After full-text scrutiny, only 23 were subjected to qualitative assessment. Conclusion: The findings of the data concluded that complete obturation with MTA and biodentine could be a viable alternative to an apical plug followed by gutta-percha obturation or bioceramic sealer with gutta-percha obturation. The lack of randomized controlled trials and long-term retrospective studies precludes clinicians from utilizing this technique. Clinical significance: Bioceramic materials can be used for complete obturation of canals, both in primary and retreatment cases, bringing about periapical healing and regeneration of tissues. They are found to reinforce and improve the strength of radicular structure on account of the monoblock effect.