| Objective In this paper,the published literature on the comparison of root fracture resistance after cold lateral obturation,warm vertical obturation and single-cone obturation of single root canal premolars at home and abroad was searched,and the effect of three different root canal obturation methods on the root fracture resistance was evaluated by using the method of network meta-analysis,providing evidence-based basis for the selection of obturation schemes during root canal treatment.Methods The published randomized controlled trial of comparing root fracture resistance after cold lateral obturation,warm vertical obturation and single-cone obturation or two of the methods of filling single root canal premolars was retrieved from foreign databases such as Pubmed,Cochrane Library,Web of science and Embase,as well as domestic databases such as CNKI,VIP,CBM and Wan Fang.The retrieval time was set from the establishment of the database to December 2022.The two researchers independently conducted literature screening,data extraction and quality evaluation in strict accordance with the inclusion criteria.In case of disagreement between the two researchers,the final agreement was reached through discussion or consultation with a third party.This network meta-analysis was completed using Stata15.1 software,with mean difference(MD)as the analysis statistic,and95% confidence interval(CI)was calculated.P < 0.05 is statistically significant.The comparison and correction funnel map was drawn to test whether there was publication bias and small sample effect in the intervention network map.Results A total of 15 articles,including 20 independent studies,and 939 cases of teeth were included in this article.In this paper,the mean compressive load of the isolated single root canal premolars at the time of fracture was used as the outcome index to conduct a network meta-analysis.The results showed that: The root fracture resistance of cold lateral obturation[ MD = 92.30,95% CI(41.51,143.09)],warm vertical obturation [ MD = 91.31,95% CI(37.10,145.52)],SC [ MD = 145.10,95% CI(87.23,202.97)] and the negative control group [ MD = 215.99,95% CI(160.89,271.09)] were higher than that of the positive control group(P < 0.05).The root fracture resistance of cold lateral obturation [ MD =123.69,95% CI(73.88,173.50)],warm vertical obturation [ MD = 124.68,95% CI(72.21,77.15)] and single-cone obturation [ MD = 70.90,95% CI(11.54,130.26)] were lower than that of the negative control group(P < 0.05).The required value of root fracture in single-cone obturation technique was higher than that in cold lateral obturation technique group and warm vertical obturation technique group,and the required value of root fracture after cold lateral obturation technique was higher than that in warm vertical obturation technique group,but the difference was not statistically significant(P > 0.05),that is,there was no significant difference in fracture resistance among the three root canal obturation methods.According to the surface under the cumulative ranking(SUCRA),the order of the root fracture resistance of three different obturation methods,negative control group and positive control group is as follows: negative control group(SUCRA = 99.7%)> single-cone obturation(SUCRA = 73.8%)> cold lateral obturation(SUCRA = 38.5%)> warm vertical obturation(SUCRA = 38.0%)> positive control group(SUCRA = 0%).Conclusion The results of this study show that,cold lateral obturation,warm vertical obturation and single-cone obturation are higher than that of the positive control group,that is,the three methods can improve the fracture resistance of the prepared root canals,but the fracture resistance of the root canals filled with the three methods is still significantly different from that of the unprepared root canals.Although there is no significant difference in the fracture resistance of root canals after filling with three different methods,based on the results of the percentage of SUCRA,it can be considered that when considering the fracture resistance of root canal filling methods in a single factor,single-cone obturation can be the preferred option. |
PDF Full Text Request