Barreira intraorifício em dentes tratados endodonticamente: uma revisão sistemática e meta-análise de estudos in vitro.

Abstract

The conventional endodontic treatment has the disinfection of the root canal system with adequate sealing of the endodontically treated teeth as its final objective. Adequate coronal sealing plays a fundamental role in the success of endodontic treatment. Thus, the main objective of this study was to evaluate, through a systematic review of the in vitro literature, the effectiveness of different materials used as an intraorifice barrier in reducing coronal microleakage of endodontically treated teeth. Two independent and blinded reviewers carried out a comprehensive search in five electronic databases: PubMed / MedLine, The Cochrane Library, SciVerse Scopus, Embase, and Web of Science. Eligible studies were studies that evaluated the use of an intraorifice barrier in endodontically treated teeth with any material of choice in reducing microleakage. Only in vitro studies published in English were included. A total of twenty-nine in vitro studies were included in the qualitative synthesis, and six of them were included in the quantitative analyses. Most of the included studies placed an intraorifice barrier at a depth of 3 mm. The microleakage reduction was observed when an intraorifice barrier was placed on endodontically treated teeth, regardless of the material used (p≤0,01). Among the materials, the mineral trioxide aggregate (MTA) and the composite resins showed similar performance in reducing microleakage (p>0,05), both being statistically superior to the glass ionomer cement subgroup. Although well-designed randomized clinical trials be required, the in vitro results showed that the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics or composite resins as intraorifice barriers seems to be the best avaiable materials for this purpose.