Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies

The fundamental goal of endodontic surgery is to remove the infection cause and create an ideal environment for periapical tissue and bone recovery. This systematic review aims to present evidence-based findings regarding the healing ability of endodontic materials in retrograde treatment. The study...

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Main Authors: Tarek Ashi, Rim Bourgi, Carlos Enrique Cuevas-Suárez, Louis Hardan, Carmen Nahat, Zaher Altaqi, Naji Kharouf, Youssef Haikel
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/15/12/6461
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author Tarek Ashi
Rim Bourgi
Carlos Enrique Cuevas-Suárez
Louis Hardan
Carmen Nahat
Zaher Altaqi
Naji Kharouf
Youssef Haikel
author_facet Tarek Ashi
Rim Bourgi
Carlos Enrique Cuevas-Suárez
Louis Hardan
Carmen Nahat
Zaher Altaqi
Naji Kharouf
Youssef Haikel
author_sort Tarek Ashi
collection DOAJ
description The fundamental goal of endodontic surgery is to remove the infection cause and create an ideal environment for periapical tissue and bone recovery. This systematic review aims to present evidence-based findings regarding the healing ability of endodontic materials in retrograde treatment. The study evaluates the advantages and drawbacks of commonly utilized materials, empowering clinicians with valuable insights for preoperative planning in endodontic surgery. A comprehensive search was conducted across multiple databases, including MEDLINE, Scielo, Web of Science, Scopus, Embase, and Google Scholar, using the PIOT framework. A total of 3124 papers were identified, of which 2534 remained after removing duplicates. Following a stringent selection process, 35 clinical studies were included for qualitative assessment. The risk of bias was assessed using the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for non-randomized trials, the Newcastle–Ottawa Scale for cohort studies, and the Joanna Briggs Institute (JBI) critical appraisal checklist for cross-sectional studies. Due to high heterogeneity in study designs and outcomes, a meta-analysis could not be performed. The review identified Super Ethoxybenzoic Acid (Super EBA), Mineral Trioxide Aggregate (MTA), and Intermediate Restorative Material (IRM<sup>®</sup>), Retroplast, Endosequence<sup>®</sup>, and gutta-percha as the primary retrograde root filling materials. Follow-up periods ranged from 6 months to 17.5 years. Although the materials showed varying degrees of success, the overall findings highlighted that no single material demonstrated universally superior healing ability. The review also emphasized the need for standardization in future clinical trials to facilitate better comparisons. The selection of retrograde filling materials plays a pivotal role in the success of endodontic surgery. New bioceramic materials like MTA and Biodentine offer improved sealing, biocompatibility, and tissue regeneration compared to traditional materials, leading to better clinical outcomes.
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institution Kabale University
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publishDate 2025-06-01
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spelling doaj-art-db7008e15f9f4cd1926c6b4d04924c6d2025-08-20T03:26:15ZengMDPI AGApplied Sciences2076-34172025-06-011512646110.3390/app15126461Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical StudiesTarek Ashi0Rim Bourgi1Carlos Enrique Cuevas-Suárez2Louis Hardan3Carmen Nahat4Zaher Altaqi5Naji Kharouf6Youssef Haikel7Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, FranceDepartment of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, FranceDental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, MexicoDepartment of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut 1107 2180, LebanonFaculty of Dentistry, International University of Catalonia (UIC Barcelona), Sant Cugat del Vallès, 08195 Barcelona, SpainPrivate Practice, Olaya Street, Riyadh 12213, Saudi ArabiaDepartment of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, FranceDepartment of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, FranceThe fundamental goal of endodontic surgery is to remove the infection cause and create an ideal environment for periapical tissue and bone recovery. This systematic review aims to present evidence-based findings regarding the healing ability of endodontic materials in retrograde treatment. The study evaluates the advantages and drawbacks of commonly utilized materials, empowering clinicians with valuable insights for preoperative planning in endodontic surgery. A comprehensive search was conducted across multiple databases, including MEDLINE, Scielo, Web of Science, Scopus, Embase, and Google Scholar, using the PIOT framework. A total of 3124 papers were identified, of which 2534 remained after removing duplicates. Following a stringent selection process, 35 clinical studies were included for qualitative assessment. The risk of bias was assessed using the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for non-randomized trials, the Newcastle–Ottawa Scale for cohort studies, and the Joanna Briggs Institute (JBI) critical appraisal checklist for cross-sectional studies. Due to high heterogeneity in study designs and outcomes, a meta-analysis could not be performed. The review identified Super Ethoxybenzoic Acid (Super EBA), Mineral Trioxide Aggregate (MTA), and Intermediate Restorative Material (IRM<sup>®</sup>), Retroplast, Endosequence<sup>®</sup>, and gutta-percha as the primary retrograde root filling materials. Follow-up periods ranged from 6 months to 17.5 years. Although the materials showed varying degrees of success, the overall findings highlighted that no single material demonstrated universally superior healing ability. The review also emphasized the need for standardization in future clinical trials to facilitate better comparisons. The selection of retrograde filling materials plays a pivotal role in the success of endodontic surgery. New bioceramic materials like MTA and Biodentine offer improved sealing, biocompatibility, and tissue regeneration compared to traditional materials, leading to better clinical outcomes.https://www.mdpi.com/2076-3417/15/12/6461clinical trialsendodontic retrograde treatmenthealing abilityMTAroot filling materialsSuper EBA
spellingShingle Tarek Ashi
Rim Bourgi
Carlos Enrique Cuevas-Suárez
Louis Hardan
Carmen Nahat
Zaher Altaqi
Naji Kharouf
Youssef Haikel
Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
Applied Sciences
clinical trials
endodontic retrograde treatment
healing ability
MTA
root filling materials
Super EBA
title Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
title_full Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
title_fullStr Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
title_full_unstemmed Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
title_short Healing Ability of Endodontic Filling Materials in Retrograde Treatment: A Systematic Review of Clinical Studies
title_sort healing ability of endodontic filling materials in retrograde treatment a systematic review of clinical studies
topic clinical trials
endodontic retrograde treatment
healing ability
MTA
root filling materials
Super EBA
url https://www.mdpi.com/2076-3417/15/12/6461
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