The influence of calcium silicate-based cement on osseous healing: A systematic review and meta-analysis

OBJECTIVES: The purpose of this systematic review was to analyze the effect of commercially available calcium silicate-based bioactive endodontic cement (BEC) on treatment outcome when used as root repair material in human permanent teeth and to compare it with traditional materials. METHODS: PubMed, Embase, and Cochrane Library were searched until June 2020. Randomized clinical studies and observational studies with a minimum 1-year follow-up and sample size of at least 20 were included. Risk of bias (ROB) was assessed using Cochrane's ROB tool and the National Institutes of Health Quality Assessment Tool. RESULTS: Thirty-nine studies were included in the systematic review. Majority of the studies used mineral trioxide aggregate. The pooled success rate for BEC was estimated by a random-effects method as 90.49% (95% confidence interval [CI]: 88.4992.34, I(2) = 54%). Eleven studies comparing BEC with traditional materials were included in the meta-analysis. The use of BEC significantly improved the treatment outcome when compared to traditional materials with odds ratio (OR) = 2.15 (95% CI: 1.57–2.96, I(2) = 0.8%, P = 0.433). CONCLUSION: Very low-to-moderate-quality evidence suggests that the use of BEC as root repair material enhanced the treatment outcome. High-quality studies are required for the newer BEC to establish their clinical performance. Registration: PROSPERO CRD42020211502.