Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis

AIM: This study aimed at systematically reviewing the clinical success of repaired iatrogenic perforations using different materials in primary teeth. OBJECTIVES: To compare mineral trioxide aggregate (MTA) with other biomaterials for the repair of iatrogenic perforations in primary molars during endodontic procedures. SEARCH METHODS: A comprehensive literature search was conducted by using three electronic databases (PubMed, Cochrane Library, Google Scholar) to identify articles that evaluated the different intervention materials for the repair of iatrogenic perforation in primary molars. Selection criteria: The articles reporting perforation repair in primary molars having clinical and radiographic success, as their outcome measures with a follow-up period of at least 1 year were included in this review. Studies and case reports with insufficient or unstated follow-up periods, in vitro, and animal studies were excluded. DATA COLLECTION AND ANALYSIS: Two reviewers (SM, LM) independently screened all titles and abstracts according to the inclusion and exclusion criteria. Full texts of the selected studies were obtained for the second stage screening. The consensus was achieved by discussion with the third reviewer (AJ). Data extraction included study design, sample size, age of the patient, year of the study, follow-up period, outcome assessment criteria, material for repair, and success and failure. REVIEW RESULTS: A total of seven publications were included in this review. Of which, one was case series, three were case reports, and three were interventional studies. The combined success rate of MTA (80.55%) was inferior to other materials-premixed bioceramics, Atelocollagen, and calcium-enriched mixture (96.07%); the same being statistically significant (p = 0.011). CONCLUSION: Within the limitations of our study, it can be concluded that newer biomimetic materials are superior to MTA for iatrogenic perforation repair in primary molars in terms of clinical success. CLINICAL SIGNIFICANCE: This paper is a first-of-its-kind investigation comparing different materials used in the repair of perforations in primary molars. It can be a foundation for further research on the topic. In absence of any available guidelines, the above study can be applied in clinical situations with appropriate judgment and caution. HOW TO CITE THIS ARTICLE: Mungekar-Markandey S, Mistry L, Jawdekar A. Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2022;15(5):610-616.