Effect of Type of Coronal Restoration on Periapical Healing and Tooth Survival of Root Filled Teeth: Systematic Review and Meta-Analysis.

Abstract

To evaluate treatment outcomes of directly and indirectly restored root filled teeth (RFT). Electronic databases (MEDLINE/PubMed, Scopus, Embase) were systematically searched for studies comparing indirect and direct restorations on RFT. Outcomes were tooth survival and periapical healing. Minimum follow-up time was 2 years. The quality of included studies was assessed using GRADE. A total of 2063 articles were screened; eventually, 11 studies were included (Ten cohort studies and one RCT). Ten studies reporting tooth survival and four studies on periapical healing were included in meta-analyses. Overall, RFT restored with indirect coronal restorations survived significantly better compared to directly restored RFT (p = 0.01), whereas no statistical difference in periapical healing was demonstrated (p = 0.72). Indirect restorations appear to be associated with improved survival in RFT, but this finding should be interpreted cautiously. No significant difference in periapical healing was found regardless of restoration type. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42024594890.