Does the filling technique and the type of sealer affect the incidence of postoperative pain in endodontic treatment? A systematic review of clinical trials.
Creators: name: Sponchiado Junior, Emílio
name: Vieira, Walbert
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Endodontics and Endodontology
subject: Dentistry
subject: FOS: Clinical medicine

description: Systematic review Review title. Does the filling technique and the type of sealer affect the incidence of postoperative pain in endodontic treatment? A systematic review of clinical trials. Anticipated or actual start date. DD/MM/YY- 03/02/2020 Anticipated completion date. DD/MM/YY - 30/11/2020 Stage of review at time of this submission. Review stage Started Completed Preliminary searches Yes Yes Piloting of the study selection process Yes Yes Formal screening of search results against eligibility criteria Yes Yes Data extraction No No Risk of bias (quality) assessment No No Data analysis No No Named contact. Emilio Carlos Sponchiado Junior spemilio@ufam.edu.br Named contact address Piracicaba Dental School- State University of Campinas (UNICAMP) , Av. Limeira, 901 - Areião, Piracicaba – São Paulo, Brazil. Organizational affiliation of the review. Piracicaba Dental School- State University of Campinas (UNICAMP) 1.Emilio Carlos Sponchiado Junior. Federal University of Amazonas and Piracicaba Dental School (UNICAMP) 2. Walbert de Andrade Vieira. Piracicaba Dental School (UNICAMP) 3. Juliana Vianna Pereira. Federal University of Amazonas and Piracicaba Dental School (UNICAMP) 4. Adriana de Jesus Soares. Piracicaba Dental School (UNICAMP) Funding sources/sponsors. There is no funding involved in the present systematic review Conflicts of interest. None Review question. Does the filling technique and the type of sealer (Interventions) affect the incidence of postoperative pain (Outcomes) in endodontic treatment? (Population) A systematic review of clinical trials. (Study design) Searches. The main databases searched was PubMed (including MEDLINE), Scopus, Embase, SciELO, Web of Science, Cochrane Library and LILACS. Each article will be assessed carefully and in detail. In case of missing information, the authors will be contacted by e-mail. After the formal search strategy, the reference lists of the eligible article will be searched for eventually missing articles. The search was performed on February 3, 2020. There wasn't any restrictions on the language or publication period. These are some terms that was used: (postoperative pain or endodontic pain or postoperative endodontic pain) and (root canal obturation or root canal sealer or root canal filling). OpenThesis, OpenGrey, REBEC and Clinical Trials base was searched for grey literature. Condition or domain being studied. This systematic review will investigate whether different obturation techniques and different sealers will influence the incidence of postoperative pain in patients undergoing endodontic treatment. Intervention(s), exposure(s). Clinical trials comparing different filling techniques and/or different type of sealers with or without overfilling that evaluated the occurrence of postoperative pain after endodontic treatment. Comparator(s)/control. Other root canal sealers and/or other obturation techniques Types of study to be included. Randomized clinical trials (RCTs) or Controlled Clinical Trials (CCTs) were considered. Participants/population. The inclusion criteria were as follows: Study participants will be adults (age 18–65 years) who underwent endodontic treatment; Participants received conventional RCT or CCT. There were no limitations on gender, ethnicity, or socio-economic status of the participants; type of endodontic diagnosis; Outcome variables included the prevalence of pain, pain intensity, or the need for analgesics; The follow-up time was at least 6h after therapy. The exclusion criteria were as follows Patients who were pregnant, immunocompromised, on medication or hypersensitive to anti-inflammatory drugs, or patients with occlusal disorders or any type of periodontitis or endodontic complications, since these conditions would interfere with the analysis of the presence of pain after endodontic treatment. The inclusion criteria were as follows: Study participants will be adults (age 18–65 years) who underwent endodontic treatment; Participants received conventional RCT or CCT. There were no limitations on gender, ethnicity, or socio-economic status of the participants; type of endodontic diagnosis; Outcome variables included the prevalence of pain, pain intensity, or the need for analgesics; The follow-up time was at least 6h after therapy. The exclusion criteria were as follows Patients who were pregnant, immunocompromised, on medication or hypersensitive to anti-inflammatory drugs, or patients with occlusal disorders or any type of periodontitis or endodontic complications, since these conditions would interfere with the analysis of the presence of pain after endodontic treatment. Studies characterized as case reports, case series, review papers, letters to the editor, monographs, conference papers, or in vitro studies. Main outcome(s). The primary outcome was the analysis of the occurrence of postoperative pain after endodontic treatment. Additional outcome(s). If apical Overfilling affect the incidence of postoperative pain; total amount of analgesics consumed in mg or number or capsules. Data extraction The papers will be screened independently by two reviewers. At first, they will screen the articles by title and abstract. Secondly, full text-papers will be retrieved and selected based on the inclusion criteria. Disagreements between the two reviewers will be resolved by discussion with a third reviewer. Data extraction will also be carried out independently by two reviewers. Data extraction forms will be used to record the following information: (a) authors and year of publication; (b) study design; (c) country; (d) participants sample size; (e) age group and sex (f) endodontic diagnosis; (g) tooth types; (h) endodontic treatment; (i) technique of obturation; (j) type of sealers; (l) extrusion of material filling; (m) evaluation method; (n) evaluation interval; (o) occurrence and pain intensity. Risk of bias (quality) assessment. This systematic review will be carried out following the Cochrane Handbook for the Systematic Reviews of Interventions and the preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines To Assess the quality of the included studies using the Cochrane risk of bias assessment tool for seven domains. For this, each domain will be divided into three categories: low risk of bias, unclear risk of bias, and high risk of bias. The studies will be classified as low risk of bias if all domains were evaluated to be of low risk, as moderate risk bias if one or more domains were evaluated to be of unknown risk, or as high risk if any domain was evaluated as high risk. These procedures will be performed blind (unknown authorship) to avoid conflicts of interest. Disagreements between the two reviewers will be resolved by discussion with a third reviewer Strategy for data synthesis. In case of homogeneous data, will include meta-analysis of the selected papers in which effect measures and 95% of CIs or standard deviation are reported or can be extracted. Data from eligible studies will be either dichotomous (occurrence of pain) or continuous (pain intensity and amount of analgesics consumed). The outcomes will be summarized by calculating the Hedge’s g standardized mean difference (continuous data) and the risk ratio (dichotomous data). The random effects models will be employed. Heterogeneity wil be assessed using the I² statistics. Potential publication bias will be tested for using the funil plot. The level of significance for all tests was 5%. Analysis of subgroups or subsets. Depending on the number of included studies, subgroup analysis will be performed to evaluate: Subgroup analysis will be carried out according to technique obturation group, type of sealers and with or without apical overfilling. Type of review Systematic Review of Intervention and Meta-analysis Language and Country English / Brazil Keywords. endodontic, postoperative pain, root canal obturation, root canal sealer Current review status. Review Ongoing Other Registers PROSPERO acknowledgement of receipt [169255]