(PO113) Outcomes of Primary Root Canal Treatment: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Abstract: The aims of this systematic review were to determine the outcomes of primary root canal treatment (pRCT) and to investigate factors associated with the outcomes of pRCT. Four electronic databases were searched from their inception until August 2023 to identify randomized clinical trials that investigated the outcomes of pRCT. The outcomes were determined based on clinical and radiographic criteria, which were strict, complete resolution of periapical radiolucency, and loose, decrease in size of the radiolucency. A random effects model was used to calculate weighted pooled success rates. The quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Thirty-five studies that met the inclusion criteria were included for the meta-analysis. The pooled success rates for pRCT based on periapical radiographs were estimated to be 86.1% under strict criteria and 91.9% under loose criteria. The pooled success rates based on cone beam computed tomography (CBCT) were estimated to be 36.4% under strict criteria and 85.1% under loose criteria. The success rate based on CBCT was significantly lower than that based on periapical radiographs under strict criteria (p < .05). There was no significant difference in success rates between one visit and multiple visits, vital and necrotic teeth, and teeth with and without periapical lesions under strict and loose criteria (p > .05). GRADE showed a "moderate" quality of evidence for the included studies. The overall success rate of pRCT was high. The outcomes of pRCT were not associated with the number of visits, vitality, and preoperative periapical lesion.