Journal Article

Comparison between immediate and delayed post space preparations: a systematic review and meta-analysis

dos Reis-Prado, Alexandre Henrique, Peixoto, Isabella Faria da Cunha, Tavares, Warley Luciano Fonseca, Viana, Ana Cecília Diniz, Abreu, Lucas Guimarães, Ribeiro-Sobrinho, Antônio Paulino, Benetti, Francine, Bastos, Juliana Vilela, de Oliveira, Elen Marise Castro

2021

Overview

Objectives This systematic review and meta-analysis compared the effects of immediate and delayed post space preparation on apical sealing. Materials and method Two independent authors conducted a systematic search (PubMed/Medline, Cochrane Library, and other databases, until February 2020) and a risk of bias evaluation. Only in vitro studies that compared the effects of immediate and delayed post space preparations on apical filling and adhesion of the post were eligible. Result Of the 742 articles retrieved, 32 were included. Most of the studies used single-rooted human teeth and rotary files for root canal preparation, a single-cone technique for the filling protocol, and rotary instruments for post space preparation. Various delayed preparation times were evaluated: 8–72 h, 5–30 days (mainly 7 days), and 4 months. In nine studies, the delayed groups showed more apical leakage, while four studies reported more leakage in the immediate groups; ten studies found no significant difference. One study found more bacterial penetration in the delayed group, whereas three studies showed no significant difference. One study reported more voids in the delayed group, while another found no such difference. Three studies showed better post-bond strength in the delayed group, one in the immediate group, whereas three found no significant difference in post-bond strength. Three studies employing varied sealers for root canal fillings were considered for meta-analysis. Two subgroup analyses were also performed (one concerning the use of resin-based sealers (AH Plus), another for zinc oxide–eugenol-based sealers). The results of the meta-analysis showed that a delayed post space preparation led to a significantly higher apical leakage than an immediate preparation (mean difference = 0.41 mm, confidence interval = 0.24–0.59, p < 0.001). Conclusion Delayed post space preparation seems to negatively influence apical sealing; however, further studies are needed to determine the influence of the timing of post space preparation on the other parameters. Clinical relevance Immediate post space preparation may be the safest clinical choice to prevent apical leakage.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Dental Leakage / Dentistry / Endodontics / Epoxy Resins / Eugenol / Gutta-Percha / Humans / Leakage / Medicine / Meta-analysis / Post and Core Technique / Review / Root Canal Filling Materials / Root Canal Obturation / Root Canal Preparation / Root canals / Sealing compounds / Systematic review / Zinc oxide