Review Article

Effect of an Intraorifice Barrier on Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Table 2

Main results of the included studies.

StudyExperimental groupsIntraorifice barrier depthControl groupsMain results of the included studies

RoghanizadCavit (3M ESPE), TERM (Dentsply), Amalgam (Dentsply)3 mm5 positive (no barrier) and 5 negative controls (nail varnish and sticky wax)A 3 mm intraorifice barrier of Amalgam prevented leakage in 96.4% of the cases, and it was significantly better than Cavit and TERM.
YavariFlow-It (Pentron), GC Gold Label LC (GC America), ProRoot MTA (Dentsply)3 mm10 positive (no barrier) and 10 negative controls (nail varnish and sticky wax)A 3 mm intraorifice barrier of ProRoot MTA was statistically superior to GIC or composite resin to minimize recontamination of the remaining gutta-percha.
MalikFuji II GIC (GC America), ProRoot MTA (Dentsply)4 mm5 positive (no barrier) and 5 negative controls (nail varnish and sticky wax)A 4 mm intracanal plug of ProRoot MTA exhibited a lower mean leakage than Fuji II GIC, and it may be used to minimize microleakage in endodontically treated teeth.
LeeProRoot MTA (Dentsply), EndoCem Zr (Maruchi), MTA Angelus (Angelus), LuxaCore (DMG), Fuji II LC (GC America), ZPC Elite (GC America)3 mm5 positive (no barrier) and 5 negative controls (nail varnish)All the materials allowed infiltration of dye. However, a 3 mm intraorifice barrier of ProRoot MTA showed significantly smaller penetration and less variation than the other materials.
AlikhaniFuji II LC (GC America)1, 2, and 3 mmNoneThe findings indicated that a 3 mm depth of Fuji II LC intraorifice barrier showed the highest preventive effect on coronal microleakage in endodontically treated teeth.
ShindoProtect Liner F (Kuraray), Panavia F (Kuraray), DC Core light-cured (Kuraray), DC Core chemically cured (Kuraray), Super EBA (Bosworth), Ketac (3M ESPE)4 mm5 positive (no barrier) and 5 negative controls (nail varnish)A 4 mm intraorifice barrier of Panavia Liner F and Panavia F had the highest sealing ability than the other materials.
ParekhFuji II LC (GC America), Tetric N-Flow (Ivoclar Vivadent), Fuji II LC+Tetric N-Flow3.5 mm5 positive controls (no barrier)Tetric N-Flow has shown more leakage than Fuji II LC+Tetric N-Flow and Fuji II LC groups when used as intraorifice barriers.
BhullarBiodentine (Septodont), Cention N (Ivoclar Vivadent), Fuji IX GIC (GC America)3 mm10 positive (no barrier) and 10 negative controls (nail varnish)The present study concluded that intraorifice barrier placement provides a better coronal seal and prevents microleakage. Biodentine placed at a 3 mm depth was statistically superior to the other groups.
PisanoCavit (3M ESPE), IRM (Dentsply), Super EBA (Bosworth)3.5 mm5 positive (no barrier) and 5 negative controls (nail varnish)A 3.5 mm intraorifice barrier of Cavit leaked the least when compared to the other included materials.
ZakizadehAmalgam, Fuji Plus LC (GC America), Geristore (DenMat), ProRoot MTA (Dentsply)2 mm5 positive (no barrier) and 5 negative controls (sticky wax)A 2 mm intraorifice barrier of Fuji Plus might be an effective barrier against saliva contamination for a limited time.
YavariProRoot MTA (Dentsply), Amalgam, Filtek Flow (3M ESPE), CEM cement (BioniqueDent)3 mm5 positive (no barrier) and 5 negative controls (nail varnish)A 2 mm intraorifice barrier of MTA and CEM cement are more effective than Amalgam or composite resin in preventing saliva leakage in endodontically treated teeth.
TselnikGray MTA, white MTA, Fuji II LC (GC America)3 mm5 positive (no barrier) and 5 negative controls (epoxy resin)Intraorifice barriers of MTA and Fuji II LC in a 3 mm depth provided an acceptable coronal seal for up to 90 days in vitro.
WolcottKetac-Bond (3M ESPE), Vitrebond (3M ESPE), trial glass ionomer (GC America)2 and 3 mm5 positive (no barrier) and 5 negative controls (epoxy resin)The intraorifice seal provided by the Vitrebond was significantly better than the seal in teeth without intraorifice barriers ().
Barrieshi-NusairProRoot MTA (Dentsply), glass ionomer cement4 mm5 positive (no barrier) and 5 negative controls (sticky wax)Mineral trioxide aggregate, when placed coronally in 4 mm thickness over gutta-percha, seals the canal content significantly more than glass ionomer does.
JenkinsCavit (3M ESPE), ProRoot MTA (Dentsply), Tetric (Ivoclar Vivadent)1, 2, 3, and 4 mm5 positive (no barrier) and 5 negative controls (nail varnish)The results of this study indicated that, at all depths, Tetric demonstrated a significantly better seal than either MTA or Cavit.
SauáiaCavit (3M ESPE), Vitremer LC (GC America), Flow-It (Pentron)3 mm10 positive (no barrier) and 10 negative controls (nail varnish)The results showed that Cavit sealed significantly better than Vitremer and Flow-It when used as intraorifice filling materials at a 3 mm depth.
DivyaComposite resin, gray MTA, white MTA, glass ionomer cement4 mm5 positive (no barrier) and 5 negative controls (nail varnish)None of the materials prevented the microleakage completely. However, the groups restored with MTA showed significantly better results in preventing microleakage than the other groups.
RamezanaliMTA Angelus (Angelus), CEM cement (BioniqueDent), Biodentine (Septodont)3 mm5 positive (no barrier) and 5 negative controls (nail varnish)There were no statistical differences between the experimental groups. However, CEM cement at 3 mm depth exhibited the least microleakage. CEM cement, Biodentine, and MTA effectively provide an efficient seal when used as intraorifice barriers in endodontically treated teeth.
GalvanAmalgambond Plus with PMMA powder (Parkell), C&B Metabond with PMMA powder (Parkell), Æliteflo LV composite (BISCO), Palfique translucent composite (Tokuyama), IRM (Dentsply)Pulpal floor and 3 mm intraorifice depth1 positive (no barrier) and 1 negative control (cyanoacrylate)All the four adhesive resins effectively decreased coronal microleakage, with Amalgambond producing the best seal at all times. IRM, however, demonstrated extensive leakage at 1 and 3 months.
WellsPrinciple cement (Dentsply) and C&B Metabond (Parkell)Pulpal floor and 2 mm intraorifice depth1 positive (no barrier) and 1 negative control (nail varnish)The seal provided by C&B Metabond was superior to the seals produced by principle. However, by 1 week, there were no significant differences among the seals.
MaloneyFuji Triage (GC America)1 and 2 mm5 positive (no barrier) and 5 negative controls (nail varnish)Teeth with Fuji Triage intracoronal barriers leaked significantly less than teeth without barriers. There was no significant difference between the 1 and 2 mm barriers. However, there was a trend towards less fluid movement when a thicker barrier was placed.
JackResilon and Epiphany (Resilon Research), Fuji Triage (GC America)2 mm2 positive (no barrier) and 5 negative controls (nail varnish)The placement of a 2 mm Triage glass ionomer intraorifice barrier after gutta-percha obturation resulted in significantly more resistance to fluid movement than the other groups.
JohnFuji Triage (GC America), gray MTA, white MTA2 mm5 positive (no barrier) and 5 negative controls (nail varnish)No statistically significant difference in fluid flow leakage was found between the experimental groups. Both Fuji Triage and MTA provide superior intraorifice seal than the control group.
BayramCoroSeal (Ivoclar Vivadent), Ketac Molar Easymix (3M ESPE), Filtek Flow (3M ESPE), Polycarboxylate cement2 mm5 positive (no barrier) and 5 negative controls (nail varnish)CoroSeal at a 2 mm intraorifice depth was the most effective material among the other groups in reducing the coronal leakage when compared to flowable composite, fissure sealant, and polycarboxylate cement.
MohammadiGray MTA, white MTA, principle cement (Dentsply)3 mm3 positive (no barrier) and 3 negative controls (epoxy resin)The results indicated that MTA, when placed coronally in 2 mm thickness over gutta-percha, significantly reduced the bacterial penetration.
FathiKetac Cem (3M ESPE), Clearfil AP-X (Kuraray), Maxcem (Kerr)2 mm5 positive (no barrier) and 5 negative controls (inoculated with sterile BHI broth)There was no statistically significant difference in the bacterial penetration of Ketac-Cem, Clearfil Protect Bond/Clearfil AP-X, and Maxcem as intracoronal barriers by 120 days.
ValadaresCavit (3M ESPE)2 and 3 mm25 positive (no barrier) and 5 negative controls (cyanoacrylate)Applying a 3 mm intraorifice barrier of Cavit practically eliminated the microleakage from E. faecalis in the apical third of the root canal system.
RashmiProRoot MTA (Dentsply), Fuji II LC (GC America), Flows-rite (PulpDent)3 mm20 positive (no barrier) and 20 negative controls (epoxy resin)Based on this study, it can be concluded that 3 mm of Fuji II LC provided a better intraorifice seal than MTA and flowable resin composite.
CelikKetac Molar Easymix (3M ESPE), Durelon (3M ESPE), Vitrebond (3M ESPE), Filtek Flow (3M ESPE)1 mm15 positive (no barrier) and 5 negative controls (nail varnish)1 mm intraorifice barrier of Ketac Molar Easymix demonstrated statistically lower leakage than the flowable resin composite group.
Bailón-SanchézProRoot MTA (Dentsply), Cavit (3M ESPE), Tetric EvoFlow (Ivoclar Vivadent)4 mm6 positive (no barrier) and 6 negative controls (nail varnish)ProRoot MTA, Cavit, and Tetric EvoFlow demonstrated similar leakage values when used as an intraorifice barrier at a 4 mm depth.