Effectiveness of mineral trioxide aggregate on postoperative pain in non-surgical endodontic treatment: a systematic review of randomized controlled trials

Maryam Altuhafy; Vikranth Ravipati; Ravleen Nagi; Luay Jabr; Zegar Zegar; Junad Khan

doi:10.1038/s41432-024-00996-7

Effectiveness of mineral trioxide aggregate on postoperative pain in non-surgical endodontic treatment: a systematic review of randomized controlled trials

Evid Based Dent. 2024 Mar 18. doi: 10.1038/s41432-024-00996-7. Online ahead of print.

Authors

Maryam Altuhafy¹, Vikranth Ravipati¹, Ravleen Nagi¹, Luay Jabr², Zegar Zegar³, Junad Khan⁴

Affiliations

¹ Division of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
² Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, NY, USA.
³ Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA.
⁴ Division of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA. junad_khan@urmc.rochester.edu.

PMID: 38499698
DOI: 10.1038/s41432-024-00996-7

Abstract

Introduction: Postoperative endodontic pain can negatively influence the quality of life of the patients. Mineral Trioxide Aggregate (MTA) has gained attention as a potential medicament in various endodontic procedures. MTA has been shown to have desirable properties such as biocompatibility, marginal adaptation, and sealing ability compared to other materials. Limited evidence is available about the effectiveness of MTA on the reduction of postoperative pain following endodontic treatment. This article aimed to compare the non-surgical post-endodontic pain-relieving effect of MTA compared with other materials.

Methods: Indexed databases (PubMed/Medline, EMBASE, OVID, Scopus, and Cochrane) were independently searched for relevant manuscripts published up to and until June 2023. Randomized controlled trials (RCTs) with a focus on teeth with pulp pathologies, with or without radiolucency, requiring primary endodontic treatment were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions.

Results: Out of the initial 169 articles searched, 9 RCTs met the selection criteria. The protocols were like all the studies, but the pain rating scales, filling material, and restoration materials varied. Out of the 9 included studies, in 4 studies MTA significantly reduced postoperative pain levels, 5 studies showed no difference between MTA and other materials, whereas 1 study reported an adverse effect of grey discoloration after MTA.

Conclusion: The findings of the present review indicate that MTA may reduce postoperative pain following non-surgical endodontic treatment. However, future standardized studies should be conducted to validate the results.