Evidence map›Paper›PMID 41555359›Full record

SynthesisBMC oral health2026

Sealing ability and marginal adaptation of premixed versus manually mixed bioceramic root-end filling materials: a systematic review and meta-analysis.

Ayham Hattab, Mouhammad Al-Tayyan, Osama Hajeer

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ayham HattabDepartment of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria.
Mouhammad Al-TayyanDepartment of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria.
Osama HajeerDepartment of Fixed Prosthodontics, Faculty of Dentistry, University of Aleppo, Al-Furqan, Aleppo City, 13310, Syria. osamahajeer@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPremixed bioceramic root-end filling materials have been introduced as an alternative to manually mixed formulations, with the aim of improving handling properties and reducing operator-dependent variability. This systematic review and meta-analysis compared the sealing ability and marginal adaptation of premixed versus manually mixed bioceramic materials used for root-end filling.

methodsThis review was conducted in accordance with PRISMA 2020 guidelines. Six electronic databases and relevant grey literature sources were systematically searched. Laboratory-based studies comparing premixed and manually mixed bioceramic root-end filling materials were included. Random-effects meta-analyses were performed using standardized mean differences (SMDs) or mean differences (MDs), each reported with 95% confidence intervals (CIs).

resultsTwelve studies met the inclusion criteria. Eight studies contributed data to the sealing ability meta-analysis, and six studies contributed to the marginal adaptation meta-analysis. No statistically significant difference in sealing ability was observed between premixed and manually mixed materials (SMD = - 0.12; 95% CI: -0.46 to 0.22; p = 0.48; I² = 58%). In contrast, premixed bioceramic materials demonstrated significantly superior marginal adaptation, reflected by smaller interfacial gaps (MD = - 1.84 μm; 95% CI: -3.20 to - 0.49; p = 0.007; I² = 62%). Heterogeneity across outcomes ranged from moderate to substantial.

conclusionsWithin the limitations of laboratory-based evidence, premixed bioceramic root-end filling materials exhibit superior marginal adaptation compared with manually mixed materials, while sealing ability appears comparable between the two groups. Further well-designed laboratory investigations and clinical studies are required to determine whether improved marginal adaptation translates into superior long-term clinical outcomes.

Indexed as

CeramicsDental Marginal AdaptationRoot Canal Filling MaterialsDental LeakageHumansRoot Canal Filling MaterialsBioceramic materialsEndodontic microsurgeryMarginal adaptationMeta-analysis.Mineral trioxide aggregateMixing methodPremixedRoot-end fillingSealing ability

Identifiers

PMID41555359
PMCPMC12896036

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.