Quality of Root Canal Fillings and Procedural Errors for In Vivo Studies Prepared in Different Clinical Settings and with Rotary Systems: A Systematic Review

BACKGROUND This systematic review of the literature aimed to identify published studies and evaluate them on the quality of root canal fillings (RCF) and procedural errors with rotary systems for in vivo studies prepared for different clinical settings. MATERIAL AND METHODS A full literature exploration was conducted in Clarivate Analytics' Web of Science, Elsevier's Scopus, Embase, and PubMed for studies published between January 2020 and March 2024. A manual search was also performed by reviewing the references of selected papers. The following keywords were used: quality of root canal filling(s) OR quality of root canal obturation, root canal obturation OR endodontic treatment, clinical setting (academic, private, governmental), AND/OR procedural errors and rotary instrumentation. RESULTS Sixteen clinical studies were included in this review. The acceptance percentages for obturation length, density, and taper were 76.3%, 74.7%, and 82.5%, respectively, indicating significantly high, good ratios. The overall RCF recorded showed that 68.2% of root canal obturations were considered acceptable. Acceptable rates remained higher than unacceptable rates in academic, hospital, and private settings, and percentages ranged from 65.2% to 93.0%. Only 5 studies reported procedural errors, namely, ledge formation, separated instruments, apical perforation, transportation, lateral perforation, and root/foramen perforation. CONCLUSIONS Using rotary instruments for different root canal treatment steps as instrumentation and obturations is highly recommended. Among different clinical setting and practice, these instruments resulted in a good and acceptable RCF, overall quality performed by those instruments, and few procedural errors.