New Bioceramics vs. Mineral Trioxide Aggregate (MTA) in the Success of Endodontic Microsurgery: A Systematic Review and Meta-Analysis

We compare the success of root-end sealing using new bioceramics versus MTA in endodontic microsurgery. A standardised search strategy was conducted in four databases using predefined terms to identify studies reporting clinical and radiographic success (von Arx criteria). Data selection, extraction and risk of bias assessment were performed independently and in duplicate. Meta-analysis and the certainty of evidence (GRADE) were completed. Five titles meet all eligibility criteria (three RCT and two retrospective cohort studies). The identified new bioceramics were EndoSequence RRM (ERRM) (n = 4) and BioMA (n = 1). Overall, the quality of evidence was considered moderate. A meta-analysis demonstrated no significant differences between new bioceramics versus MTA when assessing the number of teeth classified as success (RR 1.00, 95% CI [0.94, 1.07]) or failure (RR 0.93, 95% CI [0.51, 1.71]) according to von Arx criteria. In conclusion, new bioceramics are not conclusively superior to MTA but may be preferred due to improved handling [PROSPERO-CRD42024534258].