Applications of Finite Element Analysis in Endodontics: A Systematic Review and Meta-Analysis

Background: Endodontics increasingly uses finite element analysis (FEA) to evaluate stress distribution, fracture resistance, and temperature changes in treated teeth. FEA's endodontic uses, benefits, and drawbacks are examined in this systematic review and meta-analysis. Methods: A PubMed systematic search found relevant studies published up to January 2022. Original endodontic research articles utilizing FEA to quantify stress distribution, fracture resistance, or temperature changes in treated teeth were eligible. The systematic review comprised 30 publications, 15 of which were meta-analyzed. Data were extracted using a standard form, and the "Newcastle-Ottawa Scale (NOS)" for observational studies and the Cochrane risk of bias tool for randomized controlled trials assessed quality. Random-effects models calculated pooled effect sizes and 95% confidence intervals in RevMan 5.4 meta-analysis. Results: Meta-analysis shows FEA-guided endodontic treatment improves stress distribution (P < 0.001) and fracture resistance (P < 0.05) compared to conventional treatments. The temperature did not vary significantly (P = 0.12). Stress distribution had an effect size of 0.75 (95% CI: 0.65-0.85), fracture resistance 0.42 (95%: 0.12-0.72), and temperature variations -0.18. Conclusion: In conclusion, FEA is a valuable technique in endodontics for stress distribution study and fracture resistance testing. FEA models' accuracy, dependability, and clinical applicability were questioned, underlining the need for more research and development to maximize their endodontics clinical use.