Endodontic microleakage studies: correlation among different methods, clinical relevance, and potential laboratory errors.

Introduction: Creation of a tight seal in endodontically treated root canals is of utmost importance. Clinical and laboratory studies have a great role in the assessment of the sealing ability of endodontic materials. The present review was undertaken to evaluate correlation between different techniques used in microleakage studies in endodontics and the potential laboratory errors.
Evidence Acquisition: A systematic search was run using Medline, Biosis, Cochrane Database, Embase, Google Scholar, and Web of Science databases. Furthermore, the reference lists of the articles published on the subject were thoroughly searched. There was no language restriction in the search. Two reviewers separately evaluated the titles and abstracts.
Evidence Synthesis: All the methods used might have proved useful if the study could have been carried out with a larger sample size, with carefully designed control groups. Furthermore, extra evaluations are recommended on the reliability of the method used. Examinations like glucose reactivity test, assessment of antimicrobial activity of the tested materials and in situ FISH examination for the reliability of bacterial leakage model have been recommended. It has been recommended that two or more methods be considered for each material in the same study. On the other hand, long-term animal studies can be useful with histological and radiographic evaluations for meticulous assessment of leakage. Furthermore, long-term clinical trials on humans might be helpful on the condition that confounding factors are controlled.
Conclusions: Studies on microleakage should be focused on animal studies, clinical trials or laboratory tests. On the basis of available evidence, it appears that despite potential errors on microleakage studies they are very valuable.