To compare the apical sealing effects of two root canal fillers, GuttaFlow and AH Plus, for clinical reference.

The Cochrane system evaluation method was used to search the Cochrane Library, Embase, CBM, PubMed, CNKI, Weipu, and Wanfang databases. Additionally, relevant journals and conference papers were manually retrieved, and relevant randomized controlled trials were collected. Two reviewers independently evaluated the quality of each study and extracted the data. A meta-analysis was performed using the RevMan5.3 software for homogenous studies, and a descriptive analysis was performed for studies with poor homogeneity.

In total, 10 randomized controlled trials containing 398 isolated teeth were included. The meta-analysis results showed that the difference in apical microleakage was statistically significant at 1 week and 3 months [1 week: MD＝-0.13, 95% CI (-0.22,-0.04), P＝0.007; 3 months: MD＝-1.27, 95% CI (-1.94,-0.60), P＝0.0002] but not at 6 months [MD＝-0.10, 95% CI (-0.26, 0.06), P＝0.23].

Based on existing research results, GuttaFlow may achieve better results than AH Plus in the short term (≤ 1 week). Because it is subject to limitations of time, quality, and research methods, this conclusion requires more long-term, high-quality, large-sample, multimeasurement randomized controlled trials for further validation.