Adherence to core outcome set for endodontic treatments (COSET) international consensus: Two-year before/after bibliometric systematic review

OBJECTIVES: The Core Outcome Set for Endodontic Treatments (COSET) was introduced to standardize reporting and reduce outcome heterogeneity in clinical endodontic research. Despite its publication to guide both clinician- and patient-centred metrics, the extent of its adherence remains unexplored. This study aimed to compare the adherence of the endodontic literature to the COSET in the two-year periods preceding and following its publication, and to assess compliance among studies citing the guidelines. DATA AND STUDY SELECTION: A bibliometric systematic review was conducted comparing clinical studies published before (2022-2023) and after (2024-2025) the COSET publication. Adherence to the eight core domains (pain, signs of infection, further intervention, tenderness to percussion/palpation, radiographic healing, function, tooth survival, and patient satisfaction) was quantitatively scored. A secondary analysis evaluated documents citing COSET. Methodological quality used standard risk of bias tools. REGISTRATION: PROSPERO CRD420251122526. RESULTS: Overall adherence to the core domains did not improve post-publication, exhibiting a slight decrease from 52.4% (n = 26 studies) to 50.7% (n = 37 studies). While radiographic healing was universally reported (100%), fundamental clinical parameters such as pain declined to 73.0% and signs of infection declined to 70.3% of reporting. Crucial patient-centred metrics, including strict tooth survival (10.8%) and patient satisfaction (2.7%), remained neglected. Furthermore, citing studies revealed selective reporting rather than full eight-domain integration. The risk of bias shifted from "Serious Risk" to "Moderate Risk" after COSET. CONCLUSION: COSET publication has not yet standardized endodontic outcome reporting. However, due to the brief two-year post-publication window (2024-2025) this bibliometric analysis may serve as a foundational baseline for future evaluations of adoption rates. CLINICAL RELEVANCE: Critical aspects remain neglected, and selective compliance persists highlighting the need for COSET broader adherence.