Passive ultrasonic irrigation in root canal: systematic review and meta-analysis

Abstract Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

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Effectiveness of XP-Endo Finisher and Passive Ultrasonic Irrigation on Intracanal Medicament Removal From Root Canals: a Systematic Review and Meta-analysis

10.21203/rs.3.rs-173700/v1 ◽

2021 ◽

Author(s):

Jiani Zhou ◽

Tingjun Liu ◽

Lihong Guo

Keyword(s):

Systematic Review ◽

Large Scale ◽

Ethylenediaminetetraacetic Acid ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Passive Ultrasonic Irrigation ◽

Significant Difference ◽

Ultrasonic Irrigation

Abstract Background: XP-Endo finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias.Results: Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96-4.86; P < 0.001). In subgroup analysis, when anatomical areas were focused on the apical third region of the canal, PUI was also significantly more effective than XPF (OR: 3.42; 95% CI, 1.32-8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79-9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74-3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71-16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74-3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44-4.61; P = 0.56). Conclusions: PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. More large-scale and high-quality trials are warranted to validate the conclusions.

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Passive Ultrasonic Irrigation Efficacy in the Vapor Lock Removal: Systematic Review and Meta-Analysis

The Scientific World JOURNAL ◽

10.1155/2019/6765349 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Mario Dioguardi ◽

Giovanni Di Gioia ◽

Gaetano Illuzzi ◽

Domenico Ciavarella ◽

Enrica Laneve ◽

...

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Reaction Rate ◽

Meta Analysis ◽

Inclusion Criteria ◽

Passive Ultrasonic Irrigation ◽

Literature Research ◽

Online Databases ◽

Statistical Heterogeneity ◽

Ultrasonic Irrigation

Passive Ultrasonic Irrigation (PUI) represents one of the most used systems to improve the endodontic irrigants activity. PUI acts increasing the reaction rate of NaOCl, with an increase of dentinal debris and smear layer removal. There is a stronger shear stress and a vapor lock reduction. Aim of this systematic review was to figure out the effects of the PUI on the vapor lock removal, during irrigation. Literature research has been carried out by two reviewers, consulting online databases such as PubMed, EBSCO, and Google Scholar, using keywords like Vapor Lock, Vapour Lock, and Vapor Lock Endodontic. The articles list has been screened based on titles and abstracts, applying eligibility and inclusion criteria. The three articles were eligible for quantitative and statistical analysis, by using RevManager Software Version 5.3. Results show statistical heterogeneity (P=0.08; I2index=61%) in the vapor lock elimination between the use of PUI and PPI, with an overall Odds Ratio=0.08, CI=95% [0.03;0.25]. PUI resulted to be a useful technique to improve NaOCl activity for vapor lock removal, despite PPI alone using a needle.

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Effect of passive ultrasonic irrigation on hard tissue debris removal: a systematic review and meta-analysis

Brazilian Oral Research ◽

10.1590/1807-3107bor-2021.vol35.0123 ◽

2021 ◽

Vol 35 ◽

Author(s):

Ana Flávia Almeida Barbosa ◽

Carolina Oliveira de Lima ◽

Luciana Moura Sassone ◽

Raissa Dias Fares ◽

Tatiana Kelly da Silva Fidalgo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hard Tissue ◽

Passive Ultrasonic Irrigation ◽

Debris Removal ◽

Ultrasonic Irrigation

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Contribution of XP‐Endo files to the root canal filling removal: A systematic review and meta‐analysis of in vitro studies

Australian Endodontic Journal ◽

10.1111/aej.12503 ◽

2021 ◽

Author(s):

Emel Uzunoglu‐Özyürek ◽

Selen Küçükkaya Eren ◽

Sevilay Karahan

Keyword(s):

Systematic Review ◽

Root Canal ◽

Meta Analysis ◽

In Vitro Studies ◽

Root Canal Filling

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Prevalence and nature of fungi in root canal infections: a systematic review and meta-analysis

International Endodontic Journal ◽

10.1111/iej.12730 ◽

2017 ◽

Vol 50 (11) ◽

pp. 1055-1066 ◽

Cited By ~ 17

Author(s):

I. F. Persoon ◽

W. Crielaard ◽

A. R. Özok

Keyword(s):

Systematic Review ◽

Root Canal ◽

Meta Analysis

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Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta-analysis

Australian Endodontic Journal ◽

10.1111/aej.12212 ◽

2017 ◽

Vol 44 (1) ◽

pp. 14-25 ◽

Cited By ~ 11

Author(s):

Pinpana Tupyota ◽

Pattama Chailertvanitkul ◽

Malinee Laopaiboon ◽

Chetta Ngamjarus ◽

Paul V. Abbott ◽

...

Keyword(s):

Systematic Review ◽

Root Canal ◽

Pain Control ◽

Meta Analysis ◽

Root Canal Treatment ◽

Posterior Teeth ◽

Irreversible Pulpitis

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Passive ultrasonic irrigation in calcium hydroxide removal from root canals: a sem/eds analysis

Journal of Research in Dentistry ◽

10.19177/jrd.v3e32015668-677 ◽

2015 ◽

Vol 3 (3) ◽

pp. 668

Author(s):

Fernanda Hoffmann Busanello ◽

Angela Longo Do Nascimento ◽

Lilian Tietz ◽

Mirela Sangoi Barreto ◽

Ricardo Abreu Da Rosa ◽

...

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Eds Analysis ◽

Ultrasonic Irrigation ◽

Calcium Hydroxide Removal ◽

And Control ◽

Elementary Chemical

AIM: The aim of this study was to evaluate the efficacy of different lengths of time of passive ultrasonic irrigation (PUI) in removing calcium hydroxide (CH) paste from root canal, using scanning electron microscopy and energy dispersive spectrometry (SEM/EDS). MATERIAL AND METHODS: Fifty-four human premolars were used. After coronal access, a size #15 K-file was used to obtain apical patency. Root canal preparation was performed using WaveOne 40.08 instruments. CH paste was placed into the root canal. Specimens were stored in a humid environment, and after seven days, they were divided into five groups (n=12) according to the irrigation protocols: Manual– a size #40 K-file; PUI/1– 1 min; PUI/2– 2 min; PUI/3– 3 min; and Control– without CH paste. An elementary chemical microanalysis (SEM/EDS) was performed to quantify the presence of calcium on the dentinal walls. RESULTS: The percentage of calcium was higher in all experimental groups when compared to the control group (P < 0.05); but no differences among them were found (P > 0.05). CONCLUSION: The amount of calcium hydroxide paste on the dentinal walls was not dependent on length of time of ultrasonic activation. SEM/EDS analysis seems to be a reliable method to assess CH paste removal from the root canals.

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The Comparison of Short-Term Postoperative Pain in Single- versus Multiple-Visit Root Canal Treatment: A Systematic Review and Meta-Analysis Study

Pain Research and Management ◽

10.1155/2021/5574995 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Armin Izadpanah ◽

Ailar Javaheripour ◽

Azam Maleki ◽

Mahdieh Alipour ◽

Hossein Hosseinifard ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Pain ◽

Root Canal ◽

Meta Analysis ◽

Mean Difference ◽

Single Visit ◽

Multiple Visit ◽

Statistical Heterogeneity ◽

The Times

Postoperative pain after root canal therapy (RoCT) is an unpleasant experience for patients, and it could be affected by different factors. The times of visits could be one of these factors that were evaluated in various studies. However, there is inconsistent evidence on the relation between postoperative pain and the times of visits. Therefore, the current systematic review aimed to summarize the results of these studies and meta-analyze them. For this purpose, a comprehensive search was conducted in four main databases (Cochrane Database of Systematic Reviews, Web of Science, PubMed, and Scopus databases) for related English articles from 1978 to August 2020. The quality of studies was evaluated using the Delphi checklist. The heterogeneity of studies was determined by I2 statistic, and publication bias was assessed using the funnel plot and the Begg test. The results were presented by using relative ratio (RR) estimates and standard mean difference (SMD) with its 95% confidence intervals (CI) using a random-effects model. Initial searches from mentioned databases identified 1480 papers; of which only 27 of them met the inclusion criteria. In quality assessment, thirteen studies had quality scores of more than 7, two studies had 4 scores, and the rest had 5 scores. Overall, based on the available evidence, the meta-analysis showed that the risk of postoperative pain in single-visit was 1.02 times (CI 95% (0.99, 1.19), I2 = 60.7%, p = 0.001 ) higher than that of the multiple-visit treatment. The mean difference of postoperative pain in single-visit was −0.30 (CI 95% (−0.36, −0.25), I2 = 0.94.4, p = 0.001 ) compared with the multiple-visit treatment. Based on the results of this meta-analysis, the risk of postoperative pain in single-visit RoCT was higher than that in multiple-visit RoCT with acceptable statistical heterogeneity and moderate quality of the studies.

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