Romualdo Priscilla Coutinho, de Oliveira Katharina Morant Holanda, Nemezio Mariana Alencar, Küchler Erika Calvano, Silva Raquel Assed Bezerra, Nelson-Filho Paulo, Silva Lea Assed Bezerra
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Aust Endod J. 2017 Dec;43(3):129-137. doi: 10.1111/aej.12162. Epub 2017 Feb 2.
The aim of this study was to evaluate if apical negative pressure (ANP) irrigation prevents the apical extrusion of debris and irrigant compared with conventional needle irrigation through a systematic review and meta-analysis. A computer search of dental literature was performed using four different databases. A combination of the terms 'apical negative pressure', 'endovac', 'apical extrusion', 'extrusion' and 'endodontics' was used. Studies that used extracted human teeth with a mature apex and that evaluated the apical extrusion of debris and/or irrigating solution were included. After an evaluation of the full studies according to the eligibility criteria, eight studies were critically analysed and subjected to quality assessment and risk of bias. Only four studies that evaluated extrusion of irrigant were considered as having high methodological quality and were subjected to a meta-analysis. Studies evaluating extrusion of debris did not have sufficient methodological quality to be subjected to the meta-analysis. The forest plot indicated that ANP irrigation prevents the risk of irrigant extrusion compared with conventional irrigation (OR 0.07 [95%CI 0.02-0.20]; P < 0.00001). This systematic review and meta-analysis showed that ANP prevents the apical extrusion of irrigant. There is no evidence if this type of irrigation prevents the extrusion of debris.
本研究的目的是通过系统评价和荟萃分析，评估根尖负压（ANP）冲洗与传统针头冲洗相比，是否能防止碎屑和冲洗液的根尖挤出。使用四个不同的数据库对牙科文献进行计算机检索。使用了“根尖负压”、“Endovac”、“根尖挤出”、“挤出”和“牙髓病学”等术语的组合。纳入使用成熟根尖的拔除人类牙齿并评估碎屑和/或冲洗液根尖挤出情况的研究。根据纳入标准对完整研究进行评估后，对八项研究进行了严格分析，并进行了质量评估和偏倚风险评估。只有四项评估冲洗液挤出情况的研究被认为具有较高的方法学质量，并进行了荟萃分析。评估碎屑挤出情况的研究没有足够的方法学质量来进行荟萃分析。森林图表明，与传统冲洗相比，ANP冲洗可降低冲洗液挤出的风险（OR 0.07 [95%CI 0.02 - 0.20]；P < 0.00001）。这项系统评价和荟萃分析表明，ANP可防止冲洗液的根尖挤出。没有证据表明这种冲洗方式能防止碎屑的挤出。
