Tashkandi Nesreen, Alghamdi Faisal
Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU.
Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU.
Cureus. 2022 Jan 23;14(1):e21525. doi: 10.7759/cureus.21525. eCollection 2022 Jan.
Chemical debridement is considered one of the most important steps during root canal treatment to target unreached areas and provide thorough disinfection of the canals. The efficiency of this step efficiency can be increased using different agitation and irrigation techniques/devices. This comprehensive review aimed to summarize the effect of various irrigant activation and agitation techniques/devices on endodontic treatment outcomes. Using mechanical active irrigation, which enables the activation or agitation of the irrigating solution, is beneficial in root canal treatment by increasing the efficiency of delivering the irrigant up to working length and ensuring isthmus cleanliness. However, considerable variation was noticed between the protocols used in each technique with a lack of well-designed randomized clinical trials to focus on the long-term outcome. Moreover, a low level of evidence was noticed regarding the effectiveness of certain activation techniques over others. Therefore, each study needs to be carefully weighed before using its results and embracing its conclusion. Future studies need to focus more on the antimicrobial effect of each technique and its effect on the healing of apical periodontitis. Also, recent advances, such as multisonic and laser activation, are promising tools that need more clinical investigations to show their efficiency.
化学清创术被认为是根管治疗中最重要的步骤之一，其目的是针对未到达的区域并对根管进行彻底消毒。使用不同的搅拌和冲洗技术/设备可以提高这一步骤的效率。本综述旨在总结各种冲洗液激活和搅拌技术/设备对根管治疗效果的影响。使用机械主动冲洗，即能够激活或搅拌冲洗液，通过提高将冲洗液输送至工作长度的效率并确保峡部清洁，对根管治疗有益。然而，每种技术所使用的方案之间存在显著差异，且缺乏精心设计的随机临床试验来关注长期结果。此外，关于某些激活技术相对于其他技术的有效性，证据水平较低。因此，在使用每项研究的结果并接受其结论之前，需要仔细权衡。未来的研究需要更多地关注每种技术的抗菌效果及其对根尖周炎愈合的影响。此外，多超声和激光激活等最新进展是很有前景的工具，需要更多的临床研究来证明其效率。
