Department of Endodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Stomatology, The First People's Hospital of Neijiang, Neijiang, China.
Eur Endod J. 2022 Oct;7(3):178-186. doi: 10.14744/eej.2022.22932.
A systematic review and meta-analysis were conducted to evaluate the effectiveness of auxiliary methods in removing residual filling material (RFM). This systematic review has been registered with the International Prospective Register of Systematic Reviews (registration number CRD42020197482). A comprehensive literature search was conducted to identify relevant articles in electronic databases (PubMed, Embase, Cochrane) from January 2005 to March 2021. In vitro studies investigating or comparing at least one type of supplementary method or technique were included. A total of 26 studies were selected from the 239 records obtained after screening the databases. Ten of the included studies were suitable for meta-analysis. Strong evidence showed that ultrasonically activated irrigation (UAI) [SMD (95% CI): -0.52 (-0.88 to -0.16, P=0.266)] and XP-Endo Finisher R (XPR) [SMD (95% CI): -0.55 (-0.89 to -0.20, P=0.136)) contributed significantly to increase the removal procedure, and XPR has no significant superiority over UAI [SMD (95% CI): 0.36 (-0.12 to 0.84, P=0.994)]. Strong evidence was found to support the increased cleaning efficiency of the supplementary use of the Gentle Wave system, laser irradiation, XP Endo Finisher, and self-adjusting file. In contrast, conflicting evidence was found to support the use of sonic to improve the removal of RFM, and limited evidence was found to support the efficiency of Tornado Brush. Under in vitro conditions, UAI and XPR increase the removal of RFM from the root canal system during retreatment procedures.
一项系统评价和荟萃分析评估了辅助方法在去除残余填充物（RFM）方面的有效性。本系统评价已在国际前瞻性系统评价登记处（注册号：CRD42020197482）注册。进行了全面的文献检索，以在电子数据库（PubMed、Embase、Cochrane）中查找 2005 年 1 月至 2021 年 3 月期间的相关文章。纳入了至少比较一种辅助方法或技术的体外研究。从数据库筛选后共获得 239 篇记录，从中选择了 26 项研究。其中 10 项研究适合进行荟萃分析。有力证据表明，超声激活冲洗（UAI）[SMD（95%CI）：-0.52（-0.88 至 -0.16，P=0.266）]和 XP-Endo Finisher R（XPR）[SMD（95%CI）：-0.55（-0.89 至 -0.20，P=0.136）]显著有助于增加去除程序，并且 XPR 与 UAI 相比没有显著优势[SMD（95%CI）：0.36（-0.12 至 0.84，P=0.994）]。有力证据支持 Gentle Wave 系统、激光照射、XP Endo Finisher 和自调谐锉等辅助工具的补充使用可提高清洁效率。相反，有冲突的证据支持使用声能来改善 RFM 的去除，并且有限的证据支持 Tornado Brush 的效率。在体外条件下，UAI 和 XPR 增加了再治疗过程中从根管系统中去除 RFM。
