Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil.
Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil.
Clin Oral Investig. 2023 Apr;27(4):1343-1361. doi: 10.1007/s00784-023-04897-4. Epub 2023 Feb 9.
The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI).
A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the "META" package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence.
A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23] p < 0.0001, I = 80%; and OR 3.86 [1.98; 7.53] p< 0.0001, I = 28.7%.
Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI.
UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.
本系统评价和荟萃分析（SRM）的目的是回答以下问题：与传统冲洗（CI）相比，使用超声冲洗（UI）是否能在根管消毒中产生更好的抗菌活性。
在主要科学数据库中进行文献检索，检索截至 2021 年 10 月。纳入标准为随机临床试验（RCT）。使用 R 软件和“META”包进行了两项荟萃分析。计算效应的均数差（MD）和优势比（OR）。应用固定效应模型，置信区间为 95%。使用 Cochrane 协作量表评估偏倚风险，使用 GRADE 工具评估证据质量。
共筛选出 1782 条记录，符合标准的 12 项研究纳入本综述。除分配隐匿性被认为不明确外，大多数领域的偏倚风险较低。OR 荟萃分析的证据确定性被归类为中度，MD 荟萃分析的证据确定性被归类为低度。超声冲洗在这两项荟萃分析中均产生了更好的抗菌效果，MD 1.42[1.60；1.23]p<0.0001，I = 80%；OR 3.86[1.98；7.53]p<0.0001，I = 28.7%。
在本 SRM 的限制范围内，UI 比 CI 具有更好的抗菌效果。
UI 应被临床医生使用，因为它可以提高接受牙髓治疗的患者的抗菌效果。
