Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil.
Department of Diagnosis & Oral Health, Endodontics Division, University of Louisville, Louisville, KY, USA.
Odontology. 2024 Jan;112(1):51-73. doi: 10.1007/s10266-023-00845-6. Epub 2023 Aug 10.
The aim of this study was to perform an integrative review to identify the most effective supplementary protocols used after filling material (FM) removal and root canal reinstrumentation, during endodontic reintervention. The literature search was performed on the electronic databases PubMed and Latin American and Caribbean Health Sciences Literature (LILACS), using a combination of specific scientific descriptors. Selection criteria accepted articles published in English, Spanish and Portuguese languages, up to August 2021, involving in vitro and ex vivo studies. After applying the eligibility criteria, 46 articles were included for qualitative analysis. The tool for qualitative analysis of quasi-experimental studies of the Joanna Briggs Institute was used to determine the risk of bias of the included articles. The selected articles provided important data regarding the following supplementary protocols: sonic and ultrasonic activation of the irrigating solution; the use of ultrasonic inserts, XP-endo system instruments, and photon-induced photoacoustic streaming for mechanical debridement; and new devices as GentleWave system, and the self-adjusting file. Overall, all supplementary protocols demonstrated efficacy in removing the remaining FM. The implementation of various supplementary protocols can effectively remove the remaining FM from the root canal walls, although complete removal is not always achieved. However, it was not possible to determine the most effective protocol. Conversely, their association can enhance remaining FM removal. Remaining FM attached to root canal walls hinders proper chemical-mechanical preparation during endodontic reintervention. Supplementary protocols optimize the remaining FM removal, enhancing cleaning and disinfection of root canal.
本研究旨在进行综合评价，以确定在根管再治疗中，根管冲洗后、器械再进入时，最有效的附加方案。文献检索在电子数据库 PubMed 和拉丁美洲及加勒比地区健康科学文献库（LILACS）中进行，使用了特定科学描述符的组合。选择标准接受发表在英语、西班牙语和葡萄牙语的文章，截止到 2021 年 8 月，包括体内和体外研究。在应用入选标准后，纳入 46 篇文章进行定性分析。使用 Joanna Briggs 研究所的准实验研究定性分析工具来确定纳入文章的偏倚风险。所选文章提供了以下附加方案的重要数据：超声和超声激活冲洗液；使用超声插入物、XP-endo 系统器械和光诱导光声流进行机械清创；以及新设备如 GentleWave 系统和自调整锉。总体而言，所有附加方案都证明在去除根管壁残留的 FM 方面有效。尽管并非总能达到完全去除，但实施各种附加方案可以有效地从根管壁上去除残留的 FM。然而，无法确定最有效的方案。相反，它们的联合使用可以增强对残留 FM 的去除。附着在根管壁上的残留 FM 会阻碍根管再治疗期间的适当化学机械预备。附加方案优化了残留 FM 的去除，增强了根管的清洁和消毒。
