Campos Gustavo Oliveira, Dos Reis Prado Alexandre Henrique, de Assis Macedo Isabella Figueiredo, da Costa Ferreira Isabella, da Costa Ferreira Gabriela, Benetti Francine, da Cunha Peixoto Isabella Faria, Diniz Viana Ana Cecília
Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Rua Professor Moacir Gomes de Freitas, Belo Horizonte, MG, Brazil.
Iran Endod J. 2024;19(2):75-84. doi: 10.22037/iej.v19i2.44037.
Foraminal Enlargement (FE) is a cleaning performed in the apical-most region of the tooth, in order to optimize root disinfection. This systematic review evaluated the influence of FE during root canal treatment on bacterial reduction and repair of the periapical lesion.
Searches in PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, Embase, Scielo, Lilacs and OpenGrey were performed until January-2024. and studies evaluating the effects of FE in the bacterial reduction and repair of the periapical lesion were included, respectively, followed by risk of bias assessment (modified version of Joanna Briggs Institute's for studies and Systematic Review Centre for Laboratory animal Experimentation's risk of bias tools for studies). The meta-analysis was not feasible and a qualitative summary for each outcome was provided.
Of 950 studies, 2 studies were eligible, using animal models with infected teeth. Of these two, periapical repair was evaluated with hematoxylin-eosin stain, and FE improved periapical healing. Regarding studies, 3 were eligible, using extracted human teeth. The inoculations in models were performed with and FE reduced in the models.
Foraminal enlargement seems to increase bacterial reduction within the root canal, and provide major periapical tissue repair on the histological analysis in animal studies. However, caution is necessary when translating these results to the clinical environment.
根尖孔扩大术（FE）是在牙齿根尖最末端区域进行的一种清理操作，目的是优化根管消毒。本系统评价评估了根管治疗期间根尖孔扩大术对细菌减少和根尖周病变修复的影响。
截至2024年1月，在PubMed/MEDLINE、Scopus、Cochrane图书馆、Web of Science、Embase、Scielo、Lilacs和OpenGrey中进行检索。分别纳入评估根尖孔扩大术对根尖周病变细菌减少和修复效果的研究，随后进行偏倚风险评估（针对动物研究采用乔安娜·布里格斯研究所的修改版，针对人体研究采用实验动物系统评价中心的偏倚风险工具）。荟萃分析不可行，因此对每个结局进行了定性总结。
在950项研究中，有2项研究符合条件，使用的是感染牙齿的动物模型。在这两项研究中，用苏木精-伊红染色评估根尖周修复情况，根尖孔扩大术改善了根尖周愈合。关于人体研究，有3项研究符合条件，使用的是拔除的人类牙齿。在人体模型中接种[具体细菌名称未给出]，根尖孔扩大术减少了人体模型中的[具体细菌名称未给出]。
根尖孔扩大术似乎能增加根管内细菌的减少，并在动物研究的组织学分析中促进根尖周组织的主要修复。然而，将这些结果转化到临床环境时需要谨慎。
