Kumar Gaurav, Mohan Sumit, Viswanath Butta, Priyank Harsh
Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
J Dent Anesth Pain Med. 2025 Aug;25(4):239-250. doi: 10.17245/jdapm.2025.25.4.239. Epub 2025 Jul 23.
This systematic review aimed to assess the effect of various working length determination methods on the incidence of postoperative pain after root canal treatment. A comprehensive literature search was conducted across three electronic databases to identify randomized clinical trials. Two reviewers independently screened the articles, extracted relevant data, and assessed methodological quality using the Cochrane risk-of-bias assessment tool. For quantitative synthesis, a random-effects model was employed to compute the pooled mean difference by comparing the simultaneous and separate working-length determination methods. Sensitivity analyses were conducted after excluding studies that contributed disproportionately to overall heterogeneity. Seven studies met the criteria for qualitative review and three were included in the meta-analysis. The findings suggest that simultaneous determination of working length using integrated electronic apex locators may offer an advantage in reducing postoperative pain. However, this interpretation is limited by the substantial heterogeneity observed across the included studies. This review highlights the necessity for robust and well-designed clinical trials with large sample sizes and standardized protocols to obtain conclusive evidence.
本系统评价旨在评估各种工作长度确定方法对根管治疗术后疼痛发生率的影响。通过在三个电子数据库中进行全面的文献检索来识别随机临床试验。两名评价者独立筛选文章、提取相关数据，并使用Cochrane偏倚风险评估工具评估方法学质量。对于定量合成，采用随机效应模型通过比较同步和单独的工作长度确定方法来计算合并平均差。在排除对总体异质性贡献过大的研究后进行敏感性分析。七项研究符合定性评价标准，三项纳入荟萃分析。研究结果表明，使用集成电子根尖定位仪同步确定工作长度可能在减轻术后疼痛方面具有优势。然而，这一解释受到纳入研究中观察到的实质性异质性的限制。本评价强调了开展样本量大且方案标准化的有力且设计良好的临床试验以获得确凿证据的必要性。
