Soler-Doria Anna, Sanz José Luis, Maddalone Marcello, Forner Leopoldo
Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Gascó Oliag 1, 46010 Valencia, Spain.
Departamento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, 20854 Milan, Italy.
J Funct Biomater. 2025 Aug 14;16(8):293. doi: 10.3390/jfb16080293.
The success rate of root canal treatment is high, but it can fail. In these cases, orthograde root canal retreatment is often the treatment of choice, for which numerous biomaterials are available on the market, including endodontic files. This systematic review aimed to study the endodontic files available on the market and establish their efficacy in root canal retreatment. An electronic search of six different databases was performed, and in vitro experimental studies that studied root canal cleaning, debris extrusion, retreatment time, or dentinal damage produced with any of the comparison methods were selected. The quality of the studies was assessed with the QUIN scale. In total, 78 studies were included for the analysis, of which 9 had a high risk of bias, 53 had a moderate risk, and 16 had a low risk. The methods used to evaluate the efficacy of endodontic files in root canal retreatment are heterogeneous. Manual files produce more apical extrusion than rotary files. PTUR files are the most studied endodontic files. It is the file system that leaves the least residual filling material in the canal, takes the least time during retreatment, and removes the greatest amount of dentine. However, no file system achieved the complete removal of the root canal filling material. No consistent pattern emerged across studies when comparing rotary files with continuous and reciprocating rotation in terms of the removal of the filling material, the time required for de-obturation, dentine damage produced, or apical extrusion.
根管治疗的成功率很高，但也可能失败。在这些情况下，根管再治疗通常是首选的治疗方法，市场上有许多生物材料可供使用，包括根管锉。本系统评价旨在研究市场上现有的根管锉，并确定它们在根管再治疗中的疗效。对六个不同的数据库进行了电子检索，并选择了研究根管清洁、碎屑挤出、再治疗时间或使用任何比较方法产生的牙本质损伤的体外实验研究。采用QUIN量表对研究质量进行评估。总共纳入78项研究进行分析，其中9项存在高偏倚风险，53项存在中度风险，16项存在低风险。用于评估根管锉在根管再治疗中疗效的方法各不相同。手动锉比旋转锉产生更多的根尖挤出。PTUR锉是研究最多的根管锉。它是在根管内留下最少残余充填材料、再治疗过程中花费时间最少且去除牙本质量最大的锉系统。然而，没有一种锉系统能完全去除根管充填材料。在比较旋转锉与连续旋转和往复旋转在去除充填材料、根管疏通所需时间、产生的牙本质损伤或根尖挤出方面，各研究之间没有出现一致的模式。
