Evidence map›Paper›PMID 35174355›Full record

SynthesisFrontiers in oral health2022

Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review.

Riccardo Tonini, Matteo Salvadori, Elisabetta Audino, Salvatore Sauro, Maria Luisa Garo, Stefano Salgarello

Erratum issuedOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Frontiers in oral health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
12.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 3 countries.

Riccardo ToniniDepartment of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy.
Matteo SalvadoriDepartment of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy.
Elisabetta AudinoDepartment of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy.
Salvatore SauroDepartment of Dentistry, Dental Biomaterials and Minimally Invasive Dentistry, Cardenal Herrera-CEU University, Alfara del Patriarca, Spain.
Maria Luisa GaroDepartment of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy.
Stefano SalgarelloDepartment of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy.
University of Brescia · ITSechenov University · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background

objectiveTo evaluate the clinical endodontic protocols and limitations of irrigating solutions in the disinfection of the root canal system in patients with apical periodontitis.

methodsPubMed, Scopus, Embase, Web of Science, and Cochrane databases were searched for randomized controlled trials (RCT) published until January 2021. Hand searching was also performed. Studies focused on evaluating the effectiveness of irrigating solutions and/or irrigation activation methods in reducing the bacterial load in the root canal system were considered. The Cochrane risk-of-bias tool for randomized trials (RoB2) was used to assess the quality of the studies.

resultsFour hundred and twenty eight published articles were identified. After removing the duplicate studies and analyzing full texts, seven RCTs were selected. Two studies compared pure NaOCl with some combination of NaOCl with HEDP and MTAD. Two studies analyzed the antibacterial efficacy of NaOCl and chlorhexidine (CHX). Three studies compared conventional needle irrigation with different irrigation activation methods (PUI, XP-endo finisher, F-file activator, EndoVac activator). The review attained a satisfactory methodology. The main results of each included study were described. DISCUSSION: Activation methods provide significantly higher biofilm reduction than conventional needle irrigation methods. Combinations of NaOCl with different chelating agents were ineffective in terms of antimicrobial, but it could potentially increase the risk of irrigant extrusion. However, the irrigating protocols were not carefully detailed, especially those regarding the irrigants application time or total volume. The existing literature lacks high-quality studies. The level of evidence is moderate.

conclusionsThe available data is too heterogeneous to compare and identify the superiority of specific valuable irrigation protocols in each clinical context. Application time, volume, and activation methods should be standardized to determine the optimal irrigating procedures to reduce the bacterial load and ensure higher predictability of the endodontic treatment. SYSTEMATIC REVIEW REGISTRATION: (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218555), PROSPERO registration: CRD42020218555.

Indexed as

bacterial loadbiofilmirrigating solutionsperiapical periodontitisroot canal agents

Identifiers

PMID35174355
PMCPMC8841673
OpenAlexW4210476954

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.