SynthesisEuropean endodontic journal2023
Comparative Efficacy of Different Irrigant Activation Techniques for Irrigant Delivery Up to the Working Length of Mature Permanent Teeth: A Systematic Review and Meta-Analysis.
Synthesis in European endodontic journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Mapping risk of bias criteria in systematic reviews of in vitro endodontic studies: an umbrella review.Evidence-based dentistry · 2025Pooled it
- Determining the optimal irrigation activation or agitation techniques for postoperative pain control: A network meta-regression of clinical trials.The Japanese dental science review · 2026Review
- Endodontic implications of hypercementosis: A systematic review of anatomical challenges and therapeutic strategies.The Japanese dental science review · 2026Review
- Comparative efficacy of ultrasonic, diode laser, and manual irrigant activation around an apically separated instrument: an in vitro study.BMC oral health · 2026Article
- Comparative Evaluation of Depth of Irrigant Penetration Using Different Irrigation Systems: An In Vivo Study.Cureus · 2026Article
- Post-Operative Pain After Endodontic Instrumentation, Irrigation and Obturation: An Umbrella Review of Systematic Reviews Published from 2016 to 2025.Journal of clinical medicine · 2026Review
- Periapical Healing Following Root Canal Treatment with Narrow (0.04) Or Wide (0.07) Preparation Tapers in Private Practice: A Retrospective Observational Cohort Study.European endodontic journal · 2025Observational
- Comparison of passive ultrasonic and sonically activated irrigation methods: an investigation based on PGE2, NO and IL-6 levels.BMC oral health · 2025Article
- Debris and Smear Layer Removal in Curved Root Canals: A Comparative Study of Ultrasonic and Sonic Irrigant Activation Techniques.Dentistry journal · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review aims to establish whether various irrigant activation techniques (IATs) result in greater penetration of irrigant up to the working length. The MEDLINE, Scopus and Cochrane Library electronic databases were searched to determine the difference in irrigant penetration depth in the main canal following the use of manual dynamic activation (MDA), sonic irrigation (SI), passive ultrasonic irrigation (PUI), and apical negative pressure irrigation technique (ANP) in comparison with conventional needle irrigation technique (CNI) in mature permanent teeth. Meta-analysis was performed for straight canals as well as curved canals in addition to subgroup analyses for a) Individual IATs in comparison with CNI, b) Comparison of PUI v ANP and SI v ANP in the straight canals, c) comparison of different IATs performed in straight and curved canals. The outcome was presented as effect size: standardized mean difference (SMD) and percentage difference (% diff) of irrigant penetration up to the working length (WL) alongside 95% confidence intervals using chi-square analysis. Of the 840 records screened, 20 studies were included in the systematic review and 17 studies were included in the meta-analysis. It revealed IATs had significant improvement in irrigant delivery up to the WL in straight (% diff: 51.94%, 95% CI: 39.20-64.67%) and curved canals (SMD: 1.08, 95% CI: 0.64-1.52) over CNI. The subgroup analysis revealed ANP was the most effective and significant technique followed by PUI, SI and MDA techniques in straight canals (% diff: 91.70%, 95% CI: 75.63-107.77%) and curved canals (SMD: 1.45, 95% CI: 0.77-2.13). IATs improve irrigant penetration when compared to CNI technique. In both straight and curved canals, ANP is the most effective in delivering the irrigant up to the WL followed by PUI, SI and MDA techniques. Hence adaptation of recent IATs in routine endodontic practice is recommended. (EEJ-2022-03-036).
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Registered trials
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.