Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta‐analysis

Abstract

This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty‐six full‐text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta‐analysis. The meta‐analysis was conducted using the random‐effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount (p = 0.00) and frequency (p = 0.00) of extrusion than the open‐ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open‐ended (p = 0.00 or p = 0.01) and closed‐ended needle (p = 0.00) irrigation.

Effect of treatment variables on apical extrusion of debris during root canal retreatment: A systematic review and meta-analysis of laboratory studies

“…2,3 Some instrumentation systems, irrigants, and irrigation techniques have been used to enhance the cleaning of the root canal system during NSRCRT. [4][5][6] Stainless steel hand files, rotating and reciprocating nickel-titanium (NiTi) instruments, and ultrasonic tips have been used to efficiently clean and shape the root canals during NSRCRT procedures. 4,[7][8][9] Solvents such as chloroform, xylol, halothane, and orange oil can be used to remove previous filling materials from the root canal system.…”

Extrusion of Sodium Hypochlorite in Oval-Shaped Canals: A Comparative Study of the Potential of Four Final Agitation Approaches Employing Agarose-Embedded Mandibular First Premolars

“…Considering oval root canals have a larger surface area and a more irregular form, which might alter the flow and distribution of irrigation solutions, using oval-shaped teeth in a study on irrigation techniques is crucial. A better understanding can be gained of how well various irrigation strategies work to remove pathogens, debris, and necrotic tissue from difficult canals by using oval-shaped teeth in studies [18][19][20][21][22].…”

“…Numerous irrigation strategies in endodontic therapy, including conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation, and negative apical pressure, have been thoroughly investigated to understand the apical extrusion risk associated with each irrigation strategy [21,22]. The goal of these assessments is to improve endodontic procedures with a focus on accuracy and patient safety.…”

“…Nonetheless, it is important to remember that prior research frequently disregarded the influence on periapical tissues during extrusion evaluations, which may have led to an exaggerated appraisal of the issue and obscured its actual consequences for patient care. By providing a more accurate assessment of the extrusion, in vitro simulations enhance the security and quality of endodontic treatments [21,22]. Therefore, it is crucial to use a thorough methodology in apical extrusion research that takes periapical tissues into consideration.…”