Clinical effectiveness of ultrasonic irrigation during root canal therapy: An umbrella review

ABSTRACT Aim: The aim of this study was to synthesize available knowledge on the efficiency of ultrasonic irrigation (UI) on the reduction of bacteria, postoperative pain reduction, and radiographic assessment of periapical healing during nonsurgical root canal treatments depicted by previous published systematic reviews (SRs). Methods: SRs with or without meta-analyses published in any language, assessing outcomes of UI on the reduction of bacteria, postoperative pain reduction, and radiographic assessment of periapical healing during nonsurgical root canal treatment were included. Two reviewers worked independently on study selection, data extraction, and appraisal of the included reviews. Disagreements were settled with the assistance of a third reviewer. Results: Seven SRs were included. The "Joanna Briggs Institute [JBI] critical appraisal tool" which consists of 11 items was used for evaluation of the quality of included SRs. Each JBI item was given a score of 1 if the criterion was met or 0 if the criterion was not met or the information was unclear. Conclusion: In clinical practice, UI provides similar outcomes in root canal disinfection and periapical healing compared to other irrigation methods and achieves better postoperative pain reduction and canal cleanliness when compared to syringe irrigation. Keywords: Passive ultrasonic irrigation, periapical healing, postoperative pain, root canal disinfection, systematic reviews, umbrella review