Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis
Objective The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI). Methods A literature search was perfo...
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| Veröffentlicht in: | Clinical oral investigations 2023-04, Vol.27 (4), p.1343-1361 |
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| creator | Chalub, Lucas Orbolato Nunes, Gabriel Pereira Strazzi-Sahyon, Henrico Badaoui Ferrisse, Túlio Morandin dos Santos, Paulo Henrique Gomes-Filho, João Eduardo Cintra, Luciano Tavares Angelo Sivieri-Araujo, Gustavo |
| description | Objective
The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI).
Methods
A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence.
Results
A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23]
p
< 0.0001,
I
2
= 80%; and OR 3.86 [1.98; 7.53]
p
< 0.0001,
I
2
= 28.7%.
Conclusion
Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI.
Clinical Relevance
UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment. |
| doi_str_mv | 10.1007/s00784-023-04897-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2800390558</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2800390558</sourcerecordid><originalsourceid>FETCH-LOGICAL-c342t-f504834cd29ae77334814a57f1a4c11bba87e631ccf46e62c085ffb41699abb83</originalsourceid><addsrcrecordid>eNp9kctOxCAUhonR6Hh5AReGxHUVCi2tu8nEWzKJG10TSg8GMwUFRjO-hW8sM_W2cgMk5_-_czg_QseUnFFCxHnMR8MLUrKC8KYVBd9CE8pZXTAh6Paf9x7aj_GJEMprwXbRHqtFJXhNJ-hj6pIdrA6-s2qBwRjQyb6CgxixN3i5SEFF76zGNgT7qJL1DluHg_cJa-WyKQVQaQCXLrDCcRUTDFmmcYBXC29rSlCu94N9hx7rhc2wjSs3jDhX8ABJFWvUKtp4iHZMLsDR132AHq4u72c3xfzu-nY2nRea8TIVpsp_Zlz3ZatACMZ4Q7mqhKGKa0q7TjUCaka1NryGutSkqYzpOK3bVnVdww7Q6ch9Dv5lCTHJJ78MeYgoy4YQ1pKqWqvKUZU3FGMAI5-DHVRYSUrkOgU5piBzCnKTguTZdPKFXnYD9D-W77VnARsFMZfcI4Tf3v9gPwEsA5YU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2800390558</pqid></control><display><type>article</type><title>Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Chalub, Lucas Orbolato ; Nunes, Gabriel Pereira ; Strazzi-Sahyon, Henrico Badaoui ; Ferrisse, Túlio Morandin ; dos Santos, Paulo Henrique ; Gomes-Filho, João Eduardo ; Cintra, Luciano Tavares Angelo ; Sivieri-Araujo, Gustavo</creator><creatorcontrib>Chalub, Lucas Orbolato ; Nunes, Gabriel Pereira ; Strazzi-Sahyon, Henrico Badaoui ; Ferrisse, Túlio Morandin ; dos Santos, Paulo Henrique ; Gomes-Filho, João Eduardo ; Cintra, Luciano Tavares Angelo ; Sivieri-Araujo, Gustavo</creatorcontrib><description>Objective
The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI).
Methods
A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence.
Results
A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23]
p
< 0.0001,
I
2
= 80%; and OR 3.86 [1.98; 7.53]
p
< 0.0001,
I
2
= 28.7%.
Conclusion
Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI.
Clinical Relevance
UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.</description><identifier>ISSN: 1436-3771</identifier><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-023-04897-4</identifier><identifier>PMID: 36757461</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anti-Infective Agents ; Antimicrobial activity ; Antimicrobial agents ; Clinical trials ; Dental Pulp Cavity ; Dentistry ; Disinfection ; Endodontics ; Humans ; Lavage ; Medicine ; Meta-analysis ; Randomized Controlled Trials as Topic ; Review ; Root Canal Irrigants - pharmacology ; Root canals ; Systematic review ; Ultrasonics - methods</subject><ispartof>Clinical oral investigations, 2023-04, Vol.27 (4), p.1343-1361</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-f504834cd29ae77334814a57f1a4c11bba87e631ccf46e62c085ffb41699abb83</citedby><cites>FETCH-LOGICAL-c342t-f504834cd29ae77334814a57f1a4c11bba87e631ccf46e62c085ffb41699abb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-023-04897-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-023-04897-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36757461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chalub, Lucas Orbolato</creatorcontrib><creatorcontrib>Nunes, Gabriel Pereira</creatorcontrib><creatorcontrib>Strazzi-Sahyon, Henrico Badaoui</creatorcontrib><creatorcontrib>Ferrisse, Túlio Morandin</creatorcontrib><creatorcontrib>dos Santos, Paulo Henrique</creatorcontrib><creatorcontrib>Gomes-Filho, João Eduardo</creatorcontrib><creatorcontrib>Cintra, Luciano Tavares Angelo</creatorcontrib><creatorcontrib>Sivieri-Araujo, Gustavo</creatorcontrib><title>Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objective
The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI).
Methods
A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence.
Results
A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23]
p
< 0.0001,
I
2
= 80%; and OR 3.86 [1.98; 7.53]
p
< 0.0001,
I
2
= 28.7%.
Conclusion
Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI.
Clinical Relevance
UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.</description><subject>Anti-Infective Agents</subject><subject>Antimicrobial activity</subject><subject>Antimicrobial agents</subject><subject>Clinical trials</subject><subject>Dental Pulp Cavity</subject><subject>Dentistry</subject><subject>Disinfection</subject><subject>Endodontics</subject><subject>Humans</subject><subject>Lavage</subject><subject>Medicine</subject><subject>Meta-analysis</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review</subject><subject>Root Canal Irrigants - pharmacology</subject><subject>Root canals</subject><subject>Systematic review</subject><subject>Ultrasonics - methods</subject><issn>1436-3771</issn><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kctOxCAUhonR6Hh5AReGxHUVCi2tu8nEWzKJG10TSg8GMwUFRjO-hW8sM_W2cgMk5_-_czg_QseUnFFCxHnMR8MLUrKC8KYVBd9CE8pZXTAh6Paf9x7aj_GJEMprwXbRHqtFJXhNJ-hj6pIdrA6-s2qBwRjQyb6CgxixN3i5SEFF76zGNgT7qJL1DluHg_cJa-WyKQVQaQCXLrDCcRUTDFmmcYBXC29rSlCu94N9hx7rhc2wjSs3jDhX8ABJFWvUKtp4iHZMLsDR132AHq4u72c3xfzu-nY2nRea8TIVpsp_Zlz3ZatACMZ4Q7mqhKGKa0q7TjUCaka1NryGutSkqYzpOK3bVnVdww7Q6ch9Dv5lCTHJJ78MeYgoy4YQ1pKqWqvKUZU3FGMAI5-DHVRYSUrkOgU5piBzCnKTguTZdPKFXnYD9D-W77VnARsFMZfcI4Tf3v9gPwEsA5YU</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Chalub, Lucas Orbolato</creator><creator>Nunes, Gabriel Pereira</creator><creator>Strazzi-Sahyon, Henrico Badaoui</creator><creator>Ferrisse, Túlio Morandin</creator><creator>dos Santos, Paulo Henrique</creator><creator>Gomes-Filho, João Eduardo</creator><creator>Cintra, Luciano Tavares Angelo</creator><creator>Sivieri-Araujo, Gustavo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20230401</creationdate><title>Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis</title><author>Chalub, Lucas Orbolato ; Nunes, Gabriel Pereira ; Strazzi-Sahyon, Henrico Badaoui ; Ferrisse, Túlio Morandin ; dos Santos, Paulo Henrique ; Gomes-Filho, João Eduardo ; Cintra, Luciano Tavares Angelo ; Sivieri-Araujo, Gustavo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-f504834cd29ae77334814a57f1a4c11bba87e631ccf46e62c085ffb41699abb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-Infective Agents</topic><topic>Antimicrobial activity</topic><topic>Antimicrobial agents</topic><topic>Clinical trials</topic><topic>Dental Pulp Cavity</topic><topic>Dentistry</topic><topic>Disinfection</topic><topic>Endodontics</topic><topic>Humans</topic><topic>Lavage</topic><topic>Medicine</topic><topic>Meta-analysis</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Review</topic><topic>Root Canal Irrigants - pharmacology</topic><topic>Root canals</topic><topic>Systematic review</topic><topic>Ultrasonics - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chalub, Lucas Orbolato</creatorcontrib><creatorcontrib>Nunes, Gabriel Pereira</creatorcontrib><creatorcontrib>Strazzi-Sahyon, Henrico Badaoui</creatorcontrib><creatorcontrib>Ferrisse, Túlio Morandin</creatorcontrib><creatorcontrib>dos Santos, Paulo Henrique</creatorcontrib><creatorcontrib>Gomes-Filho, João Eduardo</creatorcontrib><creatorcontrib>Cintra, Luciano Tavares Angelo</creatorcontrib><creatorcontrib>Sivieri-Araujo, Gustavo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chalub, Lucas Orbolato</au><au>Nunes, Gabriel Pereira</au><au>Strazzi-Sahyon, Henrico Badaoui</au><au>Ferrisse, Túlio Morandin</au><au>dos Santos, Paulo Henrique</au><au>Gomes-Filho, João Eduardo</au><au>Cintra, Luciano Tavares Angelo</au><au>Sivieri-Araujo, Gustavo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>27</volume><issue>4</issue><spage>1343</spage><epage>1361</epage><pages>1343-1361</pages><issn>1436-3771</issn><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objective
The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI).
Methods
A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence.
Results
A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23]
p
< 0.0001,
I
2
= 80%; and OR 3.86 [1.98; 7.53]
p
< 0.0001,
I
2
= 28.7%.
Conclusion
Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI.
Clinical Relevance
UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36757461</pmid><doi>10.1007/s00784-023-04897-4</doi><tpages>19</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1436-3771 |
| ispartof | Clinical oral investigations, 2023-04, Vol.27 (4), p.1343-1361 |
| issn | 1436-3771 1432-6981 1436-3771 |
| language | eng |
| recordid | cdi_proquest_journals_2800390558 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Anti-Infective Agents Antimicrobial activity Antimicrobial agents Clinical trials Dental Pulp Cavity Dentistry Disinfection Endodontics Humans Lavage Medicine Meta-analysis Randomized Controlled Trials as Topic Review Root Canal Irrigants - pharmacology Root canals Systematic review Ultrasonics - methods |
| title | Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis |
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