Fifteen years of engine-driven nickel–titanium reciprocating instruments, what do we know so far? An umbrella review

IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Australian Endodontic Journal Pub Date : 2024-06-24 DOI:10.1111/aej.12870
Felipe Immich, Lucas Peixoto de Araújo, Rafaella Rodrigues da Gama, Wellington Luiz de Oliveira da Rosa, Evandro Piva, Giampiero Rossi-Fedele
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Abstract

Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel–titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly ‘high’ RoB and ‘critically low’ quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.

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发动机驱动镍钛往复式仪器十五年,我们迄今了解多少?综述。
自 15 年前 Yared 的开创性研究以来,许多系统性综述(SR)对发动机驱动的镍钛往复式器械(往复式器械)得出了相互矛盾的结论。本综述分析了有关根管治疗往复式器械的临床和实验室证据的系统综述。包括对术后疼痛、口腔健康相关生活质量(OHRQoL)、塑形能力、碎屑挤出、微生物负荷、内毒素减少、周期性疲劳、锉刀断裂、牙本质裂缝和根管充填物去除等结果进行定性和/或定量评估的 SR。AMSTAR 2 工具用于评估SR的质量,ROBIS工具用于评估偏倚风险(RoB)。共纳入了 40 份报告。结果表明,SRs 的 RoB 主要为 "高",质量为 "极低"。大多数研究侧重于技术结果,在方法学和统计学方面表现出明显的异质性。研究结果表明,往复式器械和旋转式器械的疗效相当。然而,由于高质量的证据稀缺,未来还需要设计良好的研究和考虑核心结果测量的综述。
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来源期刊
Australian Endodontic Journal
Australian Endodontic Journal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.50
自引率
6.20%
发文量
99
审稿时长
>12 weeks
期刊介绍: The Australian Endodontic Journal provides a forum for communication in the different fields that encompass endodontics for all specialists and dentists with an interest in the morphology, physiology, and pathology of the human tooth, in particular the dental pulp, root and peri-radicular tissues. The Journal features regular clinical updates, research reports and case reports from authors worldwide, and also publishes meeting abstracts, society news and historical endodontic glimpses. The Australian Endodontic Journal is a publication for dentists in general and specialist practice devoted solely to endodontics. It aims to promote communication in the different fields that encompass endodontics for those dentists who have a special interest in endodontics.
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