Efficacy of EndoActivator on the postoperative pain in the teeth with symptomatic irreversible pulpitis: A systematic review and meta-analysis

Aim: Postoperative pain affects the quality of life and upsets clinicians and patients, which could cause postoperative discomforts such as pain, swelling, and persistent inflammation. Hence conventional irrigation methods are not sufficient to reduce the postoperative pain (PP). EndoActivator can reduce the risk of irrigant extrusion into periapical tissues to help patients and clinicians. The aim is to screen the clinical trials that compared the effect of activation of Irrigant by EndoActivator compared with without activation and the severity of pain after root canal treatment in the teeth with symptomatic irreversible pulpitis. Materials and Methods: Search criteria: PubMed/Medline, PubMed Central, Cochrane Library, EBSCO, EMBASE, Scopus Web of Science, DOAJ, LILAC, Manual search, Grey literature search. Randomized clinical trials, controlled clinical trials, or clinical studies were included which recruited patients with symptomatic irreversible pulpitis teeth with preoperative pain scores (moderate to severe) on a visual analogue scale and should have used activated irrigation by EndoActivator during root canal treatment and evaluated postoperative pain at different time intervals. The Risk of Bias (RoB) and meta-analysis were analyzed using review-manager software. Results: Four trials were judged to have a low RoB. There was a significant reduction in PP in the EndoActivator group at 8 and 24 h. There was a clinical significance difference between the activated and non-activated irrigation methods. Conclusion: The review has highlighted the need for irrigant activation in the regular clinical endodontic practice to increase the success rate and reduce PP, a crucial factor related to symptomatic irreversible pulpitis teeth.