Does apical negative pressure prevent the apical extrusion of debris and irrigant compared with conventional irrigation? A systematic review and meta-analysis.
The aim of this study was to evaluate if apical negative pressure (ANP) irrigation prevents the apical extrusion of debris and irrigant compared with conventional needle irrigation through a systematic review and meta-analysis. A computer search of dental literature was performed using four different databases. A combination of the terms 'apical negative pressure', 'endovac', 'apical extrusion', 'extrusion' and 'endodontics' was used. Studies that used extracted human teeth with a mature apex and that evaluated the apical extrusion of debris and/or irrigating solution were included. After an evaluation of the full studies according to the eligibility criteria, eight studies were critically analysed and subjected to quality assessment and risk of bias. Only four studies that evaluated extrusion of irrigant were considered as having high methodological quality and were subjected to a meta-analysis. Studies evaluating extrusion of debris did not have sufficient methodological quality to be subjected to the meta-analysis. The forest plot indicated that ANP irrigation prevents the risk of irrigant extrusion compared with conventional irrigation (OR 0.07 [95%CI 0.02-0.20]; P < 0.00001). This systematic review and meta-analysis showed that ANP prevents the apical extrusion of irrigant. There is no evidence if this type of irrigation prevents the extrusion of debris.
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Priscilla Coutinho
PC
Romualdo
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Katharina Morant Holanda
KMH
de Oliveira
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Mariana Alencar
MA
Nemezio
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Erika Calvano
EC
Küchler
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Raquel Assed Bezerra
RAB
Silva
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Paulo
P
Nelson-Filho
Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Lea Assed Bezerra
LAB
Silva
D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000517:prevention & control*; D006801:Humans; D011312:Pressure; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D018915:Root Canal Preparation / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods*
D012388:Root Canal Irrigants
apical extrusion; apical negative pressure; endodontics; endovac; extrusion