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Does apical negative pressure prevent the apical extrusion of debris and irrigant compared with conventional irrigation? A systematic review and meta‐analysis
Author(s) -
Romualdo Priscilla Coutinho,
Oliveira Katharina Morant Holanda,
Nemezio Mariana Alencar,
Küchler Erika Calvano,
Silva Raquel Assed Bezerra,
NelsonFilho Paulo,
Silva Lea Assed Bezerra
Publication year - 2017
Publication title -
australian endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.703
H-Index - 34
eISSN - 1747-4477
pISSN - 1329-1947
DOI - 10.1111/aej.12162
Subject(s) - extrusion , debris , irrigation , meta analysis , medicine , dentistry , endodontics , materials science , geology , composite material , agronomy , biology , oceanography
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.