Abstract
The
aim of this study was to systematically review and critically analyse
the published data on the treatment outcome (primary outcome) and on the
cleaning and disinfection of root canals (secondary outcomes) achieved
by negative pressure irrigation as compared to syringe irrigation. An
electronic search was conducted in EMBASE, LILACS, Pubmed, SciELO,
Scopus, and Web of Knowledge using both free-text keywords and
controlled vocabulary. Additional studies were sought through
hand-searching of endodontic journals and of the relevant chapters of
endodontic textbooks. No language restriction was imposed. The retrieved
studies were screened by two reviewers according to predefined
criteria. Included studies were critically appraised and the extracted
data were arranged in tables. The electronic and hand search retrieved
489 titles. One clinical study and 14 in vitro studies were
finally included in the review; none of these studies assessed treatment
outcome, 4 studies assessed the antimicrobial effect, 7 studies
evaluated the removal of pulp tissue remnants, and 4 studies
investigated the removal of hard tissue debris or both hard tissue
debris and pulp tissue remnants. Poor standardization and description of
the protocols was evident. Inconclusive results were reported about the
cleaning and disinfection accomplished by the two irrigation methods.
Negative pressure irrigation was more effective under certain conditions
when compared to suboptimal syringe irrigation, however, the
variability of the protocols hindered quantitative synthesis. There is
insufficient evidence to claim general superiority of any one of these
methods. The level of the available evidence is low and the conclusions
should be interpreted with caution.
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