Influence of different irrigation regimens on the dentinal tubule penetration of a bioceramic-based root canal sealer: a confocal analysis study

Comparison of sealer penetration of sonic activation versus conventional needle irrigation: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Most existing studies comparing the efficiency of sonic irrigation (SI) and conventional needle irrigation (CNI) in increasing the penetration of sealers into dentine tubules are controversial; and this study aimed to determine whether the use of SI can lead to greater sealing ability than CNI, during the root canal treatment.

METHODS

The EMBASE, PubMed, and Cochrane Library databases were used to find confocal laser scanning microscopy studies evaluating percentage and maximum depth of sealer penetration following the use of SI or CNI in mature permanent teeth until October 2022. The critical estimative checklist of randomized controlled trials of the standardized Joanna Briggs Institute was adopted to independently score the quality of each study. The random-effect model for meta-analysis was used to analyse for each canal segment (apical, middle, coronal). The results are shown in the forest plots as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs).

RESULTS

Ninety-seven articles were included in the preliminary screening, and nine of them were included in this study. Eight studies were included in the meta-analysis.The meta-analysis exhibited great increases in the coronal (WMD: 8.09, 95% CI 2.78-13.40/WMD: 165.32, 95% CI 128.85-201.80), and middle segments (WMD: 8.81, 95% CI 5.76-11.87/WMD: 132.98, 95% CI 68.71-197.25) for the percentage and maximum depth of sealer penetration, respectively. The percentage of sealer penetration in the apical thirds region was nonsignificant (WMD: 4.73, 95% CI - 2.34-11.80). However, the maximum depth of sealer penetration in the apical thirds region was significant (WMD: 121.46, 95% CI 86.55-156.38). Chi-squared analysis revealed heterogeneity scores of 0.0-70.0% and 44.0-90.0% for the percentage and maximum depth of sealer penetration, respectively.

DISCUSSION

This review verified that SI significantly improves tubular dentin sealer penetration in most areas of the root canal; thus, SI may lead to better filling efficiency and anti-reinfection effects than CNI during and after the root canal therapy. Nevertheless, a large heterogeneity in the current data comparing the irrigation efficiency of SI versus CNI in the apical third of the root canal was found, implying the necessity to standardize root canal irrigation procedures and obtain more accurate results in this area.

TRIAL REGISTRATION

INPLASY database (INPLASY202270116).

Effect of Enhanced Recovery after Surgery (ERAS) Concept and Cluster Nursing on Psychological State and Pain of Oral Outpatients Undergoing Root Canal Therapy

Objective

The effect of the concept of enhanced recovery after surgery (ERAS) and pain of patients undergoing root canal therapy in oral clinic.

Methods

200 participants in an oral clinic from March 2020 to March 2022 were enrolled in our study. The control group (n = 100) accepted ERAS-based care and the research group (n = 100) accepted ERAS concept and cluster nursing. Nursing satisfaction, comfort, self-efficacy, subjective well-being, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores were compared.

Results

The research group had 100% satisfaction rate; the control group had 87% satisfaction rate. After nursing, the scores of comforts and self-efficacy of the two groups increased and the scores of comforts and self-efficacy of the research group were higher than those of the control group. After nursing, the scores of subjective well-being of the two groups increased. Furthermore, the higher scores of life satisfaction, interpersonal harmony, and self-efficacy in the research group were found. There was no significant difference in the scores of SAS and SDS between the two groups before nursing (P > 0.05), but after nursing, the scores of SAS and SDS in the two groups decreased, and the scores of SAS and SDS in the research group were lower than those in the control group, and there are statistically significant differences between the groups (P < 0.05). The scores of visual analogue score (VAS) and numerical rating scale (NRS) following intervention decreased, and there are statistically significant differences between the groups (P < 0.05). The less physiological, psychological, social functions, and health self-cognition in the research group were displayed, and there are statistically significant differences between groups (P < 0.05).

Conclusion

The adoption of the concept of ERAS and cluster nursing can effectively improve the psychological state and pain score of oral outpatients undergoing root canal therapy, improve comfort and self-efficacy, and enhance subjective well-being and quality of life. ERAS and cluster nursing is of great significance in relieving pain after root canal therapy in the outpatient department, reducing patients' pain and improving patients' quality of life.