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Comparison of crack formation induced by ultrasonic tips and burs during root-end preparation: a systematic review and meta-analysis

Evidence-Based Dentistry (2022)Cite this article

Abstract

Introduction The main objective of root canal treatment is to achieve apical seal. Crack formation during root-end preparation promotes bacterial penetration, thereby leading to failure. This systematic review aims to examine the literature and summarise studies that compare the crack formation induced by ultrasonic tips and burs during root-end preparation.

Methods This systematic review and meta-analysis were reported and conducted according to the PRISMA guidelines. The online databases PubMed, Scopus, and Google Scholar were used for data search. In vitro and ex vivo studies conducted up to March 2021 in the English language were included in the review. The risk of bias in the present study was assessed using a customised tool. A random-effects model was used for meta-analysis, χ² values and I² values were used to assess statistical heterogeneity. Meta-analysis was performed using RevMan software Version 5.4.

Results A total of 317 records were found from all of the databases and one article was added following hand-searching. Twelve articles were included in the study after the application of the eligibility criteria of which ten articles were included for the meta-analysis. Nine studies showed a medium risk of bias while three studies showed a high risk of bias. The analysis of the crack formation showed a statistically significant difference between the ultrasonic tip and the bur (P = 0.0002). The odds ratio was 2.72 (1.60, 4.65) with a confidence interval of 95% suggesting higher odds of crack formation in the ultrasonic group.

Conclusion This review concludes that ultrasonic root-end preparation resulted in higher crack formation than burs.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

The study was self-funded.

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Authors and Affiliations

  1. Department of Conservative Dentistry and Endodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Jesseca John, Prabath Singh V. P., Remya M., Deepthy Subramanian & Kaushik Haridas

  2. Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Vineetha Karuveettil

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  1. Jesseca John
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  2. Prabath Singh V. P.
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Dr Jesseca John, Dr Prabath Singh V P, Dr Vineetha Karuveettil: conceptualisation and article screening. Dr Jesseca John, Dr Vineetha Karuveettil: methodology and statistical analysis. Dr Jesseca John, Dr Prabath Singh V P, Dr Remya M, Dr Deepthy S, Dr Kaushik Haridas: writing - original draft, writing - review and editing.

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John, J., Singh V. P., P., Karuveettil, V. et al. Comparison of crack formation induced by ultrasonic tips and burs during root-end preparation: a systematic review and meta-analysis. Evid Based Dent (2022). https://doi.org/10.1038/s41432-022-0823-0

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