The influence of ProTaper and WaveOne on apically extruded debris: A systematic review and meta-analysis.
The influence of ProTaper and WaveOne on apically extruded debris: A systematic review and meta-analysis.
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ProTaper 和 WaveOne 对顶部挤出碎片的影响：系统回顾和荟萃分析
DOI：
10.4103/jcd.jcd_82_18
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Liu L
中科院分区：
文献类型：
--
作者：
Zhang C;Liu J;Liu L
根管预备过程中产生的根尖推出物可诱发术后炎症，进而导致根管治疗失败。因此，必须减少推出物以提高根管治疗的效果。
本研究旨在通过比较使用ProTaper Universal（PTU）、ProTaper Next（PTN）和WaveOne（WO）对离体人牙进行根管预备时根尖推出物量的差异，为根管治疗的改进提供理论依据。
2017年3月30日，三名研究人员检索了五个电子数据库（PubMed/Medline、Cochrane、Science Direct Online、Embase和Web of Science），无时间限制。仅检索英文文献，共获得150篇文章。然后，三名研究人员根据先前确定的纳入和排除标准独立筛选文章，对不一致的结果进行讨论。通过荟萃分析对标准化均数差（SMD）进行数据分析。
八项研究符合纳入标准并进行了定性分析。四篇文章表明PTU产生的根尖碎屑量比WO多；两篇文章表明PTU产生的根尖碎屑量比WO少；三篇文章表明PTN产生的根尖碎屑量比WO少。此外，一篇文章表明PTU产生的根尖碎屑量比PTN多。荟萃分析显示PTU和WO产生的根尖推出物量无显著差异：SMD = -0.26，Z = 0.50（P>0.05）。PTU产生的根尖推出物量比WO少：SMD = -4.98，Z = 2.79（P<0.05）。然而，所有纳入研究之间的结果存在显著异质性（I² = 97%）。PTU和WO在根尖推出物量方面无显著差异：SMD = 0.47，Z = 1.06（P>0.05）。
目前现有证据表明PTN产生的根尖碎屑量可低于WO（P<0.05）。此外，PTU和WO产生的根尖推出物量无显著差异（P>0.05）。然而，鉴于所综述的研究数量有限，无法得出明确结论。
Apically extruded debris produced during root canal preparation can induce postoperative inflammation and subsequent failure of root canal treatment. Therefore, debris production must be reduced to improve the outcome of root canal treatment. This study aimed to provide a theoretical basis for the improvement of root canal treatment by comparing the difference in the amount of apically extruded debris produced during the root canal preparation of extracted human teeth with ProTaper Universal (PTU), ProTaper Next (PTN), and WaveOne (WO). On March 30, 2017, three researchers searched five electronic databases (PubMed/Medline, Cochrane, Science Direct Online, Embase, and Web of Science) with no time limitations. Only articles written in English were retrieved, and 150 articles were obtained. Then, the three researchers independently selected articles in accordance with previously established inclusion and exclusion criteria, and inconsistent results were discussed. Data were analyzed through meta-analysis for standardized mean difference (SMD). Eight studies met the inclusion criteria and were subjected to qualitative analysis. Four articles showed that PTU produced higher amounts of apical debris than WO; two articles showed that PTU produced lower amounts of apical debris than WO; and three articles showed that PTN produced lower amounts of apical debris than WO. Moreover, one article demonstrated that PTU produced higher amounts of apical debris than PTN. A meta-analysis showed that PTU and WO did not produce significantly different amounts of apically extruded debris: SMD = −0.26, Z = 0.50 (P > 0.05). PTU produced lower amounts of apically extruded debris than WO: SMD = −4.98, Z = 2.79 (P < 0.05). However, results were significantly heterogeneous among all the included studies (I2= 97%). No significant difference was found between PTU and WO in the amounts of apically extruded debris: SMD = 0.47, Z = 1.06 (P > 0.05). Currently available evidence shows that PTN can produce lower amounts of apical debris than WO (P < 0.05). Moreover, the amounts of apically extruded debris produced by PTU and WO are not significantly different (P > 0.05). Nevertheless, given the limited number of studies reviewed, a definitive conclusion cannot be reached.