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目的系统比较单独使用注射冲洗与辅助超声荡洗在根管预备过程中的根管清洁效果。方法电子检索PubMed、Embase、Web of Science、Cochrane Library、ProQuest Dissertation and Theses,以及中文科技期刊数据库、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,检索时间为1985年1月1日—2014年3月1日,同时对中文口腔医学杂志进行手工检索,对全部纳入文献的参考文献进行追索,收集辅助超声荡洗能否提高注射冲洗质量的临床随机对照试验(RCT)和临床对照试验(CCT)。使用Cochrane协作网推荐的标准对纳入文献进行偏倚风险评价并提取数据,采用RevMan 5.2软件进行统计分析。结果最终纳入9篇文献,7篇为低度风险,2篇为中度风险。Meta分析结果:组织学方法显示辅助超声荡洗能显著提高根管根尖区主侧支根管碎屑和玷污层的清洁程度,与仅使用注射冲洗相比,其差异有统计学意义(P<0.01),但细菌培养法(P=0.26)及聚合酶链反应(PCR)检测法(0.99)均显示辅助超声荡洗的根管抗菌效果与仅使用注射冲洗无明显差异。结论辅助超声荡洗对根管根尖区碎屑和玷污层的清洁效果明显优于单独使用注射冲洗,但两者的根管抗菌效果没有明显差异。
Objective To compare the effect of root canal cleaning during root canal preparation by using single injection and auxiliary supersonic irrigation. Methods PubMed, Embase, Web of Science, Cochrane Library, ProQuest Dissertation and Theses were searched electronically. The databases of Chinese scientific journals, Chinese periodicals full text database, Wanfang database and Chinese biomedical literature database were retrieved. The search time was January 1, 1985 - March 1, 2014 At the same time, the Chinese Journal of Stomatology was searched by hand and the references of all the included articles were traced. The clinical randomized controlled trials (RCTs) and the clinical controls Test (CCT). The Cochrane Collaboration recommended standards were used to assess the risk of inclusion bias and extract data for statistical analysis using RevMan 5.2 software. The results eventually included 9 articles, 7 for low risk and 2 for moderate risk. Meta-analysis results: Histology showed that assisted ultrasonic scrubbing could significantly improve the cleanliness of root canal detritus and smear layer in root apical area, which was significantly different from that of only using rinse irrigation (P <0.01). However, bacterial culture (P = 0.26) and polymerase chain reaction (PCR) detection (0.99) showed that there was no significant difference in antibacterial effect between root canal assisted by ultrasonic cleaning and only using irrigation. Conclusions Auxiliary ultrasonic washes showed significantly better cleaning effect on the detritus and smear layer of root canal than that of single injection, but there was no significant difference in the antimicrobial effect between the two.