The Effect of Number of Visits, Use of Solvent and Gutta-percha Removal Technique on Postoperative Pain following Nonsurgical Endodontic Retreatment; A Systematic Review and Meta-analysis.

Q3 Dentistry
Iandara Lima Scardini, Giovanna Sarra, Mariana Minatel Braga, Marcelo Dos Santos, Laila Gonzales Freire
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引用次数: 0

Abstract

Introduction: The nonsurgical endodontic retreatment (NERT) is the first choice of dental ministration when primary/initial endodontic treatment fails. The present study aimed to investigate the presence of postoperative pain (POP) after NERT in permanent asymptomatic teeth as well as possible factors associated with POP.

Materials and methods: A comprehensive search of literature was performed in Pubmed/MEDLINE, Embase, Scopus and Web of Science databases, up to January 2023; including randomized clinical trials and prospective studies. The risk of bias was assessed with RoB 2.0 and ROBINS-I tools. Subgroups analyses were conducted to evaluate the differences in the incidence or level of POP between the number of visits, the use/not use of solvent, the removal technique of gutta-percha, and the period of POP analysis. Mean differences and confidence intervals (CI) of 95% were used as measures of effect, and meta-regression was used along with subgroup analysis. The certainty of evidence was assessed using GRADE, and the probability value of <0.05 was considered significant.

Results: Twenty-four studies were selected, with thirteen included in the meta-analysis. There was a statistical difference between the incidence of POP after 24 h (95% CI, 0.28 to 0.52) and one week (95% CI, 0.02 to 0.13) from the endodontic retreatment (P<0.01). However, there was no statistical difference between different techniques, number of visits and use of solvent (P>0.05) in the same period. In addition, the certainty of evidence was very low.

Conclusions: Post-operative pain is a common response to NERT, independent of the retreatment technique(s) applied, number of visits and use of solvent(s); with very low certainty of evidence as well as low risk of bias. Moreover, the current analysis showed a (very) serious risk of inconsistency and imprecision. However, POP was significantly reduced within 1 week of the NERT.

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就诊次数、溶剂使用及杜仲胶去除技术对非手术根管再治疗术后疼痛的影响系统回顾和荟萃分析。
简介:当初级/初始牙髓治疗失败时,非手术牙髓再治疗(NERT)是牙科服务的首选。本研究旨在探讨无症状恒牙NERT术后疼痛(POP)的存在及其可能的相关因素。材料和方法:全面检索截至2023年1月的Pubmed/MEDLINE、Embase、Scopus和Web of Science数据库的文献;包括随机临床试验和前瞻性研究。使用rob2.0和ROBINS-I工具评估偏倚风险。采用亚组分析的方法,评价访问次数、使用/不使用溶剂、杜仲胶去除技术和POP分析时间之间POP发生率或水平的差异。使用95%的平均差异和置信区间(CI)作为效果度量,并使用meta回归和亚组分析。使用GRADE评估证据的确定性,概率值为。结果:共选择24项研究,其中13项纳入meta分析。同一时期内再治疗后24 h (95% CI, 0.28 ~ 0.52)与1周(95% CI, 0.02 ~ 0.13)的POP发生率比较,差异有统计学意义(PP>0.05)。此外,证据的确定性非常低。结论:术后疼痛是NERT的常见反应,与应用的再治疗技术、就诊次数和溶剂的使用无关;证据的确定性非常低,偏倚风险也很低。此外,当前的分析显示出不一致和不精确的(非常)严重的风险。然而,在NERT后1周内,POP显著降低。
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来源期刊
Iranian Endodontic Journal
Iranian Endodontic Journal Dentistry-Dentistry (all)
CiteScore
1.30
自引率
0.00%
发文量
0
审稿时长
12 weeks
期刊介绍: The Iranian Endodontic Journal (IEJ) is an international peer-reviewed biomedical publication, the aim of which is to provide a scientific medium of communication for researchers throughout the globe. IEJ aims to publish the highest quality articles, both clinical and scientific, on all aspects of Endodontics. The journal is an official Journal of the Iranian Center for Endodontic Research (ICER) and the Iranian Association of Endodontists (IAE). The Journal welcomes articles related to the scientific or applied aspects of endodontics e.g. original researches, systematic reviews, meta-analyses, review articles, clinical trials, case series/reports, hypotheses, letters to the editor, etc. From the beginning (i.e. since 2006), the IEJ was the first open access endodontic journal in the world, which gave readers free and instant access to published articles and enabling them faster discovery of the latest endodontic research.
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