Insufficient evidence for the effectiveness of ultrasonic instrumentation for root canal treatment

Abstract

Relevant studies were sourced using the Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase. The reference lists of relevant articles were searched and personal databases of trial reports used, in an attempt to locate additional published and unpublished trials. No language restriction was applied. Randomised controlled trials (RCT) were selected that involved people of age >/=18 years with single and multiple permanent teeth with a completely formed apex and no evidence of internal resorption, who required root canal treatment. Patients undertaking retreatment of a tooth were excluded. Screening of eligible studies was conducted in duplicate and independently by two review authors. Results were to be expressed as fixed- or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. No eligible RCT could be found. This review illustrates how there are no published or ongoing RCT relevant to this review question and that there is currently insufficient evidence regarding the effectiveness of ultrasonic instrumentation used alone for orthograde root canal treatment. Future RCT might focus more closely on evaluating the effectiveness of hand instrumentation compared with hand instrumentation and adjunctive ultrasonic instrumentation.