Affiliation:
1. Department of Conservative Dentistry and Endodontics, Dr D. Y. Patil Dental College and Hospital, Dr D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
Abstract
Aim: The objective was to evaluate and compare the crack formation induced by ultrasonic tips and lasers with conventional burs during root-end preparation. Materials and Methods: The PROSPERO registration code for this study is CRD42023470898. Both manual and electronic database searches were performed up to 2023, August in three databases, namely, the Cochrane Library, PubMed and Google Scholar. In vitro or laboratory studies that employed the use of ultrasonic tips, LASER and conventional burs for root-end preparation on extracted teeth were collected. The data were extracted by two independent reviewers using a predesigned template. Information about the study design, year, full-text publications, inclusion and exclusion criteria were gathered. The PRISMA guidelines 2020 were followed in the reporting and execution of the systematic review and meta-analysis. To evaluate statistical heterogeneity, χ² values and I² values were employed in conjunction with a random-effects model for the meta-analysis. Results: A total of 689 articles were identified. After removing the duplicates in total 567 articles were screened. Finally, six articles were included in the meta-analysis. QUIN Risk of Bias tool showed an overall moderate risk of bias in the included studies. The pooled odds ratio for crack formation was 1.77 (0.82, 3.82) for ultrasonic tips and conventional burs suggesting higher odds of crack formation for ultrasonic tips. Conclusion: None of the included studies provided information on sample size calculation, sampling technique, randomization or blinding. The meta-analysis suggests higher chances of crack formation from ultrasonic followed by laser and conventional burs preparation. Therefore, efforts to standardize an acceptable procedure for root-end cavity preparation should be made in future study, along with encouragement of the clinical application of the same, taking into account issues like economic feasibility and convenience of usage.