Authors: Kenza ABOUZAID, Said DHAIMY.
Introduction: Irrigant mechanical agitation has been claimed to enhance the antibacterial efficacy during the root canal treatment. The aim of this study was to systematically review the antibacterial efficacy of ultrasonic compared to sonic agitation of sodium hypochlorite (NaOCl).
Materials and methods: Four databases (Cochrane Library, Medline, ScienceDirect and Scopus) were searched to identify systematic reviews, clinical and in vitro trials evaluating biofilm removal following the use of sonic irrigation (SI), passive ultrasonic irrigation (PUI) or both and the conventional syringe and needle irrigation (SNI) on mature permanent teeth or models simulating the root canal. Articles were selected according to the inclusion criteria, data were extracted and the methodological quality was assessed independently by two reviewers.
Results: The electronic and hand search retrieved 1028 studies. Two clinical controlled trials, thirteen in vitro controlled trials and one systematic review were included. The risk of bias and quality of the selected studies were qualified as moderate and high according to the JBI (Joanna Briggs Institute) and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklists. Overall, both sonic and ultrasonic irrigation improved the bacterial reduction over the conventional irrigation method. However, most of the available evidence could not state significant differences between the antibacterial efficacy of the two methods.
Conclusion: It may be concluded that sonic and ultrasonic activation of the irrigants are beneficial in bacterial reduction when compared to conventional needle irrigation, yet, the current data could not find significant differences between the two techniques.
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