Comparing Techniques for Removal of Separated Endodontic Instruments: Systematic Review and Meta-analysis

Purpose: The goal of this study is to look into several approaches to approaching damaged instruments in the root canal, as well as to show possible outcomes in terms of dentin thickness, fracture resistance, technique success, and clinical time. Methodology: PubMed, Cochrane, Lilacs, Web of Science, Scopus, grey literature, and manual searches were used to conduct the bibliographic research. The titles and abstracts of 506 papers were examined using the inclusion and exclusion criteria. Sixty items were chosen and read in their entirety. This systematic review includes fourteen papers. Results: The ultrasonic approach was the most extensively researched and yielded positive results in general. The more apically positioned the tool is, the more difficult it is to remove it, the more dentin is removed, and the poorer the tooth's fracture resistance. When removal is not possible, the bypass technique (bypassing) can be employed, and the GentleWave System approach can be used on weakened teeth or with little dental fragments. Conclusion: The data from laboratory investigations showing the curvature and root third in which instrument fractures originate is related to fracture resistance and success is presented in this comprehensive review

Success Rate of Endodontics Instrument Retrieval Using Magnification Devices: A Systematic Review and Meta Analysis

Retrieval of the broken instrument in the root canal is critical for the endodontic success. Hence in the present study we aimed to conduct a systematic review and meta-analysis to assess the success of the endodontics instrument retrieval using magnification devices. We piloted a prospective clinical trial comparing endodontic therapy performed with or without using magnification devices that was based on the clinical and radiographic estimation after a year of follow-up. The key terms searched were: “endodontic treatment, endodontic therapy, endodontic surgery, apicoectomy, periapical surgery, microscope, endoscope, loupes, magnification devices”. The sources searched were “MEDLINE, Embase, Cochrane Oral Health Specialized Register, Cochrane Central Register of Controlled Trials”, the period of searched was from September 2009 to 2021. Statistical analysis was performed using the software Review Manager. Of 470 studies only 3 studies were finalized. No significant variation in outcomes was found among patients treated using magnifying devices. Correspondingly, no variation was found with or without using the endoscope. No comparative study on magnification devices was found regarding orthograde endodontic treatment. The efficiency of the dentist is the key factor in the retrieval of the broken instrument, rather than the magnification devices