No high-level evidence to support use of ultrasonic instrumentation for root canal treatment

Searches were made for suitable reports using the Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, Medline, Embase and LILACS (Latin American and Caribbean Health Sciences Literature), and within the reference lists of identified articles. There were no language restrictions.

Randomised controlled trials (RCT) were selected if they had participants of over 18 years of age who had single and multiple permanent teeth with a completely formed apex and with no evidence of internal resorption, and which required root canal treatment. Individuals undergoing retreatment of a tooth were excluded.

Screening of eligible studies was conducted in duplicate and independently. Results were to be expressed as fixed-effect 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 were identified.

This review illustrates the current lack of published or ongoing RCT, and the lack of availability of high-level evidence dealing with clinically relevant outcomes, for the effectiveness of ultrasonic instrumentation used alone or as an adjunct to hand instrumentation for orthograde root canal treatment. Future RCT might focus more closely on evaluating the effectiveness of combinations of these interventions with an emphasis not only on clinically relevant but also patient-centred outcomes.