Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis
Abstract
Background Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips that cause no harm to dentinal walls. This review explores the intracanal cleaning efficacy of EDDY compared with UAI in vitro. Methods The systematic review was registered in the PROSPERO database (CRD42021235826). A literature search was conducted in six electronic databases. In vitro studies that compared the removal of smear layer, debris, soft tissue or microbes in root canals between EDDY and UAI were included. Data extraction and quality assessment were performed. Meta-analyses were conducted on smear layer removal and debris elimination with the standardized mean difference (SMD). Heterogeneity was measured using the I^2 test and the Chi^2 test. The random-effect model was used when I^2 > 50%, or p < 0.1, otherwise the fixed-effect model was applied. The level of significance was set at p < 0.05. Results 19 articles were included in this systematic review and 7 articles were included in meta-analyses. Meta-analyses on smear layer removal showed unimportant differences between EDDY and UAI at any canal third (coronal [SMD = 0.08, 95% confidence interval (95%CI): -0.29 to 0.45; p = 0.44, I^2 = 0%]; middle [SMD = 0.02, 95% CI: -0.44 to 0.47; p = 0.94, I^2 = 0%]; apical [SMD = 0.01, 95%CI: -0.35 to 0.38; p = 0.70, I^2 = 0%]). Meta-analyses on debris removal evaluated by scanning electron…
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Evidence Hub reads this as a meta-analysis, done in cell cultures (in vitro), not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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