Silva, Emmanuel Joao Nogueira Leal
(Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO))
,
Zanon, Mayara
(Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO))
,
Hecksher, Fernanda
(Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO))
,
Belladonna, Felipe Goncalves
(Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF))
,
de Vasconcelos, Rafaela Andrade
(Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO))
,
da Silva Fidalgo, Tatiana Kelly
(Department of Preventive and Community Dentistry, School of Dentistry, State University of Rio de Janeiro (UERJ))
Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: P...
Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results: From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions: Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.
Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results: From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions: Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.
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제안 방법
From the 5 included studies, 1 presented low risk of bias [4], 3 presented moderate [7,9,12], and 1 high risk [16]. All studies standardized the included samples, the autoclave sterilization cycle, and the test design. The power analysis of the included studies resulted in satisfactory effect size for 3 studies [9,12,16].
In this review, it was applied as a post-hoc analysis that was performed to judge if the sample size of the included studies were powerful.
It was selected studies that evaluated heat-treated NiTi instruments (P, population) submitted to autoclave sterilization (I, intervention), compared to no autoclave sterilization (C, comparison), which evaluated the cyclic fatigue resistance (O, outcome) in in vitro models (S, study design).
The calculation of the power of the included studies was performed using the cyclic fatigue resistance means, standard deviations, and sample size for each group of instruments.
The eligibility criteria were formulated according to the “PICOS” (Population, Intervention, Comparison, Outcome, and Study design) strategy.
The included studies had significant heterogeneity in their methodology because they used a great variety of cyclic fatigue set-ups, variations in angles and radii of curvature of simulated canals, and autoclave sterilization protocols.
Then, the full texts of the studies that presented the potential to be included were evaluated and judged according to eligible criteria following the PICOS strategy.
이론/모형
The number of autoclaving cycles varied from 1 to 10 cycles. All studies were performed using static cyclic fatigue assays. The testing jig varied in the angle of curvature (60° to 90°) and in the radii of curvature (3 mm to 5 mm).
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