Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta‐analysis

Abstract This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty‐six full‐text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta‐analysis. The meta‐analysis was conducted using the random‐effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount ( p = 0.00) and frequency ( p = 0.00) of extrusion than the open‐ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open‐ended ( p = 0.00 or p = 0.01) and closed‐ended needle ( p = 0.00) irrigation.