Evaluation of the Efficacy of Passive Ultrasonic Irrigation Versus Conventional Methods in Endodontic Therapy Outcomes: A Scoping Review

Abstract

Aims: To map clinical passive ultrasonic irrigation protocols and their significance, or lack thereof, in the clinical success of endodontic treatment. Study Design: Scoping review. Place and Duration of Study: Independent systematic paired searches were conducted across six databases (Cochrane Library, IEEE Xplore, PubMed, ScienceDirect, Scielo, and the Virtual Health Library) in September 2024. Methodology: The protocol for this study was registered in the Open Science Framework. Inclusion criteria encompassed randomised clinical trials, comparative in vivo and in vitro studies, and systematic reviews with or without meta-analysis. Studies were assessed for relevance and methodological quality. The risk of bias in clinical studies was evaluated using the Risk of Bias 2 tool in Review Manager 5.4. Results: Out of 472 studies identified, 8 met the inclusion criteria. Among the 4 clinical studies, 2 demonstrated a moderate risk of bias, and 2 exhibited a high risk. Some studies reported that passive ultrasonic irrigation enhanced microbial reduction and debris removal; however, no significant differences in healing or clinical success were observed compared to conventional irrigation. In vitro studies suggested potential benefits in microbial control, but clinical evidence remained inconclusive due to limited sample sizes, short follow-up periods, and variations in protocols. Conclusion: Current evidence does not support the routine use of passive ultrasonic irrigation to improve the clinical success of endodontic therapy. Further randomised clinical trials with larger sample sizes, extended follow-up durations, and standardised protocols are necessary to determine the true benefits of this technique in endodontic practice.