Why do in vitro studies often show ideal results for new techniques, while clinical outcome studies show no significant difference compared to conventional treatments?
In Endodontics specifically:
1. Irrigation techniques (e.g., GentleWave, PUI):
- In vitro: Often show superior bacterial reduction compared to conventional syringe irrigation.
- Outcome studies: Many show no statistically significant difference in long-term healing or success rates (e.g., JOE 2022, 2024 papers).
2. Root canal sealers (e.g., bioceramics vs epoxy):
- In vitro: Bioceramic sealers demonstrate better properties (e.g., antimicrobial, biocompatibility).
- Outcome studies: No significant difference in clinical success after 1–2 years.
3. Obturation techniques (e.g., warm vertical vs single cone):
- In vitro: Warm techniques show better adaptation and fewer voids.
- Clinical evidence: Success rates are often comparable when disinfection is adequate.
4. Post space cleaning or bonding agents in prosthodontics:
- In vitro: Certain adhesives or protocols outperform others under laboratory conditions.
- Clinical outcomes: Failures are more related to occlusion, case selection, or patient habits.
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