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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.

Background: Squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity with a highly aggressive nature. Verrucous carcinoma (VC) is a low-grade SCC with mild clinical and pathological characteristics. Extracellular matrix degradation (ECM) by several proteolytic enzymes, especially matrix metalloproteinases (MMPs), is an important factor in tumor growth, invasion, and metastasis. Objectives: The aim of this study was to evaluate the expression level of immunohistochemistry of MMPs 2 and 9 in SCC and VC of oral cavity. Methods: The present study was conducted on the data of 20 SCC and 18 VC samples obtained from the pathology department archives. Microscopic examination was performed after immunohistochemical staining of the samples for MMP-2 and MMP-9. Data analysis was performed in SPSS 20 software. Kruskal-Wallis test was used to compare variables between groups. Results: All SCC and VC samples were positive for MMP-2 and MMP-9. The mean expression level of MMP-9 was 24.41 ± 20.68 in VC and 48.27 ± 12.11 in SCC. The mean expression level of MMP-9 in SCC was higher than VC. In addition, the expression level of MMP-9 varied in different histopathological grades of SCC. Matrix metalloproteinase expression levels were different in SCC grades and was especially higher in grade III. The mean expression level of MMP-2 in VC was 35.28 ± 30.63 and in SCC was 23.50 ± 12.68. The mean expression level of MMP-2 in VC was higher than SCC. Conclusions: Our findings showed that the expression levels of MMPs 2 and 9 in SCC and VC are higher than healthy tissue.