Different outcomes of rotary and manual instrumentation in primary teeth pulpectomy: a systematic review and meta-analysis.

Abstract

Purpose: The aim of the present meta-analysis was to compare the rotary and hand files efficacy in primary teeth pulpectomy.

Methods: A structured search was conducted through four electronic bibliographic databases; MEDLINE via PubMed, Web of Science, Scopus, and Cochrane Library. The risk of bias was assessed using the Cochrane (RoB 2.0) tool. A meta-analysis was conducted using the Review manager software at a significance level of p < 0.05 The heterogeneity was measured by the Cochrane Q test and I 2. Sensitivity analysis was performed according to the leave-one-out method and the GRADE approach was used to assess the certainty of evidence.

Results: A total of 47 trials were included in the present review. Results showed that rotary instruments presented a significantly reduced instrumentation and obturation time. Rotary files, in root canal preparation of primary teeth, resulted in better root/tooth obturation. With rotary instrumentations, a significantly lower incidence of postoperative pain was reported after 6 h, 24 h, and 48 h. No significant differences were noted between the two groups regarding the children's behaviour and the clinical and radiographic success after 3 and 6 months, respectively.

Conclusion: Although no differences have been reported in the clinical and radiographic success between rotary files and manual files in primary teeth pulpectomy, rotary systems have been shown to provide better obturation quality, reduced instrumentation time, and less postoperative pain compared with conventional techniques.