Rotary versus Manual Glide Path Preparation in Root Canal Treatment: A Systematic Review and Meta-Analysis on Apically Extruded Debris.

IF 3.6 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2025-08-01 Epub Date: 2025-05-29 DOI:10.1016/j.joen.2025.05.014

Adinath Walmik Talekar, Dax Abraham, Rajat Sharma, Alpa Gupta, Rajeev Kumar Malhotra

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引用次数: 0

Abstract

Introduction: This systematic review and meta-analysis evaluated the influence of rotary and manual glide path preparation techniques on apically extruded debris during root canal treatment, addressing a critical aspect of endodontic treatment outcomes.

Methods: Following PRISMA 2020 and COSMOS-E guidelines, a comprehensive search of Medline, Scopus, Embase, Epistemonikos, and grey literature identified ex vivo studies using human extracted teeth. Study quality was assessed with the RoBDEMAT tool, and meta-analysis (of four studies) used a random-effects inverse-variance model with a DerSimonian-Laird estimate. The level of evidence was evaluated using the DARE tool. A heat matrix was developed to map the confounding variables.

Results: Eleven studies (2016-2024) met the inclusion criteria. Rotary systems, especially ProGlider, One G, and PathFile, showed significantly less debris extrusion compared to manual K-files. Meta-analysis revealed a standardized mean difference of 1.35 (95% CI: 0.82-1.87; P < .01), indicating greater apical debris with manual techniques. Newer rotary systems exhibited progressive improvements in debris reduction capabilities.

Conclusions: This systematic review provides strong evidence that rotary glide path systems are more effective than manual techniques in minimizing apical debris extrusion during root canal treatment. These findings have significant clinical implications for reducing postoperative complications and improving treatment outcomes in endodontic practice.

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旋转与手动滑动路径预备在根管治疗中：对根尖挤压碎片的系统回顾和荟萃分析。

本系统综述和荟萃分析评估了旋转和手动滑动路径准备技术对根管治疗期间根尖挤出碎片的影响，解决了根管治疗结果的一个关键方面。方法：根据PRISMA 2020和COSMOS-E指南，综合检索Medline、Scopus、Embase、Epistemonikos和灰色文献，确定使用人类拔牙的离体研究。使用RoBDEMAT工具评估研究质量，（四项研究的）荟萃分析使用随机效应反方差模型和dersimonan - laird估计。使用DARE工具评估证据水平。开发了一个热矩阵来映射混杂变量。结果：11项研究（2016-2024）符合纳入标准。旋转系统，特别是ProGlider、One G和PathFile，与手动k文件相比，显示出更少的碎片挤压。meta分析显示标准化平均差（SMD）为1.35 (95% CI: 0.82-1.87；P < 0.01)，说明手工方法造成的根尖碎片较多。较新的旋转系统显示出碎片减少能力的逐步提高。结论：本系统综述提供了强有力的证据，证明在根管治疗过程中，旋转滑动路径系统在减少根尖碎片挤压方面比手工技术更有效。这些发现对于减少术后并发症和改善根管治疗效果具有重要的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.