Postoperative Pain After Root Canal Preparation With Different Instruments in Primary Teeth: A Systematic Review and Meta-Analysis

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2025-07-24 DOI:10.1002/cre2.70180

Kavalipurapu Venkata Teja, Kaligotla Apoorva Vasundhara, Gianrico Spagnuolo, Mariangela Cernera, Niccolò Giuseppe Armogida, Flavia Iaculli, Carlo Rengo

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引用次数: 0

Abstract

Objective

This systematic review and meta-analysis aimed to evaluate the effectiveness of different instrumentation systems in reducing postoperative pain following root canal preparation in primary teeth.

Material and Methods

The present study was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42020135904). The review aimed to determine whether there is a difference in postoperative pain incidence using various instrumentation systems (manual and mechanical) for root canal preparation of primary teeth during pulpectomy. An extensive database search was performed using specific MeSH terms to include clinical studies up to November 2024. Based on eligibility criteria, the selected articles were subjected to quality assessment and the risk of bias was conducted using the Cochrane Risk of Bias (RoB 2) tool. In addition, meta-analyses were conducted on homogeneous studies.

Results

A total of 11 studies were included for qualitative assessments, and 7 studies underwent quantitative analysis. The results review indicated that mechanical instrumentation systems yielded better overall pain reduction compared to manual systems. The meta-analysis further demonstrated statistically significant pain reduction at 6 (p < 0.01, 95% CI: 1.46) and 12 h (p < 0.01, 95% CI: 2.15). However, no notable pain reduction or significance were observed at other time points (p = 0.41, 95% CI: 1.66; p = 0.23, 95% CI: 1.67; p = 0.61, 95% CI: 1.25). The overall risk of bias was low for the included studies.

Conclusion

Rotary NiTi instrumentation systems were superior in reducing Postoperative pain incidence in primary teeth undergoing pulpectomy.

Clinical Relevance

Mechanical instrumentation is not only advantageous in decreasing overall treatment time, but also in reducing pain incidence after pulpectomy, which nowadays represents an important and widely used procedure to preserve primary teeth.

Abstract Image

查看原文本刊更多论文

不同器械预备乳牙根管后疼痛：系统回顾和meta分析

目的本系统综述和荟萃分析旨在评估不同器械系统在减少乳牙根管预备术后疼痛方面的有效性。材料和方法本研究按照PRISMA指南进行，并在PROSPERO注册（CRD42020135904）。本综述旨在确定在除牙术中使用不同的器械系统（手动和机械）进行乳牙根管预备时，术后疼痛发生率是否存在差异。使用特定的MeSH术语进行了广泛的数据库搜索，包括截至2024年11月的临床研究。根据入选标准，对入选文章进行质量评估，并使用Cochrane风险偏倚（RoB 2）工具进行偏倚风险评估。此外，对同质研究进行了荟萃分析。结果共纳入11项研究进行定性分析，7项研究进行定量分析。结果表明，与手动系统相比，机械仪器系统可以更好地减少整体疼痛。meta分析进一步显示，6小时（p < 0.01, 95% CI: 1.46）和12小时（p < 0.01, 95% CI: 2.15）疼痛减轻具有统计学意义。然而，在其他时间点未观察到明显的疼痛减轻或显著性(p = 0.41, 95% CI: 1.66；p = 0.23, 95% CI: 1.67；p = 0.61, 95% CI: 1.25)。纳入研究的总体偏倚风险较低。结论旋转NiTi器械系统在减少乳牙除牙术后疼痛发生率方面具有优势。机械器械不仅有利于缩短整体治疗时间，而且可以减少牙髓切除术后的疼痛发生率，这是当今保存乳牙的重要和广泛应用的手术。

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

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.