Comparison of Two Reciprocating File Systems with Continuous Rotation System in Root Canal Preparation: A Randomized Clinical Control Trial.

Background: This study aimed to compare the degree of postoperative pain and analgesic consumption after the root canal procedure of mandibular premolar by utilizing two reciprocating and a continuous rotary file system and also evaluate the long-term periradicular status by periapical index (PAI) scores.

Materials and methods: There were 84 patients, aged 18-55 years with mandibular premolar teeth recommended for root canal treatment who were treated under a predetermined protocol. Based on the instrumentation system used, all the patients were allocated randomly into three groups (n = 28): Group I: Reciprocating file no 1-ONE RECI, group II: Reciprocating file no 2-E3 AZURE, and Group III: Continuous rotary file-HERO GOLD, respectively. Patients were directed to score their degree of postoperative pain utilizing a visual analog scale after 12, 24, 48, and 72 hours. Additionally, patients were directed to note the analgesic consumption during the aforementioned time. Clinical and radiological assessments of the patients were carried out after 1, 3, and 6 months. Periapical index scores (PAIs) were recorded in all three groups. By utilizing post hoc tests and one-way analysis of variance, the data were analyzed.

Results: There was no significant variability among the three groups at any of the four-time intervals examined regarding postoperative pain and analgesic intake (p > 0.05). Group III (HERO GOLD) showed a slightly greater mean reduction in pain over 72 hours (0.75) compared to Group I (ONE RECI) and group II (E3 AZURE), with reductions of 0.464 and 0.535, respectively. Analgesic intake was comparable across the groups, with the mean averaging 0.714 in group I (ONE RECI), 0.786 in group II (E3 AZURE), and 1.00 in Group III (HERO GOLD) (p = 0.539). Radiographic data revealed no significant variability in periapical changes at any of the three-time intervals examined, with 80 out of 84 patients showing no abnormalities. The findings confirm that all instrumentation systems were equivalent in managing postoperative pain and maintaining periapical health over six months.

Conclusions: It was determined that the degree of postoperative pain and consumption of analgesic over the period examined, was found that the continuous and reciprocating rotary systems were comparable. Regarding periapical changes, there was no significant variability across the three-group system at any of the three-time intervals examined.

Clinical significance: This study highlights that reciprocating and continuous rotary file systems provide comparable outcomes in terms of postoperative pain, analgesic intake, and periapical changes. The findings suggest that both systems are equally effective, allowing clinicians to choose based on preference, efficiency, ease of use, and cost without compromising patient outcomes. How to cite this article: Bathla S, Bhattacharyya S, Hans MK, et al. Comparison of Two Reciprocating File Systems with Continuous Rotation System in Root Canal Preparation: A Randomized Clinical Control Trial. J Contemp Dent Pract 2025;26(3):257-264.