Effect of rotary and reciprocating instrumentation motions on postoperative pain incidence in non-surgical endodontic treatments: A systematic review and meta-analysis

Abstract

Objective: A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours. Methods: Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity. Results: At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis. Conclusion: There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.

Avaliação da instrumentação reciprocante no tratamento endodôntico de molares decíduos

“…Considering children's discomfort and the variables related to the postoperative pain, we also observed a similarity between the techniques, differently from previous studies that observed least postoperative pain for rotary techniques (16,17). Other discrepancy is related to the quality of the obturation, that was superior for mechanized methods (3).…”

“…Therefore, in the final regression model, we opted to keep the variable dental arch, because its association with the instrumentation time is more plausible. Actually, a higher proportion of caries occurrence in lower primary molars for younger children was observed (16,17).…”

“…The occurrence of postoperative pain and the duration of clinical procedure of endodontic treatment in primary teeth are believed to be directly influenced by the instrumentation technique applied. In the endodontic treatment of permanent teeth, the association between postoperative pain and instrumentation technique is a very controversial issue (13,14,15,16). In primary teeth, evidence regarding rotary systems has been related to less occurrence of postoperative pain, but the evidence on this issue with reciprocating systems still lacks.…”

Post-Operative Quality of Life after Single-Visit Root Canal Treatment Employing Three Different Instrumentation Techniques—An Institutional Randomized Clinical Trial

“…Repeated-measures ANOVA test determined that mean VAS scores differed significantly across five timepoints among the three methods. Another systematic review and meta-analysis conducted by Nobar et al in 2021 did not find a difference in 12, 24, or 48 h post-operative pain when reciprocating or rotary instrumentation was used for non-surgical root canal treatment [ 22 ].…”

Incidence of Postoperative Pain after Single Visit Root Canal Treatment using XP-endo Shaper, 2Shape and ProTaper Gold Rotary Systems: A Prospective Randomized Clinical Trial

“…This has been made possible by the introduction of improved NiTi metallurgy and innovative instrument design, thereby simplifying the shaping procedures and consequently resulting in reduction of number of instruments and instrumentation time. Literature has reported numerous studies comparing single and multiple files, rotary and reciprocating systems ( 11 , 12 ).…”