Manual versus rotary instrumentation for primary molar pulpectomies- A 24 months randomized clinical trial

Rahul, Morankar; Goyal, Ashima; Gauba, Krishan; Kapur, Aditi; Bhatia, Sarabjot Kaur

doi:10.1016/j.pdj.2018.02.002

Cited by 24 publications

(87 citation statements)

References 14 publications

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“…). However, the RR of optimum quality in the only study (Morankar et al ) with low risk was 0.90 (95% CI: 0.69–1.17) favouring the manual group, although it was not statistically significant ( P = 0.445).…”

Section: Resultsmentioning

confidence: 87%

“…The study with low overall risk (Morankar et al ) favoured manual ( P = 0.55 at 6 months), whereas the study with high overall risk (Elheeny et al ) favoured rotary technique 6 months ( P = 0.60). At 24 months, the clinical success rate was 85.2% for rotary techniques and 92.3% for manual techniques ( P = 0.41) (Morankar et al ). Radiographic success: Radiographically, the treatment was considered successful when the treated tooth did not have any sign of internal or external root resorption, new radiolucency on follow‐ups or increase in the size of preoperative radiolucency. The pooled estimate of RR for radiographic success in rotary versus manual techniques was found to be 0.97 (95% CI: 0.74–1.27; P = 0.805) at 6‐month follow‐up (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Quality of root canal filling and instrumentation time in primary teeth via manual and rotary techniques were assessed in seven trials (Ochoa‐Romero et al , Makarem et al , Vieyra & Enriquez , Mokhtari et al , Govindaraju et al ,; Jeevanandan & Govindaraju , Morankar et al ). Root filling time was evaluated in four studies (Ochoa‐Romero et al , Makarem et al , Gomes et al , Morankar et al ).…”

Section: Resultsmentioning

confidence: 99%

“…). The study by Morankar et al () had a maximum follow‐up of 24 months, whereas the study by Elheeny et al () evaluated the success rate at 12 months. Clinical success: Clinical success was defined as an outcome when the tooth was asymptomatic (no history of pain, tenderness to percussion, gingival swelling, sinus tract formation or abnormal tooth mobility).…”

Section: Resultsmentioning

confidence: 99%

“…The results of four trials could be pooled to evaluate the quality of root filling as optimum filled versus under‐ or over‐filled (Ochoa‐Romero et al , Govindaraju et al ,; Jeevanandan & Govindaraju , Morankar et al ). The RR of optimum quality was calculated to be 1.20 (95% CI: 0.99–1.46) in the rotary technique at P = 0.062 (Fig.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review and meta‐analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth

2019

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Background Use of rotary instruments in the root canals of permanent teeth is well known; however, there are no evidence‐based recommendations on the effectiveness of rotary canal instrumentation techniques over manual instrumentation techniques during root canal treatment in primary teeth. Aim To appraise the current literature on the effectiveness of rotary canal preparation techniques compared to manual techniques during root canal treatment in primary teeth. Data sources MEDLINE, Embase, Cochrane Library, Scopus, PubMed and Web of Science (1 January 1991 to 3 January 2019). Study eligibility criteria, participants and interventions Population: Children with primary teeth; Intervention: Rotary canal instrumentation; Control: Manual canal instrumentation; Outcomes: Success rates (clinical and/or radiographic), quality of root filling, instrumentation and root filling time, postoperative pain, cleaning effectiveness. Study appraisal and synthesis methods Cochrane risk of bias tool 2.0 was used to ascertain the validity across five domains. Risk ratio (RR) for dichotomous variables and weighted mean difference for continuous variables were used as summary measures. The GRADE approach was used to assess the certainty of evidence using GRADE‐pro software. Results A total of 13 trials were selected of 2471 records after screening of the databases. The RR of clinical success in rotary versus manual canal preparation technique was 1.01 (95% CI: 0.91–1.12; P = 0.913) at 6 months. The RR of radiographic success in rotary versus manual techniques was 0.97 (95% CI: 0.74–1.27; P = 0.805) at 6 months. The quality of root filling was not significantly different between the two groups (P = 0.062). The weighted mean difference of instrumentation time and canal filling time was significantly less with rotary techniques (P < 0.001); however, postoperative pain was non‐significant across both techniques at 12, 24 and 72 h but significantly less with rotary techniques at 6 h (P < 0.001) and 48 h (P = 0.023). Limitations Inclusion of only English literature. Conclusions and implications of key findings Rotary canal instrumentation had a similar clinical and radiographic success rate, less postoperative pain (at 6 and 48 h), and took less instrumentation time compared to manual instrumentation techniques (moderate level of evidence).

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%