Comparative in vitro evaluation of remaining dentine thickness following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars: a systematic review

Purpose: The aim was to compare the remaining dentine thickness (RDT) following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars. Research question was 'Is there any difference between the remaining dentine thickness following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars?'.

Methods: Electronic Databases like MEDLINE PubMed, Cochrane Library, EBSCOhost, Google scholar and grey literature were searched between January 1, 2006 and August 31, 2022 for in vitro and ex vivo studies that compared hand and rotary endodontic instrumentation to evaluate the RDT in primary molars. Articles published in English or which could be translated into English were searched. Two reviewers independently selected studies, extracted data, assessed risk of bias using the Revised, validated version of MINORS criteria.

Results: Twelve studies were included in qualitative analysis. All included studies showed low risk of bias. Six studies showed more RDT with rotary instrumentation compared to manual instrumentation. Whereas, five studies showed variable results for RDT with manual and rotary instrumentation at different levels of root canals. One study showed no significant difference between manual and rotary instrumentation. In view of methodological heterogeneity of the findings, a meta-analysis was not conducted.

Conclusion: High quality of evidence based on low risk of bias was found in all the included studies. Statistically, rotary instrumentation showed more RDT than manual instrumentation according to majority of studies. Despite the shortcomings of this systematic review, it is possible to infer that the use of rotary instrumentation provides more RDT and thus there is considerable conservation of tooth structure.