Clinical differences of hand and rotary instrumentations during biomechanical preparation in primary teeth-A systematic review and meta-analysis.

Background: The hand and rotary instruments are used for cleaning and shaping of root canals during biomechanical preparation in primary teeth.

Aim: To determine clinical differences of hand versus rotary root canal instrumentation in primary teeth.

Design: Comprehensive searches were made in four electronic databases [MEDLINE (via PubMed), EMBASE, Google Scholar, and The Cochrane Central Register of Controlled Trials] till March 2020, and prospective studies that met the inclusion criteria were included. The primary outcome was instrumentation time, whereas the secondary outcomes were quality of obturation, obturation time, and clinical and radiographic success. From 604 screened studies, eleven studies qualified for meta-analysis. The random-effect model and generic inverse variance approach were used for meta-analysis.

Results: There was significant decrease in instrumentation time [MD-5.00 minutes (95% CI: 3.05-6.94), P < .00001, moderate evidence quality] and obturation time [MD-0.43 minutes (95% CI: 0.15-0.71), P = .003, low evidence quality] with rotary instrumentation. Optimal quality of obturation was achieved in significantly more number of teeth [risk ratio (RR) = 0.71(95% CI: 0.53-0.95),P = .02, moderate to high evidence quality] with rotary instrumentation. Similar clinical and radiographic success was observed in hand and rotary instrumentation techniques.

Conclusion: Significant reduction in instrumentation time of five minutes was observed using rotary instrumentation with moderate quality evidence.