Faghihian Reyhaneh, Amini Kiana, Tahririan Dana
Dental Research Center, Department of Pediatric Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Contemp Clin Dent. 2022 Jul-Sep;13(3):197-204. doi: 10.4103/ccd.ccd_77_20. Epub 2022 Sep 24.
The aim of this systematic review was to assess the scientific evidence on the effect of rotary versus manual instrumentation for root canal preparation in primary teeth.
Search terms were selected based on Medical Subject Headings (MeSH) and non-MeSH terms. Electronic database search of English published literature was performed in March 2020 within the following databases: Scopus, Cochrane, PubMed, and Embase. The risk of bias of selected studies was assessed by means of Cochrane collaboration tool. The heterogeneity level among the included studies was measured by index. For statistical analysis of instrumentation time, standard mean difference (SMD) of continuous data was analyzed with 95% confidence intervals (95% CIs) using the fixed-effects model. A random-effects model was used for analysis of odds ratio (OR) to assess the probability of optimal fill, underfill, and overfill obturations. Forest plots were applied to show the results and to estimate the effectiveness of rotary instrumentation.
Seven articles were selected for this review. The SMD in rotary techniques was 1.79 min less than manual techniques (95% CI: -2.56--1.03 min) and had a significant = 0.001. The OR of optimum quality was calculated to be 3.53 (95% CI: 1.79-6.97) in the rotary technique at = 0.254.
Within the limitations of this review, it can be asserted that rotary files decrease the instrumentation time and increase the rates of optimally filled canals in primary teeth. However, these files do not decrease the risk of underfilling and overfilling compared to manual files.
本系统评价旨在评估乳牙根管预备中旋转器械与手动器械效果的科学证据。
根据医学主题词（MeSH）和非MeSH词选择检索词。2020年3月在以下数据库中对英文发表文献进行电子数据库检索：Scopus、Cochrane、PubMed和Embase。采用Cochrane协作工具评估所选研究的偏倚风险。纳入研究之间的异质性水平通过 指数测量。对于器械操作时间的统计分析，使用固定效应模型分析连续数据的标准平均差（SMD）及其95%置信区间（95%CI）。采用随机效应模型分析比值比（OR），以评估最佳充填、欠填和超填充填的概率。应用森林图展示结果并估计旋转器械的有效性。
本评价纳入7篇文章。旋转技术的SMD比手动技术少1.79分钟（95%CI：-2.56--1.03分钟）， = 0.001，具有显著性。旋转技术中最佳质量的OR在 = 0.254时计算为3.53（95%CI：1.79-6.97）。
在本评价的局限性内，可以断言旋转锉减少了乳牙根管预备的操作时间并提高了根管最佳充填率。然而，与手动锉相比，这些锉并未降低欠填和超填的风险。
