Background: In endodontic therapy, continuous rotary instrumentation reduced debris compared to reciprocal\ninstrumentation, which might affect the incidence of post-endodontic pain (PP). The aim of our study was to assess\nwhether PP incidence and levels were influenced by the choice of rotary or reciprocal instruments.\nMethods: In this meta-analysis the Pubmed and EM databases were searched for prospective clinical randomized trials\npublished before April 20, 2016, using combinations of the keywords: root canal preparation/instrumentation/\ntreatment/therapy; post-operative/endodontic pain; reciprocal and rotary instruments.\nResults: Three studies were included, involving a total of 1,317 patients, 659 treated with reciprocating instruments\nand 658 treated with rotary instruments. PP was reported in 139 patients in the reciprocating group and 172 in the\nrotary group. The PP incidence odds ratio was 1.27 with 95% confidence interval (CI) (0.25, 6.52) favoring rotary\ninstruments. The mild, moderate and severe PP levels odds ratios were 0.31 (0.11, 0.84), 2.24 (0.66, 7.59) and 11.71\n(0.63, 218.15), respectively. No evidence of publication bias was found.\nConclusions: Rotary instrument choice in endodontic therapy is associated with a lower incidence of PP than\nreciprocating instruments, while reciprocating instruments are associated with less mild PP incidence.
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