Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis
Background: Our umbrella review examines the impact of instrumentation kinematics on postoperative pain in endodontic treatment by synthesizing current evidence from systematic reviews and meta-analyses. Methods: We performed an extensive search across six major electronic databases up to March 2025...
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| Format: | Article |
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Elsevier
2025-07-01
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| Series: | Journal of Oral Biology and Craniofacial Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212426825001216 |
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| author | Dax Abraham Aakansha Puri Alpa Gupta Karina Singal Adinath Walmik Talekar Praharsha Anabathula |
| author_facet | Dax Abraham Aakansha Puri Alpa Gupta Karina Singal Adinath Walmik Talekar Praharsha Anabathula |
| author_sort | Dax Abraham |
| collection | DOAJ |
| description | Background: Our umbrella review examines the impact of instrumentation kinematics on postoperative pain in endodontic treatment by synthesizing current evidence from systematic reviews and meta-analyses. Methods: We performed an extensive search across six major electronic databases up to March 2025, focusing on English-language literature comparing rotary and reciprocating instrumentation systems. Quality assessment was rigorously conducted using the AMSTAR 2 tool, and a comprehensive risk of bias evaluation was carried out using the ROBIS tool. Results: Our analysis incorporated eight systematic reviews, seven of which provided meta-analytic data, thus ensuring a robust consolidation of findings. The results reveal that rotary instrumentation generally produces lower overall post-operative pain levels compared to reciprocating systems. However, the influence of instrumentation type appears to be time-dependent, with evidence suggesting that reciprocating systems may offer advantages in the immediate post-operative phase by reducing mild pain within 24 h. The review underscores the multifactorial nature of post-operative pain, where clinical outcomes are influenced not only by instrumentation kinematics but also by patient-specific factors, operator experience, and procedural variables. Conclusion: The insights provided by our review contribute to the current understanding of endodontic pain management and encourage further research utilizing standardized methodologies and extended follow-up periods to elucidate long-term outcomes. These findings have significant implications for clinical practice and the development of patient-centered treatment protocols in endodontics. |
| format | Article |
| id | doaj-art-19bbe0f5dc6746efa93bc5ad8b6b4e30 |
| institution | Kabale University |
| issn | 2212-4268 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Oral Biology and Craniofacial Research |
| spelling | doaj-art-19bbe0f5dc6746efa93bc5ad8b6b4e302025-08-20T03:59:30ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682025-07-0115488889810.1016/j.jobcr.2025.06.008Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysisDax Abraham0Aakansha Puri1Alpa Gupta2Karina Singal3Adinath Walmik Talekar4Praharsha Anabathula5Corresponding author. Room no. QS 21, Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Sec 43, Delhi Surjakund Road, Faridabad, 121001, Haryana, India.; Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaDepartment of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaDepartment of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaDepartment of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaDepartment of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaDepartment of Conservative Dentistry and Endodontics, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, IndiaBackground: Our umbrella review examines the impact of instrumentation kinematics on postoperative pain in endodontic treatment by synthesizing current evidence from systematic reviews and meta-analyses. Methods: We performed an extensive search across six major electronic databases up to March 2025, focusing on English-language literature comparing rotary and reciprocating instrumentation systems. Quality assessment was rigorously conducted using the AMSTAR 2 tool, and a comprehensive risk of bias evaluation was carried out using the ROBIS tool. Results: Our analysis incorporated eight systematic reviews, seven of which provided meta-analytic data, thus ensuring a robust consolidation of findings. The results reveal that rotary instrumentation generally produces lower overall post-operative pain levels compared to reciprocating systems. However, the influence of instrumentation type appears to be time-dependent, with evidence suggesting that reciprocating systems may offer advantages in the immediate post-operative phase by reducing mild pain within 24 h. The review underscores the multifactorial nature of post-operative pain, where clinical outcomes are influenced not only by instrumentation kinematics but also by patient-specific factors, operator experience, and procedural variables. Conclusion: The insights provided by our review contribute to the current understanding of endodontic pain management and encourage further research utilizing standardized methodologies and extended follow-up periods to elucidate long-term outcomes. These findings have significant implications for clinical practice and the development of patient-centered treatment protocols in endodontics.http://www.sciencedirect.com/science/article/pii/S2212426825001216Root canal therapyEndodonticsPostoperative painRotary instrumentationReciprocating instrumentationSystematic review |
| spellingShingle | Dax Abraham Aakansha Puri Alpa Gupta Karina Singal Adinath Walmik Talekar Praharsha Anabathula Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis Journal of Oral Biology and Craniofacial Research Root canal therapy Endodontics Postoperative pain Rotary instrumentation Reciprocating instrumentation Systematic review |
| title | Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis |
| title_full | Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis |
| title_fullStr | Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis |
| title_full_unstemmed | Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis |
| title_short | Impact of instrumentation kinematics on post endodontic pain-an umbrella review with stratification of evidence and sensitivity analysis |
| title_sort | impact of instrumentation kinematics on post endodontic pain an umbrella review with stratification of evidence and sensitivity analysis |
| topic | Root canal therapy Endodontics Postoperative pain Rotary instrumentation Reciprocating instrumentation Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2212426825001216 |
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