Effectiveness of hand and rotary instrumentations during biomechanical preparation in primary teeth: an umbrella review with evidence stratification.

Q3 Dentistry Evidence-based dentistry Pub Date : 2024-11-04 DOI:10.1038/s41432-024-01080-w

Arun Kumar Patnana, Krupal Joshi, Satya Narain, Shantanu Choudhari, Ashwini Agarwal, Pravin Kumar

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Abstract

Aims/objectives: Biomechanical preparation (BMP) of primary teeth often involves using hand and rotary instruments. This study aimed to assess the effectiveness of hand and rotary instruments during BMP in primary teeth.

Methods: A thorough search for relevant systematic reviews and meta-analyses (SRMAs) was conducted in four databases, including MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. The primary outcome assessed was the instrumentation time (IT) for BMP, and the identified SRMAs were qualitatively analysed using the ROBIS tool. Furthermore, quantitative analysis, evidence stratification, and GRADE analysis of eligible SRMAs were performed using the browser-based R package metaumbrella software.

Results: Six SRMAs addressing the research question were included, with five being evaluated as having a high risk of bias (ROB). The findings indicated that the IT required for BMP in primary teeth was 3.2 min less (95% CI = 1.52 to 4.93; I² = 96%; P = < 0.001) using rotary instruments compared to hand instruments, with a 'class IV' evidence stratification and 'very low' class of evidence.

Conclusions: Based on the existing evidence, it can be inferred that there is insufficient quality data to recommend the use of rotary instruments over hand instruments in primary teeth.

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乳牙生物力学预备过程中手动器械和旋转器械的有效性：带证据分层的总体综述。

目的/目标：乳牙的生物力学预备（BMP）通常需要使用手动和旋转器械。本研究旨在评估手用器械和旋转器械在基牙生物力学预备过程中的有效性：方法：在 MEDLINE、EMBASE、Google Scholar 和 Cochrane Library 等四个数据库中对相关的系统综述和荟萃分析 (SRMA) 进行了全面搜索。评估的主要结果是 BMP 的器械植入时间（IT），并使用 ROBIS 工具对确定的 SRMA 进行了定性分析。此外，还使用基于浏览器的 R 软件包 metaumbrella 对符合条件的 SRMA 进行了定量分析、证据分层和 GRADE 分析：结果：针对研究问题纳入了六项SRMA，其中五项被评估为高偏倚风险（ROB）。研究结果表明，基牙BMP所需的IT时间减少了3.2分钟（95% CI = 1.52至4.93；I2 = 96%；P = 结论：根据现有证据可以推断，没有足够的高质量数据建议在乳牙治疗中使用旋转器械而非手工器械。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Evidence-based dentistry Dentistry-Dentistry (all)

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Evidence-Based Dentistry delivers the best available evidence on the latest developments in oral health. We evaluate the evidence and provide guidance concerning the value of the author''s conclusions. We keep dentistry up to date with new approaches, exploring a wide range of the latest developments through an accessible expert commentary. Original papers and relevant publications are condensed into digestible summaries, drawing attention to the current methods and findings. We are a central resource for the most cutting edge and relevant issues concerning the evidence-based approach in dentistry today. Evidence-Based Dentistry is published by Springer Nature on behalf of the British Dental Association.