Machine assisted instrumentation for preparation of primary teeth: an umbrella review

Maintaining primary teeth in optimal anatomical and functional condition until physiological exfoliation is crucial for the healthy development of permanent dentition. Trauma and extensive carious lesions may result in pulp involvement, necessitating endodontic treatment. Various techniques for the instrumentation of root canals in primary teeth, including both manual and rotary instruments, are potential treatment options. This study aims to evaluate, through an umbrella review, the feasibility of rotary instrumentation of root canals in primary teeth for clinical practice. The work is grounded in Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and seeks to address the following PICO question: In primary teeth undergoing endodontic treatment (P), is it feasible (O) to perform rotary instrumentation (I) compared to the conventional (manual) root canal preparation technique (C)? The data sources utilized were PubMed, Web of Science and Scopus, supplemented by manual search. The methodological quality of the included studies was assessed using the A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) tool, while the risk of bias was evaluated with the Risk of bias (ROBIS) tool. Two reviewers independently conducted the quality assessment and risk of bias analyses. The search identified several potentially relevant references, resulting in a total of 39 publications. However, after applying the eligibility criteria, only three articles were ultimately included in the review. Regarding the principal findings, no systematic review provided a defiNi-Tive conclusion concerning the optimal method of root canal instrumentation in primary teeth. However, empirical data have shown that rotary canal preparation in rotary root canal preparation in primary teeth reduces clinical working time and, due to its various kinematics and instrument designs, facilitates the filling process. Nevertheless, we cannot defiNi-Tively assert that this method yields superior benefits for treatment outcomes.