Abstract：
BACKGROUND: This systematic review aimed to compare reciprocating with continuous rotary instrumentation kinematics, by means of microcomputed tomography evaluations, in extracted human permanent teeth with moderate and severe canal curvatures.
METHODS: The research protocol was registered in the International Prospective Register of Systematic Reviews and given the reference number CRD42023404035. An electronic search was undertaken in MEDLINE (PubMed), EBSCO, Scopus, Web of Science databases until December 2021. Manual screening of issues in endodontic journals and references of relevant articles were assessed individually. The risk of bias (RoB) of the included articles was evaluated with the QUIN tool (Quality Assessment Tool for In Vitro Studies).
RESULTS: Among 1640 retrieved articles, 49 were included in the qualitative synthesis. Fifteen articles had low RoB, 33 articles had medium RoB, and only 1 study was at high RoB. Continuous rotary systems had better centering ability in both moderate and severe canal curvatures and resulted in less apical transportation in severely curved root canals. None of the kinematic systems was capable of instrumenting the entire canal surface area. Reciprocating kinematics systems tended to provide higher increase in surface area of severely curved canals and produced fewer dentinal microcracks in moderately curved canals.
CONCLUSIONS: The evidence presented in this review suggests that continuous rotary system seems to be better than reciprocating system in solving the major issues encountered during root canal instrumentation of extracted teeth with moderate and severe curvatures.
METHODS: The research protocol was registered in the International Prospective Register of Systematic Reviews and given the reference number CRD42023404035. An electronic search was undertaken in MEDLINE (PubMed), EBSCO, Scopus, Web of Science databases until December 2021. Manual screening of issues in endodontic journals and references of relevant articles were assessed individually. The risk of bias (RoB) of the included articles was evaluated with the QUIN tool (Quality Assessment Tool for In Vitro Studies).
RESULTS: Among 1640 retrieved articles, 49 were included in the qualitative synthesis. Fifteen articles had low RoB, 33 articles had medium RoB, and only 1 study was at high RoB. Continuous rotary systems had better centering ability in both moderate and severe canal curvatures and resulted in less apical transportation in severely curved root canals. None of the kinematic systems was capable of instrumenting the entire canal surface area. Reciprocating kinematics systems tended to provide higher increase in surface area of severely curved canals and produced fewer dentinal microcracks in moderately curved canals.
CONCLUSIONS: The evidence presented in this review suggests that continuous rotary system seems to be better than reciprocating system in solving the major issues encountered during root canal instrumentation of extracted teeth with moderate and severe curvatures.
摘要：
背景：本系统综述旨在比较往复式与连续旋转仪表运动学，通过显微计算机断层扫描评估，在拔除的人类恒牙中，有中度和重度的根管弯曲。
方法：研究方案已在国际前瞻性系统评价登记册中注册，参考号为CRD42023404035。在MEDLINE（PubMed）进行了电子搜索，EBSCO,Scopus,WebofScience数据库至2021年12月。对牙髓学期刊中的问题进行手动筛选，并对相关文章的参考文献进行单独评估。使用QUIN工具（体外研究质量评估工具）评估纳入文章的偏倚风险（RoB）。
结果：在检索到的1640篇文章中，49个被包括在定性合成中。15篇文章的RoB很低，33篇文章有中等的RoB，只有1项研究处于高RoB。连续旋转系统在中度和重度根管曲率中均具有更好的对中能力，并且在严重弯曲的根管中导致根尖运输减少。没有一个运动学系统能够对整个运河表面积进行仪器测量。往复运动系统倾向于提供严重弯曲的运河的表面积的更高增加，并在中等弯曲的运河中产生更少的牙本质微裂纹。
结论：这篇综述中提供的证据表明，连续旋转系统似乎比往复式系统更好地解决了在中，重度弯曲拔牙的根管器械中遇到的主要问题。
方法：研究方案已在国际前瞻性系统评价登记册中注册，参考号为CRD42023404035。在MEDLINE（PubMed）进行了电子搜索，EBSCO,Scopus,WebofScience数据库至2021年12月。对牙髓学期刊中的问题进行手动筛选，并对相关文章的参考文献进行单独评估。使用QUIN工具（体外研究质量评估工具）评估纳入文章的偏倚风险（RoB）。
结果：在检索到的1640篇文章中，49个被包括在定性合成中。15篇文章的RoB很低，33篇文章有中等的RoB，只有1项研究处于高RoB。连续旋转系统在中度和重度根管曲率中均具有更好的对中能力，并且在严重弯曲的根管中导致根尖运输减少。没有一个运动学系统能够对整个运河表面积进行仪器测量。往复运动系统倾向于提供严重弯曲的运河的表面积的更高增加，并在中等弯曲的运河中产生更少的牙本质微裂纹。
结论：这篇综述中提供的证据表明，连续旋转系统似乎比往复式系统更好地解决了在中，重度弯曲拔牙的根管器械中遇到的主要问题。
