17 studies, none of which were at low risk of bias, were included in this review of the effect of type of instrumentation on post endodontic pain. The findings suggest lower incidence and intensity of postoperative pain with rotary instruments compared to hand files.
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This review of the effect of rotary or reciprocating instruments on post-endodontic pain included 3 RCTs involving 1317 patients. There is limited evidence of any clear difference between the two techniques.
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10 studies of limited quality were included in this review and they suggest that there is no difference in complete caries removal with chemo-mechanical systems and rotary instruments. While chemo-mechanical removal was less painful, it took longer to carry out.
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