Comparative analysis of rotary versus manual instrumentation in paediatric pulpectomy procedures: A systematic review and meta‐analysis

Abstract The use of rotary file in permanent teeth is well‐documented, but there is limited scientific evidence for its effectiveness in primary teeth. A meta‐analysis was conducted to compare rotary and manual tools in primary tooth pulpectomy procedures. Ten databases were searched from 2000 to 2024 to find relevant literature. The Cochrane Risk of Bias (ROB) tool assessed bias in randomised control trials. STATA software version 18 conducted the meta‐analysis. A random‐effects model was used for instrumentation time and obturation quality evaluation while sensitivity analysis followed high heterogeneity detection. Twenty RCTs were included after screening 723 studies. Publication bias and heterogeneity were found for instrumentation time, leading to removal of nine studies. Significant difference in mean instrumentation time (1.42) was noted. Obturation quality assessment showed an odds ratio of 1.82. Use of rotary instrumentation yielded superior outcomes compared with manual instrumentation for pulpectomy for primary teeth.