Comparison of postoperative pain reduction using continuous rotation glide path system with other methods of glide path creation - a systematic review

Abstract

Objective: Various glide path preparation techniques have been introduced, providing easiness to the practitioners.Recent literature has shown that glide path preparation influences the levels of postoperative pain occurrencein individuals receiving endodontic therapy. This systematic review aims to compare the different glide pathpreparation system in reduction of postoperative pain. Material and Methods: Electronic databases such asPubMed, Scopus, Cochrane Library, LILACS, Google Scholar, and European PMC were searched for publishedarticles until July 2020. The studies included were randomized control trial (RCT) studies published during thistime frame with comparison of continuous glide path system with various other glide path systems in reducingpostoperative pain. The studies were reviewed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The studies were reviewed independently by two reviewers who had assessedthe included studies, extracted data and the quality using the Cochrane risk of bias assessment tool. Results:544 studies were received from the initial search, 11 articles were included in full text appraisal, 4 studieswere obtained for qualitative analysis. Mean VAS Scores showed an increased reduction of postoperative painin continuous glide path treated individuals (1.90-0.20) compared to reciprocating glide path (2.00-0.50) andmanual glide path (3.80-0.85). The consumptions of analgesics were seen to be as follows; Manual Glide Path> Reciprocating Glide Path > Continuous Glide Path. Three out of four studies showed an overall “high” riskof bias and another study showed an overall “unclear” bias. Conclusion: From the achieved results, continuousglide path with 5.25% NaOCl irrigation has shown better reduction of postoperative pain compared to otherglide path systems. Individuals who had undergone manual glide path preparation showed higher incidence ofpostoperative pain compared to other systems. The consumption of analgesics was seen to be higher in manualglide path prepared individuals followed by reciprocating glide path and least being continuous glide path.KEYWORDSAnalgesics; Endodontics; Pain; Root canal preparation; Sodium hypochlorite.