Context: Postoperative pain occurs in 25%–60% of patients following endodontic treatment. It can significantly impact a patient’s quality of life and requires timely management or, preferably, prevention. Aims: The present systematic review was conducted aiming to analyze randomized controlled trials that compared postoperative pain in patients whose canals were shaped by XPS versus other endodontic file systems. Materials and Methods: A systematic search was performed using key terms “postoperative pain” AND “XP-endo Shaper” across multiple databases to identify relevant randomized controlled trials. Details concerning the study design, endodontic preparation, XP-endo Shaper-related factors, and pain assessment were recorded. The risk of bias was calculated using the RevMan 5.3 software. Meta-analysis done using the random effects model which was represented using forest plots. Results: Six studies evaluating a total of n = 290 samples of XP-endo Shaper file and other file systems each, respectively, were included in the final review and meta-analysis. The standard mean difference ranged from 0.8 to 2.88 with a mean of 1.04 (0.80–2.88) favoring other file systems. This signifies that the postoperative pain is on average 1.04 times more by other file systems as compared to XP-endo Shapers file although the difference was statistically nonsignificant (P > 0.05). Conclusions: XP-endo Shaper has proven to be a relatively more efficient file system that effectively cleans and shapes the root canals, including those with difficult anatomy.
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