Non-Cochrane · intervention · PM42030017
TruNatomy versus protaper gold for postoperative pain in pulpitis: a systematic review and meta-analysis of randomized controlled trials.
Owayed Abdulaziz, Alkandari Bader E, Al-Ali Latifah Abdulrahman, et al. · The Saudi dental journal · 2026 · PubMed · doi:10.1007/s44445-026-00154-y
Findings
Population Adults (18 years or older) with pulpitis undergoing root canal treatment
4 findings
| TruNatomy rotary file system | ProTaper Gold rotary file system | Presence of postoperative pain 24 h · Root canal treatment | RR 1.02 [0.82, 1.26] 55/91 vs 57/90 Very low Downgraded: risk of bias, imprecision 2 studies · 181 participants |
| TruNatomy rotary file system | ProTaper Gold rotary file system | Postoperative pain intensity (VAS/NRS) 48 h · Root canal treatment | SMD 0.13 [-0.16, 0.42] Very low Downgraded: risk of bias, imprecision 2 studies · 181 participants |
| TruNatomy rotary file system | ProTaper Gold rotary file system | Analgesic intake Not specified · Root canal treatment | RR 1.2 [0.7, 2.06] 49/151 vs 57/151 Very low Downgraded: risk of bias, imprecision, publication bias 3 studies · 302 participants |
| TruNatomy rotary file system | ProTaper Gold rotary file system | Postoperative pain intensity (VAS/NRS) 24 h · Root canal treatment | SMD 0.03 [-0.17, 0.23] Low Downgraded: risk of bias 4 studies · 381 participants |
Included primary studies 5
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Kim 2024 Postoperative pain of minimally invasive root canal treatment:a randomized clinical trial. PMID:38429393 | 2024 | this review only | not stated | not extracted yet |
| Kwon 2025 Impact of minimally invasive root canal treatment on healing outcomes in a randomized clinical trial. PMID:40603366 | 2025 | this review only | not stated | not extracted yet |
| Poorani 2025 Comparing rotary and reciprocation files for postoperative pain in single-visit root canal treatment: A randomized controlled clinical trial DOI:10.4103/endo.endo_156_24 | 2025 | this review only | not stated | not extracted yet |
| Usta 2025 Impact of conservative versus conventional instrumentation on the release of inflammatory mediators and post-operative pain in mandibular… PMID:40085189 | 2025 | this review only | not stated | not extracted yet |
| Valliappan 2023 Evaluation of postoperative pain with new heat-treated rotary and reciprocating nickel-titanium files: A randomized controlled clinical… PMID:37205884 | 2023 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients (18 years or older) with pulpitis undergoing root canal treatment | Mature permanent teeth with vital or necrotic pulp or irreversible pulpitis needing root canal treatment (4 RCTs, n=381) |
| Intervention | TruNatomy rotary file system | TruNatomy (n=190) |
| Comparison | ProTaper Gold rotary file system | ProTaper Gold (n=191) |
| Outcomes | Postoperative pain and analgesic intake | Pain intensity at 24 h (4 studies) and 48 h (2); analgesic intake (3); presence of pain at 24 h (2) |
| Study designs | RCTs | 4 RCTs (5 publications) |
| Timing | 24, 48 and 72 h postoperative evaluation | 1 to 7 days (2 to 3 years for healing in one trial) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | No | Yes | no |
| Overall | Critically Low | Low | no |