Multiple-file vs. single-file endodontics in dental practice: a study in routine care

Andreas Bartols; Gunter Laux; Winfried Walther

doi:10.7717/peerj.2765

Multiple-file vs. single-file endodontics in dental practice: a study in routine care

PeerJ. 2016 Dec 7:4:e2765. doi: 10.7717/peerj.2765. eCollection 2016.

Authors

Andreas Bartols¹, Gunter Laux², Winfried Walther³

Affiliations

¹ Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany; Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany.
² University Hospital Heidelberg, Department of General Practice and Health Services Research, University of Heidelberg , Heidelberg , Baden-Württemberg , Germany.
³ Dental Academy for Continuing Professional Development Karlsruhe , Karlsruhe , Germany.

Abstract

Background: Little is known about the differences of rotary multiple file endodontic therapy and single-file reciprocating endodontic treatment under routine care conditions in dental practice. This multicenter study was performed to compare the outcome of multiple-file (MF) and single-file (SF) systems for primary root canal treatment under conditions of general dental practice regarding reduction of pain with a visual analogue scale (VAS 100), improvement of oral-health-related quality of life (OHRQoL) with the german short version of the oral health impact profile (OHIP-G-14) and the speed of root canal preparation.

Materials and methods: Ten general dental practitioners (GDPs) participated in the study as practitioner-investigators (PI). In the first five-month period of the study, the GDPs treated patients with MF systems. After that, the GDPs treated the patients in the second five-month period with a SF system (WaveOne). The GDPs documented the clinical findings at the beginning and on completion of treatment. The patients documented their pain and OHRQoL before the beginning and before completion of treatment.

Results: A total of 599 patients were included in the evaluation. 280 patients were in the MF group, 319 were in the SF WaveOne group. In terms of pain reduction and improvement in OHIP-G-14, the improvement in both study groups (MF and SF) was very similar based on univariate analysis methods. Pain reduction was 34.4 (SD 33.7) VAS (MF) vs. 35.0 (SD 35.4) VAS (SF) (p = 0.840) and the improvement in OHIP-G-14 score was 9.4 (SD 10.3) (MF) vs. 8.5 (SD 10.2) (SF) (p = 0.365). The treatment time per root canal was 238.9 s (SD 206.2 s) (MF) vs. 146.8 sec. (SD 452.8 sec) (SF) (p = 0.003).

Discussion: Regarding improvement of endodontic pain and OHRQoL measure with OHIP-G-14, there were no statistical significant differences between the SF und the MF systems. WaveOne-prepared root canals significantly faster than MF systems.

Keywords: BioRaCe; Clinical trial; Dental public health; Endodontics; Health services research; Mity Roto Files; Multiple-file systems; Patient outcomes; Single-file endodontics; WaveOne.

Grants and funding

Andreas Bartols was funded within the young scientists’ program of the German network “Health Services Research Baden-Württemberg” of the Ministry of Science, Research and Arts, in collaboration with the Ministry of Employment and Social Order, Family, Women and Senior Citizens, Baden-Württemberg, Germany. Dentsply Maillefer made WaveOne motors available on loan and WaveOne files free of charge for the purpose of this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.