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Comparison of the incidence of flare-up and time efficiency in single visit root canal treatment employing either rotary or manual step-back canal preparatory technique

Aim: This study aims to compare the incidence of flare-up and operating time in root canal treatments where rotary or manual step-back canal preparatory technique was employed. Materials and Methods: A randomised study was conducted in a Nigerian Teaching Hospital. One hundred and twenty teeth belonging to 95 patients were randomised into two (Rotary and Manual) groups. Root canal treatment was performed using either rotary or manual step-back canal preparatory technique. Canal preparation time and total operating time were measured. Patients were monitored for severe pain and/or swelling over 1-week. Data were analysed using SPSS version 20.0, at alpha-level of P ≤ 0.05. Chi-square and independent Student's t-test were employed for comparison where categorical and numeric variables were involved, respectively. Results: There was neither associated pain/swelling before treatment in 28 (46.7%) of the teeth in rotary group nor in 27 (45.0%) of the teeth in manual group. Pain incidence was 11.7% and 16.7% in rotary and manual groups, respectively, at 1-week review. Severe pain was experienced by 3.3% patients in both groups at 1-week review. Only 1.7% and 6.7% in rotary and manual groups, respectively, presented with swelling over 1-week. Flare-up incidence at 1-week review was 3.3% in rotary and 8.3% in manual groups, the difference was not significant (P = 0.243). Canal preparation and total operating times were significantly shorter (P < 0.05) in the rotary group in all tooth categories. Conclusion: No significant difference was noted in flare-up incidence between rotary and manual groups. Canal preparation time and total operating time were significantly shorter for rotary technique. Time efficiency is clinically invaluable, especially for multi-rooted teeth.