Efficiency and Safety of a Continuous Rotation Instrumentation System and a Reciprocating Motion Instrumentation System: A Randomized Clinical Trial

Introduction: It has been suggested that single-file reciprocating systems, such as WaveOne, are capable of more rapid root canal instrumentation compared to systems that utilize multi-file continuous rotation. The purpose of this study was to evaluate the efficiency and safety of WaveOne and ProTaper Next instrumentation systems in vivo in a randomized clinical trial. The null hypothesis was that no differences would be seen in canal preparation time, working length control, or occurrence of adverse events. Materials and Methods: A total of 89 teeth requiring primary non-surgical endodontic treatment were included in the study. Root canal therapy was performed per routine clinical procedures. Following glide path creation, teeth were randomized into groups according to instrumentation system to be used: WaveOne or ProTaper Next. Time required for cleaning and shaping was recorded. Discrepancies between the final working length and the initial master cone length and any occurrence of adverse events were also recorded. Differences between groups and tooth types were evaluated with regression models and least squares mean analyses. Results: No overall difference was found between instrumentation systems for average time required per tooth or per canal to complete instrumentation. WaveOne required significantly less time to instrument premolar teeth and teeth with a single canal compared to ProTaper Next. No significant differences could be detected between WaveOne and ProTaper Next in regard to working length control. No adverse events occurred in the sample in either treatment group. Conclusions: WaveOne and ProTaper Next perform with similar efficiency for most tooth types. WaveOne and ProTaper Next can be used safely and predictably to instrument root canals in a clinical setting