BMC oral health
Comparative evaluation of dentin microcrack formation after root canal preparation with different nickel-titanium instrument systems based on micro-CT: a systematic review and meta-analysis
By Li A, Zhang J, Lin Y and 3 others.
Abstract
Background
Dentin microcracks following root canal treatment may progress to vertical root fractures, a severe clinical complication. Engine-driven nickel-titanium (NiTi) instruments are associated with dentin microcrack initiation, but current evidence remains inconsistent. This review systematically synthesizes micro-CT-derived evidence on the effects of different NiTi instrument systems on dentin microcrack formation.
Methods
A systematic search of PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, and grey literature was performed from inception to October 1, 2025. Eligible studies were ex vivo investigations comparing dentinal microcrack incidence after root canal preparation with various NiTi instruments. Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment using adapted JBI and CRIS checklists; meta-analysis was performed for sufficient comparable data.