Comparison of Heat Generation Between Manual Metal Strips and Motor Stripping Discs for Interproximal Reduction: A Systematic Review and Meta-Analysis
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Abstract
Background: Interproximal reduction (IPR) is a widely used orthodontic procedure that reduces the mesiodistal thickness of teeth to alleviate crowding and achieve optimal occlusion. It involves contouring tooth surfaces using manual or motor instruments. Despite being commonly used, there are concerns about the potential thermal impact on dental pulp caused by friction during the procedure. Objective: To conduct a systematic review and meta-analysis comparing the temperature changes, measured in degrees Celsius, between manual metal strips and motor stripping discs during IPR in a non-clinical setting. Materials and methods: A comprehensive literature search was conducted using four databases: Embase, PubMed, Scopus, and Google Scholar. The risk of bias in the identified studies was assessed using the QUIN tool. Meta-analysis and subgroup analysis were performed, while publication bias was evaluated using Egger’s test. A sensitivity analysis was also conducted. Results: Four in vitro studies met the inclusion criteria, showing a low to moderate risk of bias. The meta-analysis, which included data from 354 tooth surfaces, found that motor stripping discs generated higher temperatures than manual metal strips, with a mean difference of 2.57°C (95 % confidence interval = −3.89, −1.26). A subgroup analysis of premolar teeth showed similar results. Sensitivity analysis confirmed the robustness of the findings. Conclusion: Both manual and motor IPR methods generate mild heat. Clinicians should be aware of overheating risks and employ intermittent stripping with water coolants to reduce temperature increases. The predominance of in vitro studies highlights the need for more clinical trials to enhance generalizability.
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