Comparative evaluation of buckling resistance of manual and rotary glide path instruments: A systematic review and meta-analysis

Aim: Effective initial exploration aids in navigating natural anatomical barriers within the root canal and ensures that larger instruments can safely and effectively reach the canal’s full length during subsequent procedures. This systematic review and meta-analysis aimed to evaluate and compare the buckling resistance of manual and rotary glide path instruments. Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The systematic review protocol was registered at the International Prospective Register of Systematic Reviews, and a comprehensive literature search was conducted across the following electronic databases: PubMed, Scopus, EBSCOhost, sciELO, and Google Scholar for articles until April 2025. The quality assessment of the included studies was conducted using the QUIN tool. Pooled estimates were calculated using a random-effects model implemented in the meta package (version 4.3) in R (R Foundation for Statistical Computing, Vienna, Austria). Results: After screening based on the inclusion and exclusion criteria, seven studies were included in the final analysis. Four studies demonstrated a low risk of bias, whereas three showed a moderate risk of bias. Moderate heterogeneity was observed ( I 2 = 54%–68%). The results consistently indicated that hand files, particularly C+ files and C-Pilot files, exhibited superior buckling resistance relative to rotary glide path instruments. Conclusion: Within the limitations of in vitro evidence, manual glide path instruments demonstrated higher buckling resistance; however, these findings cannot be generalized to all clinical scenarios.