Ex vivo study of manual and rotary instrumentation techniques in human primary teeth

Comparison of cyclic fatigue resistance of four pediatric rotary file systems at body temperature: an in vitro study

BACKGROUND

The aim of this study was to compare the cyclic fatigue resistance (CFR) of the newly developed pediatric nickel-titanium (NiTi) rotary file systems for root canal preparation of primary teeth.

METHODS

Eighty pediatric NiTi rotary file systems files were used in this study, including 20 EasyInSmile X-Baby (25/0.04), 20 Scope miniScope (25/0.04), 20 EndoArt Pedo Gold (25/0.04), and 20 EndoArt Pedo Blue (25/0.04) files. Static CFR tests; performed on a custom-made stainless steel block with an inner diameter of 1.5 mm, an angle of curvature of 60° and a curved artificial canal with a radius of curvature of 5 mm. The test system was filled with distilled water and the temperature was kept constant at 35 ± 1 °C. The files were rotated in the simulated canal until fracture occurred. The number of cycles to failure (NCF) data was recorded, and all the fracture surfaces of the files were evaluated using scanning electron microscopy (SEM). One-way ANOVA and Tukey tests were used for statistical analysis of the data, and the significance level was set at p < 0.05.

RESULTS

EndoArt Pedo Blue showed the highest NCF values (2668.10 ± 755.26), while the miniScope showed the lowest NCF values (453.65 ± 72.51), with a statistically significant difference between all the tested file systems (p < 0.05). There was no statistical difference in terms of fractured fragment lengths among all tested files (p > 0.05).

CONCLUSION

The EndoArt Pedo Blue file system showed the best CFR performance among the four file systems specifically designed for primary teeth.

Cone-beam computed tomography evaluation of shaping ability of kedo-S square and fanta AF™ baby rotary files compared to manual K-files in root canal preparation of primary anterior teeth

BACKGROUND

Pediatric rotary file systems were developed to solve manual file limitations. With many systems available, it may be tricky to select the most appropriate one.

AIM

to assess & compare Kedo-S Square, Fanta-AF™-Baby rotary files with manual K-file concerning removed dentin amount, canal transportation, centric ability & root canal taper using CBCT in primary anterior teeth.

DESIGN

Extracted Seventy-five upper primary anterior teeth with intact 2/3 root length were collected and divided into three groups based on root canal instrumentation, group-I: prepared using K-file, group-II: prepared using Kedo-S Square, and group-III: prepared using Fanta AF™ Baby file. The teeth were imaged with CBCT before & following canal instrumentation. Then, the removed dentin amount was calculated at each root-canal level. The Kruskal-Wallis test was utilized to statistically analyze study data.

RESULT

The difference among the three groups was highly statistically significant at cervical & apical thirds concerning dentin thickness changes on both mesial & distal sides following canal preparation with the least removed dentin in the Kedo-S Square group(P < 0.0001). Regarding transportation & centering ability, a non-significant difference between the three groups was found. 80% of the Fanta AF™ Baby group had good-tapered preparation compared to the Kedo-S Square (72%) and K-file (40%) groups(P < 0.05).

CONCLUSION

Kedo-S Square was preferable to Fanta-AFTM-Baby & manual K-files in primary root canal preparation.

Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography

Aim

This study was planned to evaluate and compare the cleaning efficacy of three pediatric rotary files with the standard Protaper adult file system in primary teeth using cone-beam computed tomography (CBCT).

Materials and methods

A total of 40 extracted deciduous second molars, with palatal/mesial roots having at least two-thirds of root length and an intact furcation area, were distributed randomly among four groups, with each group containing 10 teeth. Canal preparation of group I (Pro AF Baby Gold), group II (Kedo SG Blue), group III (Prime Pedo), and group IV (Protaper) was done. Pre- and postoperative CBCT images were taken. The volumetric changes of the root canals were assessed and subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 16 and R Studio 3.1.1. Volumetric changes within the groups were analyzed using paired t-tests and between the groups using analysis of variance (ANOVA).

Results

The comparison of mean volume difference between groups using ANOVA was statistically significant with F = 4.467, p = 0.002. A Tukey post hoc test revealed that group IV was statistically significant compared with groups I (p = 0.033) and III (p = 0.008) but was not statistically significant with group II (p = 0.170). There was no statistically significant difference in volumetric changes within the three pediatric rotary file systems.

Conclusion

Protaper removed more dentin than all the pediatric rotary files, but it was not statistically significant over Kedo SG Blue. Among the pediatric rotary files, Kedo SG Blue removed more dentin than Pro AF Baby Gold and Prime Pedo, but they were not statistically significant.

How to cite this article

Nainer Chidambaram JV, Jayaprakash J, Arangannal P. Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2024;17(1):15-20.

Comparative in vitro evaluation of remaining dentine thickness following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars: a systematic review

PURPOSE

The aim was to compare the remaining dentine thickness (RDT) following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars. Research question was 'Is there any difference between the remaining dentine thickness following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars?'.

METHODS

Electronic Databases like MEDLINE PubMed, Cochrane Library, EBSCOhost, Google scholar and grey literature were searched between January 1, 2006 and August 31, 2022 for in vitro and ex vivo studies that compared hand and rotary endodontic instrumentation to evaluate the RDT in primary molars. Articles published in English or which could be translated into English were searched. Two reviewers independently selected studies, extracted data, assessed risk of bias using the Revised, validated version of MINORS criteria.

RESULTS

Twelve studies were included in qualitative analysis. All included studies showed low risk of bias. Six studies showed more RDT with rotary instrumentation compared to manual instrumentation. Whereas, five studies showed variable results for RDT with manual and rotary instrumentation at different levels of root canals. One study showed no significant difference between manual and rotary instrumentation. In view of methodological heterogeneity of the findings, a meta-analysis was not conducted.

CONCLUSION

High quality of evidence based on low risk of bias was found in all the included studies. Statistically, rotary instrumentation showed more RDT than manual instrumentation according to majority of studies. Despite the shortcomings of this systematic review, it is possible to infer that the use of rotary instrumentation provides more RDT and thus there is considerable conservation of tooth structure.

Evaluation and Comparison of Effectiveness of Kedo-S Pediatric Rotary Files vs Manual Instrumentation for Root Canal Treatment in Primary Molars

Purpose

To evaluate and compare the clinical and radiographic success of Kedo-S pediatric rotary files vs manual K-Files for pulpectomy in primary mandibular molars.

Materials and methods

A sample of 30 primary mandibular molars with irreversible pulpitis was taken per group. The groups were divided as below mentioned-group I (n = 30) was treated using the Kedo-S file system. Group II (n = 30)-treated using manual stainless steel K-File. The clinical and radiographic success was compared of both techniques. Statistical analysis involved t-test, Chi-squared test, and Cochran's Q test.

Results

The overall clinical success at 3, 6, and 9 months in group I were 72.4, 89.7, and 93%, respectively and in group II were 82.1, 92.9, and 92.9%, respectively. The overall radiographic success in group I at 3, 6, and 9 months were 6.9, 17.2, and 69%, respectively and in group II were 0, 7.1, and 35.7%, respectively. According to the Frankl behavior rating scale, 19 children in group I (65.5%) showed negative behavior, and 15 children in group II (53.57%) showed positive behavior. The mean instrumentation time in group I (Kedo-S pediatric rotary file group) and group II (hand K-File group) was 8.03 ± 0.823 and 11.25 ± 0.928, respectively.

Conclusion

There was a statistically significant/highly significant difference in intergroup comparison postoperative behavior among the children in the two study groups. There was a statistically significant difference between the two study groups with relation to instrumentation time. The trend that was observed in the clinical and radiographic profile was that group I (Kedo-S rotary files) cases had more success when absolute numbers and figures were compared than group II (hand stainless steel K-File) in which success rates were comparable; however, the difference between the groups were found to be statistically nonsignificant.

How to cite this article

Rajain T, Tsomu K, Namdev R. Evaluation and Comparison of Effectiveness of Kedo-S Pediatric Rotary Files vs Manual Instrumentation for Root Canal Treatment in Primary Molars. Int J Clin Pediatr Dent 2023;16(1):22-29.

Cone-beam computed tomography analysis of primary root canals transportation and dentin loss after instrumentation with two-pediatric rotary files

Background

This in vitro study aims to compare rotary files (Fanta and Zuanba) with manual K files according to the amount of dentin removed and canal transportation in primary mandibular second molars by CBCT images.

Methods

This experimental study was conducted on 60 extracted human second primary molars. That were divided into three groups according to root canal preparation group "I" instrumented with manual K-files, group "II" instrumented with rotary Fanta files, and group "III" instrumented with rotary Zuanba files. After root canal preparation, teeth were scanned before and after mechanical preparation with CBCT scanner. Then the amount of dentin removed was determined at three levels, including the coronal, middle and apical levels. Data were statically analysed using the Kruskal–Wallis test.

Result

No statistically significant difference in the amount of dentin removed were noted between the manual and the rotary groups at the coronal and apical RC levels (P = 0.420) and (P = 0.819) respectively but significant difference was noted at the middle third (P = 0.043). Regarding RC transportation, no significant difference was noted among the three groups with the exception of the apical RC level (P = 0.043).

Conclusion

Although no significant differences were noted between rotary and manual files, the rotary files showed better performance.

Comparison between the rotary (Hyflex EDM®) and manual (k-file) technique for instrumentation of primary molars: a 12-month randomized clinical follow-up study

OBJECTIVES

Rotational instrumentation is an alternative for the clinical practice of pediatric dentists. However, there are few records in the literature on the clinical and radiographic aspects of treated teeth over time. Compare instrumentation time and filling quality between manual (k-file) and rotary (Hyflex EDM®) files, and clinically and radiographically follow-up the treated teeth for 12 months. Moreover, the characteristics of glass ionomer restorations and their interference in the treatment prognosis over time were evaluated.

METHODOLOGY

In total, 40 children with pulp involvement in primary molars received treatment with Hyflex EDM® or manual rotary files, performed by an operator. Clinical and radiographic aspects were observed at different times to determine the effectiveness of each technique.

RESULTS

The rotary system reduced instrumentation time when compared to the use of manual files (p≤0.05), but there was no difference in filling quality between the groups (p≥0.05). Moreover, both types of instrumentation were effective for 12 months (p≥0.05), and restoration retention influenced the emergence of periapical lesions (p≤0.05).

CONCLUSION

Although rotary files reduce clinical time, the clinical and radiographic aspects of both techniques were similar over 12 months. Moreover, restoration retention has been shown to be related to treatment prognosis.

Modified Conventional Root Canal Shaping Technique in Primary Teeth: An In Vivo Study

Aim and objective

The purpose of the study was to compare the efficiency of modified conventional root canal shaping technique versus conventional shaping technique in primary teeth.

Materials and methods

A total of 184 primary root canals (2 groups of 92 canals each) with two-thirds of root length were selected and randomly allocated into two different shaping techniques, i.e., Group I: conventional root canal shaping technique, Group II: modified root canal shaping technique. The quality of obturation (Coll and Sadrain, 1996) and presence or absences of voids were assessed by using radiographs. The recorded data was statistically analyzed.

Results

Significant difference was seen between conventional and modified conventional techniques in underfilled and optimally filled canals.

Conclusion

This modified cleaning and shaping technique can be considered as alternative to conventional instrumentation technique, as it improves quality of obturation and decreases the number of voids.

How to cite this article

Reddy ER, Raju SS, Sandipamu T, et al. Modified Conventional Root Canal Shaping Technique In Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(S-1):S8-S11.

Comparative Analysis of Root Canal Dentin Removal Capacity of Two NiTi Endodontic Reciprocating Systems for the Root Canal Treatment of Primary Molar Teeth. An In Vitro Study

The objective of the present study was to evaluate and compare the dentin removal capacity of Endogal Kids and Reciproc Blue NiTi alloy endodontic reciprocating systems for root canal treatments in primary second molar teeth via a micro-computed tomography (micro-CT) scan. Materials and Methods: Sixty root canal systems in fifteen primary second molar teeth were chosen and classified into one of the following study groups: A: EK3 Endogal Kids (n = 30) (EDG) and B. R25 Reciproc Blue (n = 30) (RB). Preoperative and postoperative micro-CT scans were uploaded into image processing software to analyze the changes in the volume of root canal dentin using a mathematical algorithm that enabled progressive differentiation between neighboring pixels after defining and segmenting the root canal systems in both micro-CT scans. Volumetric variations in the root canal system and the root canal third were calculated using a t-test for independent samples or a nonparametric Mann–Whitney–Wilcoxon test. Results: Statistically significant differences (p = 0.0066) in dentin removal capacity were found between the EDG (2.89 ± 1.26 mm³) and RB (1.22 ± 0.58 mm³) study groups for the coronal root canal third; however, no statistically significant differences were found for the middle (p = 0.4864) and apical (p = 0.6276) root canal thirds. Conclusions: Endogal and Reciproc Blue NiTi endodontic reciprocating systems showed similar capacity for the removal of root canal dentin, except for the coronal root canal third, in which the Reciproc Blue NiTi endodontic reciprocating system preserved more root canal dentin tissue.

Effect of Different Preparation Techniques on Root Canal Geometry: An In Vitro Study

Aim and objective

To compare and evaluate canal preparation using hand stainless steel files, hand ProTaper files, and rotary ProTaper files for change in root canal geometry in terms of surface area and volume changes assessed by computed tomography.

Materials and methods

The present study was conducted in Nair Hospital and Dental College, Department of Pediatric and Preventive Dentistry in collaboration with insight CBCT, imaging technologies. A total of 36 extracted human primary mandibular second molars were collected from the Department of Pediatric and Preventive Dentistry. All the teeth were scanned using cone-beam CT (i-CAT CT Scanner Next Generation, Imaging Sciences International) preoperatively and postoperatively to assess the mean absolute change in surface area and mean change in the volume of all the canals at different levels with the use of hand stainless steel files, hand ProTaper and rotary ProTaper files.

Results

ProTaper instruments, both hand ProTaper and rotary ProTaper caused significant changes in the surface area in the coronal thirds and middle thirds of the canal when compared to hand stainless steel files. No difference was found in surface area and volume changes between hand ProTaper and rotary ProTaper instrumentation.

Conclusion

Use of ProTaper instruments for preparation of deciduous teeth can render benefit of an improved canal preparation to facilitate better obturation and successful root canal therapy.

How to cite this article

Bheda P, Kakade A, Takate V, et al. Effect of Different Preparation Techniques on Root Canal Geometry: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(S-1):S71-S79.

Cone-beam Computed Tomographic Evaluation of the Quality of Obturation Using Different Pediatric Rotary File Systems in Primary Teeth

Aim and objective

To compare and evaluate the efficacy of three different pediatric rotary file systems in primary molars using cone-beam computed tomography (CBCT).

Materials and methods

Thirty extracted mandibular primary molars were selected and divided into three groups with ten teeth each, instrumented with Kedo SG Blue rotary files, Pro AF Baby gold rotary files, and Pedo Flex rotary files, respectively. Root canal obturation was done with zinc-oxide eugenol cement and the quality of obturation was assessed using CBCT based on the extent of filling as underfilled or optimally filled and the presence or absence of voids within the filling. The data were statistically analyzed using the Chi-square test.

Results

Among the three groups, the Kedo SG Blue group showed more number of optimally filled teeth with minimal voids (p < 0.05) followed by the Pro AF Baby gold group and Pedo Flex group.

Conclusion

Within the study limitations, the Kedo SG Blue group showed ideal endodontic obturation when compared with Pro AF baby gold and Pedo Flex rotary file systems.

Clinical significance

The present study will guide the pedodontists regarding the efficacy of pediatric rotary file systems and their usage protocols.

How to cite this article

Vaishali Naidu D, Sharada Reddy J, Patloth T, et al. Cone-beam Computed Tomographic Evaluation of the Quality of Obturation Using Different Pediatric Rotary File Systems in Primary Teeth. Int J Clin Pediatr Dent 2021;14(4):542-547.

Canal Transportation and Volumetric Dentin Removal Abilities of Ni-Ti Rotary File Systems in Curved Primary Root Canals: CBCT Study

Current improvements in nickel-titanium (Ni-Ti) rotary file systems have created a paradigm shift in the root canal therapy of primary teeth. Therefore, it is necessary to perform a comprehensive evaluation regarding the efficiencies of newly manufactured instruments for different parameters. The current study was conducted to evaluate the abilities of RaceEvo, R-Motion, ProTaper Gold (PTG) systems in curved primary root canals with regard to the patterns of canal transportation and volumetric dentin removal by using cone-beam computed tomography (CBCT). Two experimental sets were designed following the determination of experimental groups by using pre- and post-operative CBCT data: canal transportation and volumetric dentin removal. The highest amount of canal transportation was significantly detected in the PTG group in comparison to RaceEvo and R-Motion groups. When the mean values of volumetric dentin removal data were analyzed across all groups, the PTG group again exhibited the significantly highest value of dentin removal volumetrically, compared to RaceEvo, R-Motion and manual instrumentation groups. It is possible to state that R-Motion and RaceEvo rotary systems could be used as reliable alternatives without causing adverse mechanical effects and maintaining the original root canal anatomy of curved primary root canal systems compared with PTG rotary systems and manual instrumentation, with a high diagnostic sensitivity of CBCT in pediatric endodontics when the alternative methods are not adequate.

Comparing the amount of removed dentin thickness in root canal treated primary molar teeth using different instrumentation techniques: in-vitro study using CBCT

PURPOSE

There is a clinical dilemma about root canal preparation for endodontic treatment of primary teeth. This study aimed to compare the amount of dentin removal in root canal treated primary molar teeth with three preparation techniques by cone-beam computed tomography (CBCT).

METHODS

A total of 39 s primary molar teeth were selected with a minimum of two-thirds of the entire root length. Access cavity was prepared and preliminary CBCT images were taken and viewed by Romexis programme. The wall thickness of the canal was measured in the danger zone at two axial cut sections of 1 and 2 mm below furcation. Then, the teeth were instrumented with three different methods as manual K-files (size 15-30), Gates glidden burs (in decreasing order of size #2 and #1 followed by hand k-files up to file number 25), and ProTaper rotary files. After canal preparation, the specimens were placed in the same position, and the canal wall thickness was remeasured. Data were analysed by using one-way ANOVA and Kruskal-Wallis tests (α = 0.05).

RESULTS

The amounts of removed dentin thickness was not significantly different among the three groups at two axial cut sections of 1 mm and 2 mm below furcation (P = 0.27 and 0.17, respectively).

CONCLUSION

Within the limitations of this study, the three instrumentation techniques used in primary molars were comparable regarding the amount of dentin removal.

Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial

AIM AND OBJECTIVE

To estimate the obturation quality and instrumentation time on comparing traditional hand files and two rotary file types during root canal instrumentation in deciduous molars.

MATERIALS AND METHODS

Forty-five deciduous mandibular molars were taken and randomly allotted to three groups (n = 15). Group I: K-hand files, group II: ProTaper Gold rotary file, and group III: Kedo-SG Blue rotary files. Before and after root canal instrumentation, standardized digital radiography was taken and the instrumentation time was also noted. The recorded data were then subjected to statistical analysis utilizing SPSS Software version 22.0. To compare the instrumentation time and quality of obturation between the groups, a Chi-square test and ANOVA with the level of significance at 0.05 were employed.

RESULTS

There was no significant difference recorded with reference to the quality of obturation (p > 0.05). However, the difference was noticed to be statistically significant when the instrumentation time between the two rotary groups and the manual instrumentation groups was taken into account (p < 0.05). The rotary systems ProTaper Gold and Kedo-SG Blue exhibited a significantly less instrumentation time on comparing with that of the hand files.

CONCLUSION

Concerning the quality of obturation, all three file groups demonstrated almost a similar performance. However, there was a significant difference noticed in the instrumentation time with the use of manual instrumentation in comparison to rotary instrumentation in deciduous teeth.

HOW TO CITE THIS ARTICLE

Preethy NA, Jeevanandan G, Mathew MG, et al. Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(4):471-474.

Effect of Adaptive, Rotary, and Manual Root Canal Instrumentation in Primary Molars: A Triple-Armed, Randomized Controlled Clinical Trial

Simple Summary

Untimely loss of primary molars may lead to undesirable consequences; hence, pulpectomy is considered a rational treatment approach to avoid it. Advances in root canal instrumentation by means of motorized files while treating primary teeth have reduced the chair-side time and have also exhibited better quality of obturation. This helps reduce the patient’s anxiety about pulpectomy procedures. However, root canals in primary teeth exhibit a larger perimeter and are irregular in shape, posing a challenge to currently used motorized endodontic files. Instrumenting root canals in three dimensions is the need of the hour and is vastly explored in the literature, albeit for adult dentition. The application of adaptive root canal instrumentation for pulpectomies in primary teeth is yet to be reported in the literature.

Abstract

This clinical trial focused on collating the instrumentation time and quality of root canal obturation in primary molars treated with three instrumentation techniques: adaptive, rotary, and manual. A triple-armed, randomized controlled clinical trial was performed on 75 primary molars requiring pulpectomy treatment, divided into three groups (n = 25 per group). The teeth in Group 1 were instrumented with an adaptive technique (XP-endo Shaper, FKG Dentaire, La Chaux-de-Fonds, Switzerland), Group 2 with pediatric rotary files (Kedo-S; D1 and E1), and Group 3 with a manual technique (hand K-files). The apical size of the final instrumentation was maintained at #30 for all groups. Instrumentation time and the grade of the root canal obturation were evaluated. Instrumentation duration was recorded, employing a digital stopwatch from the insertion of the first file until the completion of final irrigation. Obturation quality was assessed using radiographs. The criteria taken as a reference for obturation were: optimal (1 mm short of the apex), underfilled (2 mm short of the apex), or overfilled (beyond the apex). The use of an adaptive technique was associated with the lowest instrumentation time (p < 0.0001) when used for instrumenting primary molars and with the highest root canal filling quality of the three groups. The application of the new concept of adaptive instrumentation for pulpectomy of primary molars was a favorable technique, considering the significant reduction in instrumentation time and better obturation.

Comparative Evaluation of Dentin Removal and Taper of Root Canal Preparation of Hand K File, ProTaper Rotary File, and Kedo S Rotary File in Primary Molars Using Cone-beam Computed Tomography

Various rotary endodontic instruments were used and studied for the root canal preparation of the primary teeth. Recently, a new venture evolved in the field of pediatric endodontic, which was Kedo S rotary files. These are the files designed exclusively for root canal preparation of the primary teeth.

Rotary Endodontics in Pediatric Dentistry: Embracing the New Alternative

Pulpectomy is one of the most important procedures in maintaining the necrotic primary teeth until physiologic exfoliation. In clinical practice, time efficacy is invaluable, especially in pediatric endodontics, where unpredictability and difficulty of root canal morphology adds to a clinician's challenge. The success of a pulpectomy procedure mainly depends upon the biomechanical preparation of the root canal systems. With the advent of NiTi rotary files, adult endodontic procedures have been rendered easy, but its popularity in pedodontic practice is limited. Therefore, the purpose of this article is to review the use of NiTi rotary files for root canal instrumentation in primary teeth.

How to cite this article

Chauhan A, Saini S, Dua P, et al. Rotary Endodontics in Pediatric Dentistry: Embracing the New Alternative. Int J Clin Pediatr Dent 2019;12(5):460-463.

A micro-computed tomographic assessment of root canal preparation with conventional and different rotary files in primary teeth and young permanent teeth

BACKGROUND

Root canals of primary teeth are commonly prepared with endodontic files that are originally manufactured for permanent teeth.

AIM

This micro-computed tomography (micro-CT) study evaluated and compared the changes in root canal morphology after preparation with different conventional and rotary files in primary teeth and young permanent teeth.

DESIGN

Seventy-two extracted primary and permanent molars were selected and randomly assigned to three subgroups according to the file systems used (n = 12/each). After pre-scanning of teeth with micro-CT, root canals were prepared with One Shape and Revo-S rotary systems and conventional endodontic files. After rescanning procedure, changes in canal volume, surface area, uninstrumented surface area, and apical transportation were evaluated. Mann-Whitney U test, Kruskal-Wallis test, and Conover's multiple comparison test were used for statistical analysis (P = .05).

RESULTS

Instrumentation with rotary files resulted in significantly greater volume and surface area of root canals and less uninstrumented areas (P < .001) than with manual files (P < .001). Primary molars showed significantly less apical transportation than permanent teeth (P < .001).

CONCLUSIONS

Preparation of canals with rotary files could be a viable alternative to conventional files in primary teeth. Regardless of the file system used, uninstrumented areas still exist in both primary teeth and permanent teeth.

Endodontic Treatment in Artificial Deciduous Teeth through Manual and Mechanical Instrumentation: A Pilot Study

“In vitro” studies seek to simulate actual biological conditions in the laboratory providing principles to be studied later. To facilitate the development of new techniques of root instrumentation in primary teeth and to ensure the integrity and function of the element, this study aimed to demonstrate the technological advances in endodontics through endodontic treatment performed on artificial primary teeth using a rotary instrumentation system and reciprocation. Instrumentation of the root canal was performed via a manual, rotary, and Reciproc system. Results showed that current systems can facilitate endodontic treatment in one session. These procedures become increasingly easy with the help of technological advances in dentistry.

Biomechanical preparation in primary molars using manual and three NiTi instruments: a cone-beam-computed tomographic in vitro study

PURPOSE

To evaluate nickel-titanium rotary systems, ProTaper Universal (PTU), ProTaper Next (PTN), self-adjusting file (SAF), and stainless steel hand K files in deciduous root canals in longitudinal and horizontal sections by three-dimensional reconstruction. Whether there was any difference in shaping ability, transportation, dentine removal, untouched canal surface area, and preparation time among the different groups when used in primary root canals.

METHODS

Shaping and cleaning of canals in primary molars were done using the four systems, and CBCT and specialized software were used for scanning, image processing, three-dimensional reconstruction, and analysis of pre-operative and post-operative to evaluate the groups for their shaping properties, transportation, amount of dentine removal, untouched canal surface area, and preparation time in primary root canals.

RESULTS

None of the groups reported stripping of canals or instrument failure. SAF demonstrated less removal of dentine as compared to other groups. Hand K files presented with high untouched canal surface area, while it was least with SAF. In addition, rotary files provided faster preparation than hand files, and among the rotary systems, PTN took least time for cleaning and shaping of canals. All the groups were similar in transportation at cervical and apical third.

CONCLUSION

Under the conditions of this study, SAF seemed to result in more conservative and meticulous removal of dentine. This is desirable to preserve the integrity of thin-walled primary root canals. SAF also showed less untouched canal areas suggesting better contact with the primary canal walls. The rotary file groups required less clinical time which is important in paediatric treatments.

Morphological measurements of anatomical landmarks in human maxillary first molar pulp chambers and evaluation of number of pulp canal orifices using spiral computed tomography: An in vitro study

Context:

Comprehensive understanding of the anatomic position of pulp canal orifices and the measurements of the molar pulp space may maintain the pulp health during conservative tooth preparation and minimize the possibility of mishaps during endodontic therapy.

Aims:

The idea of the present study was to analyze the morphological measurements of anatomical landmarks in human maxillary first molar pulp chambers and evaluation of number of pulp canal orifices using three-dimensional spiral computed tomography (SCT).

Subjects and Methods:

One hundred and thirty extracted intact human adult maxillary first molars were chosen from the North Indian population and were analyzed using SCT in axial and coronal sections.

Statistical Analysis Used:

Standard deviation, mean, and coefficient of variance were calculated. Interobserver reliability was evaluated using kappa value to avoid any bias.

Results:

The results from our study showed that 69.23% of the sample teeth had four canal orifices, the mesial and distal pulp horns were present at an average distance of 0.80 ± 0.36 mm and 0.41 ± 0.34 mm, respectively, above the cementoenamel junction (CEJ), and the mean distance from the central groove of central fossa to furcation and the central groove of central fossa to the pulp chamber's roof was 8.37 ± 0.33 mm and 3.87 ± 0.29 mm, respectively. The average distance of the pulp chamber's floor from the furcation was found to be 2.47 ± 0.11 mm. The highest degree of variance was observed in case of relation of CEJ to pulp horns, i.e., 44.85% and 82.60%.

Conclusions:

The dimensions observed in this study and its resemblance to the various studies reported in literature shift the fundamental anatomic approach to a more systemic quantifiable approach to the endodontic maxillary first molar access preparation.

Endodontic Treatment in Artificial Deciduous Teeth by Manual and Mechanical Instrumentation: A Pilot Study

Introduction

“In vitro” studies seek to simulate actual biological conditions in the laboratory and providing principles to be studied later, to facilitate the development of new techniques of root instrumentation in primary teeth and to ensure the integrity and function of the element.

Aim

This study aimed to demonstrate the technological advances in endodontics by endodontic treatment performed on artificial primary teeth using a rotary instrumentation system and reciprocation.

Materials and methods

Instrumentation of the root canal was performed via a manual, rotatory and Reciproc system.

Results

The rotatory systems can facilitate endodontic treatment in one session.

Conclusion

These procedures become increasingly easy and rapid with the help of technological advances in dentistry.

How to cite this article

Hecksher F, Vidigal B, Coelho P, Otoni D, Alvarenga C, Nunes E. Endodontic Treatment in Artificial Deciduous Teeth by Manual and Mechanical Instrumentation: A Pilot Study. Int J Clin Pediatr Dent, 2018;11(6):510-512

Reciprocating instrumentation in a maxillary primary central incisor: A protocol tested in a 3D printed prototype

BACKGROUND

Efficient endodontic instrumentation of primary teeth is a challenge for paediatric dentists.

AIM

To evaluate biomechanical outcomes of endodontic instrumentation with a reciprocating system in a polymer-prototyped primary maxillary central incisor.

DESIGN

The specimen was systematically instrumented and micro-CT scanned before and after each file. The amount of debris, percentage of non-instrumented areas, removed dentin volume, and lower dentin thickness at specific points along the root canal were analyzed.

RESULTS

A 10% increase in removed dentin volume was observed when R40 was compared to R25 (14.5% vs 4.2%). When comparing R50 with R40, this increase was only 3.4% (17.9% vs 14.5%). In the root cervical third, there was substantial reduction in dentin thickness with R50 (48.8%), followed by R40 (39.5%) and R25 (18.6%). There was no difference between R25 and R40 in the removal of dentin at the apical third (15.8%), while R50 resulted in 39.8% reduction in dentin thickness. Percentage of non-instrumented areas were the same for all files. Accumulated debris with R40 and R50 was the same (0.19 mm³) while for R25 was 0.11 mm³.

CONCLUSIONS

The Reciproc^® system was effective for instrumentation of a prototyped primary maxillary central incisor. The most suitable file for apical preparation was R40.

Comparison between the Effectiveness of Rotary and Manual Instrumentation in Primary Teeth: A Systematic Review

Aim

To develop a scientifically current and evidence based protocol on the efficacy of rotary and hand root canal instrumentation in primary teeth.

Materials and methods

Previous randomized control trials were used for the current review. Hand search and online search engines of PUBMED and Google Scholar were used to search English language articles with human subjects published up to December 2016.

Results

After screening of the abstracts and articles, based on the inclusion and exclusion criteria a total of 13 articles were included in the systematic review.

Conclusion

Rotary instrumentation shows equivalent cleaning efficiency than hand files depending on the system of instrumentation and techniques used. However, use of rotary in primary teeth leads to improved shaping of canals providing better quality of treatment in less time.

How to cite this article

Panchal V, Jeevanandan G, et al. Comparison between the Effectiveness of Rotary and Manual Instrumentation in Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent 2019;12(4):340–346.

A smart rotary technique versus conventional pulpectomy for primary teeth: A randomized controlled clinical study

Background

Techniques with adequate accuracy of working length determination along with shorter duration of treatment in pulpectomy procedure seems to be essential in pediatric dentistry. The aim of the present study was to evaluate the accuracy of root canal length measurement with Root ZX II apex locator and rotary system in pulpectomy of primary teeth.

Material and Methods

In this randomized control clinical trial complete pulpectomy was performed on 80 mandibular primary molars in 80, 4-6-year-old children. The study population was randomly divided into case and control groups. In control group conventional pulpectomy was performed and in the case group working length was determined by electronic apex locator Root ZXII and instrumented with Mtwo rotary files. Statistical evaluation was performed using Mann-Whitney and Chi-Square tests (P<0.05).

Results

There were no significant differences between electronic apex locator Root ZXII and conventional method in accuracy of root canal length determination. However significantly less time was needed for instrumenting with rotary files (P=0.000).

Conclusions

Considering the comparable results in accuracy of root canal length determination and the considerably shorter instrumentation time in Root ZXII apex locator and rotary system, it may be suggested for pulpectomy in primary molar teeth.

Key words:Rotary technique, conventional technique, pulpectomy, primary teeth.

Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth

Introduction

Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Nickel-Titanium (Ni-Ti) instruments are available to perform efficient root canal preparation in primary teeth. These Ni-Ti instruments has been designed to aid in better root canal preparation in permanent teeth but are rarely used in primary teeth. It is necessary to assess the feasibility of using these adult rotary files with a modified sequence in primary teeth.

Aim

To compare the quality of obturation and instrumentation time during root canal preparation using hand files and modified rotary file systems in primary molars.

Materials and Methods

Forty-five primary mandibular molars were randomly assigned to three experimental groups (n=15). Group I was instrumented using k-hand files, Group II with S2 ProTaper universal file and Group III with 0.25 tip 4% taper K3 rotary file. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS Software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation was done using ANOVA and Chi-square test with the level of significance set at 0.05.

Results

No significant differences were noted with regard to the quality of obturation (p=0.791). However, a statistically significant difference was noted in the instrumentation time between the three groups (p<0.05). ProTaper rotary system had significantly lesser instrumentation time when compared to that of K3 rotary system and hand file system.

Conclusion

The hand files, S2 ProTaper Universal and K3 0.25 tip 4% taper files systems performed similarly with respect to the quality of obturation. There was a significant difference in instrumentation time with manual instrumentation compared to the modified rotary file systems in primary teeth.

Mechanical Preparation Showed Superior Shaping Ability than Manual Technique in Primary Molars - A Micro-Computed Tomography Study

Abstract The aim of the study was to evaluate canal preparation in primary molars with hand files, ProTaper Next and Self-Adjusting File (SAF) by 2D and 3D micro-computed tomography (micro-CT) analysis. Canals of 24 primary molars were prepared with hand files (HF), ProTaper Next (PTN) and SAF (n=8/group). The teeth were scanned before and after root canal preparation and the pre- and postoperative micro-CT images were reconstructed. Changes in 2D (area, perimeter, roundness, minor and major diameter) and 3D [volume, surface area, structure model index (SMI)] morphological parameters, as well as canal transportation and lateral perforations were evaluated (Kruskal-Wallis and ANOVA; a=0.05). SAF presented smaller changes in minor diameter, volume and surface area compared with HF and PTN (p<0.05). PTN presented more circular canals after preparation. 3D analysis revealed greater transportation in HF. PTN and SAF presented more centered canal preparation, especially in curved areas. SAF and HF presented, respectively, the lowest (0.05±0.02 and 0.07±0.04) and highest (0.14±0.11 and 0.29±0.17) apical transportation. There were fewer lateral perforations in SAF (4.2%) and PTN (7.7%) than in HF (47.8%) (p<0.05). In primary molars, mechanical preparation showed better shaping ability than hand files, promoting more centered preparations and lower occurrence of lateral perforations and canal transportation. Clinical Relevance: Manual instrumentation is still reported as the main choice in the primary teeth preparation; however, studies have shown limitations in its use. The morphological characteristics of primary teeth and the limited knowledge of shaping procedures in these teeth using mechanical preparation become a challenge for clinical practice and might impair the predictability of endodontic treatment.

Kedo-S Paediatric Rotary Files for Root Canal Preparation in Primary Teeth - Case Report

Nickel-Titanium (Ni-Ti) instrument are widely used for root canal preparation in permanent tooth compared to primary teeth. Hand instrumentation technique remains the conventional method for root canal preparation in primary teeth. The time taken for root canal preparation with the conventional method is more resulting in patients and clinicians fatigue. Recently Ni-Ti rotary files designed for permanent tooth has been used for root canal preparation in primary teeth. Using rotary instruments for primary tooth pulpectomies resulted in better and predictable root canal filling. This article presents case reports of pulpectomy treatment performed using Kedo-S an exclusive paediatric Ni-Ti rotary files. The advantages and disadvantages in use of Ni-Ti rotary files in primary teeth are discussed in this article.

'Volumetric analysis of hand and rotary root canal instrumentation and filling in primary teeth using Spiral Computed Tomography' - an invitro study

AIM

To compare and evaluate the volumetric analysis of pre- and post-root canal instrumentation in primary teeth using hand and rotary files and also to analyse the volume of root canal filling.

MATERIALS AND METHODS

A total of 20 primary teeth were divided into two groups randomly and subjected to spiral computed tomography (SCT) analysis before and after instrumentation. For manual technique (Group 1), teeth were prepared using K files and rotary (Group 2) preparation was performed with Mtwo files. Volumetric enlargement was calculated using Osirix software. Root canals were then filled with rotary lentulospiral using zinc oxide-eugenol cement (ZOE). The filled volume in each canal was measured using SCT and the percentage of obturated volume was calculated. The data were statistically analysed using paired t-tests.

RESULTS

There was a statistically significant difference in the volume of root canal enlarged in both the groups. Rotary files showed significant increase in the volume compared to K files. Mtwo instrumented root canals showed good obturated volume compared to manual technique, although voids were common in both the groups.

CONCLUSION

Rotary root canal instrumentation may be indicated for utilization in primary teeth, for enhancing root canal preparation and good quality of root canal filling.

In vitro investigation of the cleaning efficacy, shaping ability, preparation time and file deformation of continuous rotary, reciprocating rotary and manual instrumentations in primary molars

Background. Efficient canal preparation is the key to successful root canal treatment. This study aimed to assess the cleaning and shaping ability, preparation time and file deformation of rotary, reciprocating and manual instrumentation in canal preparation of primary molars.

Methods. The mesiobuccal canals of 64 extracted primary mandibular second molars were injected with India ink. The samples were randomly divided into one control and three experimental groups. Experimental groups were instrumented with K-file, Mtwo in continuous rotation and Reciproc in reciprocating motion, respectively. The control group received no treatment. The files were discarded after four applications. Shaping ability was evaluated using CBCT. After clearing, ink removal was scored. Preparation time and file fracture or deformation was also recorded. Data were analyzed with SPSS 19 using chi-squared, Fisher’s exact test, Kruskal-Wallis and post hoc tests at a significance level of 0.05.

Results. Considering cleanliness, at coronal third Reciproc was better than K-file (P < 0.001), but not more effective than Mtwo (P = 0.080). Furthermore, Mtwo leaved the canal cleaner than K-file (P = 0.001). In the middle third, only Reciproc exhibited better cleaning efficacy than K-file (P = 0.005). In the apical third, no difference was detected between the groups (P = 0.794). Regarding shaping ability, no differences were found between Reciproc and Mtwo (P = 1.00). Meanwhile, both displayed better shaping efficacy than K-file (P < 0.05). Between each two groups, there were differences in preparation time (P < 0.05), with Reciproc being the fastest. No file failure occurred.

Conclusion. Fast and sufficient cleaning and shaping could be achieved with Mtwo and especially with Reciproc.

Computed Tomographic Evaluation of K3 Rotary and Stainless Steel K File Instrumentation in Primary Teeth

INTRODUCTION

The intention of root canal preparation is to reduce infected content and create a root canal shape allowing for a well condensed root filling. Therefore, it is not necessary to remove excessive dentine for successful root canal preparation and concern must be taken not to over instrument as perforations can occur in the thin dentinal walls of primary molars.

AIM

This study was done to evaluate the time preparation, the risk of lateral perforation and dentine removal of the stainless steel K file and K3 rotary instrumentation in primary teeth.

MATERIALS AND METHODS

Seventy-five primary molars were selected and divided into three groups. Using spiral computed tomography the teeth were scanned before instrumentation. Teeth were prepared using a stainless steel K file for manual technique. All the canals were prepared up to file size 35. In K3 rotary files (.02 taper) instrumentation was done up to 35 size file. In K3 rotary files (.04 taper) the instrumentation was done up to 25 size file and simultaneously the instrumentation time was recorded. The instrumented teeth were once again scanned and the images were compared with the images of the uninstrumented canals.

STATISTICAL ANALYSIS

Data was statistically analysed using Kruskal Wallis One-way ANOVA, Mann-Whitney U-Test and Pearson's Chi-square Test.

RESULTS

K3 rotary files (.02 taper) removed a significantly less amount of dentine, required less instrumentation time than a stainless steel K file.

CONCLUSION

K3 files (.02 taper) generated less dentine removal than the stainless steel K file and K3 files (.04 taper). K3 rotary files (.02 taper) were more effective for root canal instrumentation in primary teeth.

Rotary endodontics in primary teeth - A review

Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.

Evaluation of the effect of using electrosurgery in pulpectomy of deciduous teeth on succedaneous teeth: an animal study

OBJECTIVES

The aim of this study was to determine the probable side effects of electrosurgery in pulpectomy of deciduous teeth on succedaneous teeth in dogs.

MATERIALS AND METHODS

In this animal study, all maxillary and mandibular teeth at one side of five puppies' mouths were treated employing electrosurgical pulpectomy and were then compared with those of the other side treated using the conventional method. The electrosurgical dental electrode was placed in canals to the point of working length for the experimental group. After pulpectomy, the canals were filled with zinc oxide eugenol paste and the access cavity was restored with amalgam. The dogs remained under care until their successor teeth erupted and clinical examination was performed.

RESULTS

The teeth treated employing electrosurgical pulpectomy presented natural appearance with no observable defects including enamel hypoplasia, diffuse opacities of enamel, demarcated opacities, and enamel discoloration.

CONCLUSION

Electrosurgical pulpectomy can be considered as an option for pulpectomy of deciduous teeth.

Comparison of Cleaning Efficacy and Instrumentation Time in Primary Molars: Mtwo Rotary Instruments vs. Hand K-Files

INTRODUCTION

Pulpectomy is the preferred treatment for restorable primary teeth with symptomatic irreversible pulpitis or periradicular lesion. Considering the rather new application of rotary files for pulpectomy of primary teeth, the aim of this study was to compare the cleaning efficacy and instrumentation time of hand K-files and Mtwo rotary system for preparation of human primary molars.

METHODS AND MATERIALS

This experimental study was conducted on 100 extracted primary maxillary and mandibular intact molars with no resorption. Access cavities were prepared and India ink was injected into the root canal on a vibrator using an insulin syringe. Canals were then divided into 5 groups (n=20): in group I, canals were instrumented using K-files up to #25 for mesial and buccal canals and #30 for palatal and distal canals. In group II, canals were prepared using Mtwo rotary files (15/0.05, 20/0.06 and 25/0.06 for mesial and buccal canals and 15/0.05, 20/0.06, 25/0.06 and finally 30/0.05 for distal and palatal canals). In group III, root canals were only irrigated with saline. Groups IV and V were the positive and negative control groups, respectively. The time required for cleaning and preparation of the canals for each of the specimens in groups I, II and III was recorded.

RESULTS

The mean score of cleanliness of Mtwo was not significantly different from K-file group (P>0.05). However the mean instrumentation time in Mtwo group was significantly shorter (P<0.001).

CONCLUSION

Although there were no differences regarding the cleaning efficacy of either system, Mtwo rotary files were far more time efficient.

Microbial reduction by two chemical-mechanical protocols in primary teeth with pulp necrosis and periradicular lesion - an in vivo study

The objective of this study was to determine the efficacy of chemical-mechanical procedures of two endodontic protocols for septic content reduction of root canals from primary teeth with pulp necrosis and periradicular lesion. Twenty-four primary root canals with pulp necrosis and periradicular lesion were divided into two treatment groups (n=12): multiple-visit and single-visit protocols. Samples were collected using sterile paper points before and after endodontic cleaning followed by microbiological identification through checkerboard DNA-DNA hybridization. Statistical analysis was performed using Proportion Test for score=0 comparing the findings before and after treatment for each group (Wilcoxon's test) as well as the differences in scores between protocols (Mann-Whitney's test) (p<0.05). Data were expressed as prevalence (presence or absence) and estimate of the average count (x10(5) cells) of each species. Differences in proportions of score=0 prior to treatment were non-significant (p=0.415), demonstrating equivalence between groups. A significant increase in score=0 was detected after treatment for both groups (p<0.0001). Single-visit protocol achieved a significantly greater reduction in mean scoring following endodontic treatment (p=0.024). Both protocols were capable of significantly reducing septic content in root canals of primary teeth with periradicular lesion. Moreover, single-visit protocol showed greater efficacy in reducing endodontic infection.

Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCT

AIM

This in vitro study aimed to evaluate the efficacy of rotary ProFile, ProTaper, Hero Shaper and K-files in shaping ability, cleaning efficacy, preparation time and instrument distortion in primary molars.

METHODS

Sixty extracted primary mandibular second molars were divided into four equal groups: Group I K-file, Group II ProFile, Group III ProTaper file and Group IV Hero Shaper file. The shaping ability was determined by comparing pre- and post-instrumentation CBCT scans and data analysed with SPSS program using the Chi-square test. Cleaning efficacy was evaluated by the degree of India ink removal from the canal walls under stereomicroscopy. Instrumentation times were calculated for each tooth and instrument distortion was visually checked and duly noted. The cleaning efficacy and instrumentation time were determined using ANOVA with Tukey's correction. Instrument distortion was analysed using Chi-square test.

RESULTS

The canal taper was significantly more conical for rotary files as compared to K-files with Chi-square test (p < 0.05). Cleaning efficacy of rotary files with average scores (Groups II- 0.68, III- 0.48 and IV- 0.58) was significantly better than K-files (Group I- 0.93) (p < 0.05). Mean instrumentation time with K-file (20.7 min) was significantly higher than rotary files (Groups II 8.9, III 5.6, and IV 8.1 min) (p < 0.05). Instrument distortion was observed in Group I (4.3%), while none of the rotary files were distorted.

CONCLUSIONS

Rotary files prepared more conical canals in primary teeth than manual instruments. Reduced preparation time with rotary files enhances patient cooperation especially in young children.

Comparison of the cleaning capacity of Mtwo and Pro Taper rotary systems and manual instruments in primary teeth

Background:

Root canal cleaning is an important step in endodontic therapy. In order to develop better techniques, a new generation of endodontic instruments has been designed. The aim of this study was to compare the effectiveness of manual K-files (Mani Co, Tokyo, Japan) and two rotary systems–Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper (VDW, Munich, Germany)–for root canal preparation in primary molars.

Materials and Methods:

India ink was injected to 160 mesiobuccal and distal root canals of mandibular primary molars. The teeth were randomly divided into three experimental groups and one control group. In each experimental group, either manual instruments (K-files) or rotary instruments (Mtwo or ProTaper) were used to prepare root canals. After cleaning the canals and clearing the teeth, ink removal was evaluated with a stereomicroscope. Statistical analysis was done with Kruskal–Wallis and Friedman tests.

Results:

There were no significant differences in cleaning efficiency between manual and rotary instruments. Only ProTaper files performed significantly better in the coronal and middle thirds than in the apical third of the root canal.

Conclusion:

Manual K-files and the Mtwo and ProTaper rotary systems showed equally acceptable cleaning ability in primary molar root canals.

Evaluation of cleaning capacity and instrumentation time of manual, hybrid and rotary instrumentation techniques in primary molars

AIM

To compare the cleaning effectiveness of manual, hybrid and rotary instrumentation techniques in primary molar teeth.

METHODOLOGY

Fifteen primary molars were selected. After endodontic access, the teeth were immersed in a medium containing Enterococcus faecalis and divided into three groups, according to the root canal instrumentation technique: group 1 - manual, group 2 - hybrid and group 3 - nickel-titanium (NiTi) rotary files. For microbiological evaluation, comparisons before and after instrumentation were performed using the paired Student's t-test. One-way anova complemented with the Student's t-test was used to compare the percentage of microbial reduction. Instrumentation time was evaluated by Kruskal-Wallis and Student-Newman-Keuls tests. Images obtained under scanning electron microscopy were analysed by three blinded examiners, and kappa statistics was used to evaluate calibration among examiners. The most frequent results among examiners were analysed using Kruskal-Wallis and Student-Newman-Keuls tests.

RESULTS

The hybrid technique required a significantly longer instrumentation time than the manual and rotary techniques (P < 0.05). All techniques tested were able to significantly reduce the number of E. faecalis (P < 0.05). The hybrid technique was associated with the highest intracanal bacterial reduction, with a statistically significant difference compared with manual instrumentation (P = 0.01). Manual instrumentation resulted in the lowest amount of debris and the highest amount of smear layer when compared with the rotary and hybrid techniques (P < 0.05). There was no difference between rotary and hybrid instrumentation in the removal of debris and smear layer.

CONCLUSION

The use of NiTi rotary files is an option for root canal instrumentation in primary teeth.