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Eren İ, Sezer B. Comparative evaluation of the remaining dentin volume following instrumentation with rotary, reciprocating, and hand files during root canal treatment in primary molars: An ex vivo study. J Dent Sci 2024; 19:2126-2134. [PMID: 39347077 PMCID: PMC11437276 DOI: 10.1016/j.jds.2024.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/02/2024] [Indexed: 10/01/2024] Open
Abstract
Background/purpose The effectiveness of root canal treatments with different file systems in primary teeth is important in terms of clinical practice and the use of file systems that work with different principles in primary tooth pulpectomy is becoming widespread. The amount of remaining dentin in the coronal region of the root is important in terms of the prognosis of the tooth and the long-term success of the treatment in teeth that have undergone root canal treatment. The aim of this study was to evaluate the remaining dentin volume in the coronal part of the root after the use of rotary, reciprocating, and conventional hand files in primary tooth pulpectomy. Materials and methods A total of 30 primary molars were divided into three groups. In each group, the preparations were made with three different file types: WaveOne Gold, which works with reciprocating motion; TruNatomy, which works with rotational motion; and conventional hand files. The three-dimensional images were evaluated for remaining dentin volume in the 2-mm coronal part of the root. Group means were compared using one-way analysis of variance, and post hoc analyses were performed with the Tukey test. Results There was no statistically significant difference between the groups in terms of preoperative and postoperative dentin volume (P > 0.05). The mean difference after preparation was observed the most in the WaveOne Gold group and the least in the TruNatomy group. When the mean percentage differences were evaluated, it was observed that statistically significantly more dentin volume was preserved after the preparation with TruNatomy than with WaveOne Gold (P = 0.021). Conclusion In primary tooth pulpectomy, file systems working with rotational motion can be preferred over file systems working with reciprocating motion in preserving the amount of dentin in the 2-mm coronal part of the root.
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Affiliation(s)
- İrem Eren
- Department of Endodontics, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
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Elagami RA, Reis TM, Hassan MA, Tedesco TK, Braga MM, Mendes FM, Cenci MS, Huysmans MC, Raggio DP. CONSORT statement adherence and risk of bias in randomized controlled trials on deep caries management: a meta-research. BMC Oral Health 2024; 24:687. [PMID: 38872165 PMCID: PMC11177528 DOI: 10.1186/s12903-024-04417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Recently, trials have supported changes in deep caries management. However, reporting might lack details, affecting interpretation and implementation. Thus, we aimed to evaluate the adherence to the CONSORT statement and the risk of bias of randomized controlled trials (RCTs) on deep caries management published in pediatric dental journals. METHODS We searched PubMed for RCTs in six pediatric dental journals between 2010 and 2022, focusing on deep caries lesion management. Adherence to the CONSORT guideline and the risk of bias were assessed using a modified tool with 19 items; each scored from 0 to 2 (maximum of 38 points), and the Cochrane risk-of-bias (RoB 2) tool. We performed descriptive and regression analyses (α = 5%). RESULTS We analyzed 127 RCTs. The mean (standard deviation) CONSORT adherence score was 21.1 (6.7). Notably, 96.1% of the studies received a score of 2 for the "intervention" item, whereas 83.5% scored 0 for the "estimated effect size". The risk of bias assessment revealed that 40.2% of the RCTs were at high risk, 59% were at low risk, and 0.8% were at low risk. RCTs with a high risk of bias had lower CONSORT scores (p<0.001) than those with low or some concerns. RCTs published in journals without the endorsement of the CONSORT statement had lower scores than those in journals with the endorsement of the CONSORT statement. Older RCTs (6-10 years old and more than 10 years old) showed significantly lower CONSORT statement compliance than trials published recently within 5 years. CONCLUSION Adherence to the CONSORT was relatively low among the investigated RCTs. Moreover, lower adherence to the CONSORT was associated with a higher risk of bias. TRIAL REGISTRATION This study protocol was prospectively registered on the Open Science Framework - DOI ( 10.17605/OSF.IO/V6SYZ ).
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Affiliation(s)
- Rokaia Ahmed Elagami
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Radboud University Medical Center, Research Institute for Medical Innovation, Nijmegen, The Netherlands
| | - Thais Marchezini Reis
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mohamed Ahmed Hassan
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Tamara Kerber Tedesco
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Radboud University Medical Center, Research Institute for Medical Innovation, Nijmegen, The Netherlands
| | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Research Institute for Medical Innovation, Nijmegen, The Netherlands
| | - Marie-Charlotte Huysmans
- Department of Dentistry, Radboud University Medical Center, Research Institute for Medical Innovation, Nijmegen, The Netherlands
| | - Daniela Prócida Raggio
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil.
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Hadwa SM, Ghouraba RF, Kabbash IA, El-Desouky SS. Assessment of clinical and radiographic efficiency of manual and pediatric rotary file systems in primary root canal preparation: a randomized controlled clinical trial. BMC Oral Health 2023; 23:687. [PMID: 37742023 PMCID: PMC10518081 DOI: 10.1186/s12903-023-03393-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/07/2023] [Indexed: 09/25/2023] Open
Abstract
INTRODUCTION The success of primary teeth pulpectomy is strongly reliant on instrumentation techniques and their impact on obturation quality & postoperative pain. Recently, pediatric rotary file systems have been implemented. AIM to compare two pediatric rotary file systems (Kedo-S-Square & Fanta AF™ Baby) with manual K-files concerning obturation quality, instrumentation time, and postoperative pain in root canal preparation of primary molars using cone beam computed tomography (CBCT). METHODS A randomized clinical trial was conducted with the trial registration number (TRN: NCT05619796 and date of registration: (17/11/2022) on sixty primary lower 2nd molars in healthy children aged 4-7 years. Molars were assigned randomly to three groups (n = 20). Group-I and -II were prepared with Kedo-S-Square & Fanta AF™Baby rotary systems respectively while group-III was prepared with a manual K-file. Instrumentation time was recorded using a stopwatch. CBCT was used to assess obturation quality immediately & recorded as optimal, underfilled, or overfilled. Postoperative pain was evaluated at 6, 12, 24, 48 h-time intervals using a four-point pain intensity scale. Statistical analysis was performed for the collected data. RESULTS Among the three groups, group-I revealed a greater number of optimally filled teeth (85%) & less instrumentation time (74.75 s) followed by group-II & manual-K file group (p < 0.05). The hand K-file group had significantly more postoperative pain than the two rotary groups (p < 0.05). CONCLUSION the tested rotary file systems resulted in better obturation quality, less instrumentation time, and less postoperative pain compared to manual-K files during primary teeth pulpectomy.
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Affiliation(s)
- Shimaa M Hadwa
- Pediatric Dentistry, Oral Health, and Preventive Dentistry Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Rehab F Ghouraba
- Oral Medicine, periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Ibrahim A Kabbash
- Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shaimaa S El-Desouky
- Pediatric Dentistry, Oral Health, and Preventive Dentistry Department, Faculty of Dentistry, Tanta University, Tanta, Egypt.
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Elheeny AAH, Sermani DI, Abdelmotelb MA. Postoperative pain perception and associated risk factors in children after continuous rotation versus reciprocating kinematics: A randomised prospective clinical trial. AUST ENDOD J 2023; 49 Suppl 1:345-352. [PMID: 37026535 DOI: 10.1111/aej.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 04/08/2023]
Abstract
To compare the postoperative pain of continuous rotation and reciprocating movements after pulpectomy of non-vital primary molars and determine associated risk factors. 146 children aged 4-8 years with one primary molar indicated for pulpectomy were randomly assigned to two equal groups: those instrumented with continuous rotation motion (Hyflex EDM Coltene/Whaledent) and reciprocating motion (Reciproc R25 (VDW)). A 4-point pain scale was used to assess postoperative pain frequencies, which were compared at different intervals using the Chi-square test. Postoperative pain risk factors were determined using logistic regression analysis. There was no statistically significant difference between the follow-ups. Gender, pulp status, and radiographic radiolucency increased the risk of postoperative pain incidence. Postoperative pain likelihood in children with chronic apical periodontitis was 8.72 times that of children with necrotic pulps. Postoperative pain after instrumentation with both kinematics was comparable. Postoperative pain incidence is increased by preoperative pulp condition, radiographic radiolucency, and gender.
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Affiliation(s)
- Ahmad Abdel Hamid Elheeny
- Department of Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
| | - Dania Ibrahem Sermani
- Department of Paediatric Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
- Intern at Minia University Minia Hospital, Minia University, El Minia, Egypt
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Incidence of Post-Operative Pain following a Single-Visit Pulpectomy in Primary Molars Employing Adaptive, Rotary, and Manual Instrumentation: A Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020355. [PMID: 36837556 PMCID: PMC9966361 DOI: 10.3390/medicina59020355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/05/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives. To differentiate the intensity of postoperative pain after primary molar pulpectomy employing manual instrumentation versus two single-file systems with different kinetics (the XP-Endo shaper file with adaptive instrumentation vs. the Kedo-SG blue file with continuous rotation instrumentation). Materials and Methods. This three-arm, single-blind, randomized clinical trial included assessing 75 healthy children between 4 to 9 years who required pulpectomy for primary molars (mandibular first and second). The three groups each had an equal number of children. Children in Group 1 had their teeth instrumented with the XP-endo Shaper, children in Group 2 had their teeth instrumented with the Kedo-SG Blue file, and children in Group 3 had their teeth instrumented manually using K-files. The degree of postoperative pain was measured using a four-point pain scale at 6-, 12-, 24-, 48-, and 72-h following therapy. Each participant's parent received five flashcards with four faces and a word characterizing each face. The data were analyzed using Kruskal-Wallis and chi-square tests. The level of significance was set to 5%. Results. During the follow-up period, there was a significant difference in postoperative pain intensity between the three groups. The XP-endo shaper was associated with considerably decreased post operative at the 6- and 12-h interval followed by Kedo-SG. The highest post-operative discomfort across the groups was related to the patients who underwent manual instrumentation. Conclusion. In comparison to rotary and manual instrumentation, postoperative pain severity was reduced with adaptive instrumentation.
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Abd El Fatah YAM, Khattab NMA, Gomaa YF, Elheeny AAH. Cone-beam computed tomography analysis of primary root canals transportation and dentin loss after instrumentation with two-pediatric rotary files. BMC Oral Health 2022; 22:214. [PMID: 35641977 PMCID: PMC9153195 DOI: 10.1186/s12903-022-02245-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/18/2022] [Indexed: 12/05/2022] Open
Abstract
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.
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