Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial

Comparative Evaluation of Effectiveness of Rotary and Hand File Systems in Terms of Quality of Obturation and Instrumentation Time among Primary Teeth: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Aim

This systematic review and meta-analysis aimed to answer the following focused question: Are rotary file systems more effective than hand file systems in terms of the quality of obturation and instrumentation time among primary teeth?

Study eligibility criteria participants and interventions

The inclusion criteria comprised studies that compared the effect on quality of obturation and instrumentation time among primary teeth after using rotary and hand file systems for biomechanical preparation of the root canals.

Materials and methods

This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included Medline (via PubMed), EBSCO, and Google Scholar. Articles published from January 2000 to December 2021, but only in English, were included.

Results

The search resulted in 8,003 published studies. After the removal of duplicate studies and full-text analysis, 9 studies were selected for systematic review, and 8 were selected for meta-analysis. Overall, the results demonstrated the promising effects of rotary file systems in reducing instrumentation time and improving obturation quality compared to hand files.

Conclusion

Within the limitations of this review, it can be asserted that rotary file systems are superior to hand files in primary teeth for pulpectomy procedures.

Clinical significance

Rotary files, a more recent technique, are more efficient than traditional hand files in lowering the time required for instrumentation. Additionally, they provide superior obturation quality in primary molars, making them particularly beneficial for pediatric patients.

How to cite this article

Gala UP, Kalaskar R, Vinay V, et al. Comparative Evaluation of Effectiveness of Rotary and Hand File Systems in Terms of Quality of Obturation and Instrumentation Time among Primary Teeth: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Clin Pediatr Dent 2024;17(8):962-969.

Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial

Background

Single-visit pulpectomy (SVP) protocol with rotary files is highly recommended for the treatment of teeth with irreversible pulpitis. Various rotary endodontic files specially designed for use in the pediatric population are available. The aim is to clinically assess the parameters related to the time required for biomechanical preparation (TBMP) and quality of filling using a single file system vs a sequential multi-file system in infected primary mandibular molars.

Materials and methods

A total of 45 infected primary molars were allocated to three groups (two experimental groups (n = 15) and a control group. The first experimental group was instrumented using NiTi K-Flex files, the second group with a single file rotary system with variably variable (VV) taper, and the third with a sequential multi-file system with constant taper. Biomechanical preparation time was recorded and standardized digital radiograph (RVG) were taken pre- and postinstrumentation. The data recorded was sent for statistical analysis.

Conclusion

There is a substantial reduction of TBMP in primary molars using single file VV taper and multi-sequential file constant taper. Obturation time for all three file systems was comparable and there were no differences between the three file systems used (p > 0.05). Multi-sequential file constant taper files showed a higher probability of optimal obturations and minimal voids followed by NiTi "K-Flex" files and single file system but the difference was nonsignificant (p > 0.05). However, using a rotary in primary teeth results in better canal shape, and less TBMP leading to a better quality of treatment in less time.

How to cite this article

Shetty B, Singh R, Patil V, et al. Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(S-3):S247-S252.

Incidence of Post-Operative Pain following a Single-Visit Pulpectomy in Primary Molars Employing Adaptive, Rotary, and Manual Instrumentation: A Randomized Clinical Trial

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.

Evaluation of quality of obturation in 6-9-year-old children

The effectiveness of root canal therapy is dependent on the quality of obturation. The objective of the current study was to evaluate the obturation quality in pediatric patients of age 6-9 years reporting for pulpectomy treatment. Among the comprehensive data of patients attending Saveetha Dental College, a retrospective analysis of all the patients referred for pulpectomy was extracted. SPSS software version 19 was used to analyze the data gathered. Data were statistically evaluated using the Chi-square test. RESULTS: In the present study carried out, it was observed that the most frequent quality of obturation was normal (12.36%) and it is higher in the 7-year-old age category. The second frequent quality of obturation was voids (6.55%) and its higher in the 9-year-old age category. The results obtained were positively significant (P < 0.05). The most frequent quality of obturation was normal and it is higher in the 7 years category. The second frequent quality of obturation was voids with higher level in the 9 years category.