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

Endodontic treatment of a C-shaped mandibular second molar with narrow dentinal thickness: A case report

Formulating an effective root canal treatment plan necessitates clinician awareness of the complexities of the root canal system and possible anatomic challenges. The C-shaped canal variation accompanying the radicular lingual groove makes the lingual dentinal wall so thin that cleaning and shaping of canals require accurate management. This report presents endodontic treatment of a C-shaped mandibular second molar diagnosed with pulpal necrosis and asymptomatic apical periodontitis, that initial radiographic assessment revealed extremely thin (0.3 mm) width of the lingual wall of the canals prone to perforation. Mechanical preparation was performed through the anti-curvature technique and basically by chemical irrigation rather than mechanical instrumentation. The C-shaped isthmus was prepared up to 25/02 rotary system without dentinal defect while maintaining adequate dentin thickness so as to not significantly reduce the strength of the root. Follow-up radiographs showed normal periodontal ligament and lamina dura indicating significant healing of the periapical lesion.

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.

Rotary versus Manual Instrumentation for Root Canal Preparation in Primary Teeth: A Systematic Review and Meta-Analysis of Clinical Trials

Objectives

The aim of this systematic review was to assess the scientific evidence on the effect of rotary versus manual instrumentation for root canal preparation in primary teeth.

Materials and Methods

Search terms were selected based on Medical Subject Headings (MeSH) and non-MeSH terms. Electronic database search of English published literature was performed in March 2020 within the following databases: Scopus, Cochrane, PubMed, and Embase. The risk of bias of selected studies was assessed by means of Cochrane collaboration tool. The heterogeneity level among the included studies was measured by I ² index. For statistical analysis of instrumentation time, standard mean difference (SMD) of continuous data was analyzed with 95% confidence intervals (95% CIs) using the fixed-effects model. A random-effects model was used for analysis of odds ratio (OR) to assess the probability of optimal fill, underfill, and overfill obturations. Forest plots were applied to show the results and to estimate the effectiveness of rotary instrumentation.

Results

Seven articles were selected for this review. The SMD in rotary techniques was 1.79 min less than manual techniques (95% CI: -2.56--1.03 min) and had a significant P = 0.001. The OR of optimum quality was calculated to be 3.53 (95% CI: 1.79-6.97) in the rotary technique at P = 0.254.

Conclusions

Within the limitations of this review, it can be asserted that rotary files decrease the instrumentation time and increase the rates of optimally filled canals in primary teeth. However, these files do not decrease the risk of underfilling and overfilling compared to manual files.

Influence of Rotation Speed of Mtwo Files on Root Canal Instrumentation Time with Different Canal Curvatures

Introduction

The aim of this study was to analyze the effect of rotation speed on the instrumentation time of root canals with different curvatures using Mtwo NiTi rotary instruments.

Methods and Materials

Forty root canals were selected and divided into 2 groups, according to the angle of curvature (group A>30^°, group B<30^°). Both groups were divided into 2 subgroups (n=10), according to the rotational speed used for root canal instrumentation (150 rpm: group A1 and B1; 250 rpm: group A2 and B2). The total instrumentation time and the total number of instrumentation cycles (NCI) required to complete root canal preparation were registered for each canal. The mean and standard deviation were then calculated. Data were then statistically analyzed using two-way ANOVA and interaction effect P-values (P<0.05).

Results

During root canal instrumentation, there were no file fractures. Total instrumentation time of the low speed groups A1 (150 rpm) and B1 (150 rpm) were significantly higher (P<0.05) than that of the high speed groups, A2 (250 rpm) and B2 (250 rpm); however, there was no statistically significant difference in terms of NCI between the different groups (P>0.05). Statistical difference was not found between the different angles of curvature, group A1 vs B1 and A2 vs B2 in terms of total instrumentation time (P>0.05) and NCI (P>0.05).

Conclusions

This ex-vivo study showed that canal preparation with Mtwo rotary files could be completed safely with an increase of the instrumentation time at low rotational speed independently of the root canal curvature.

Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial

Objective:

In permanent dentition, different rotary systems are used for canal cleaning and shaping. Rotary instrumentation in pediatric dentistry is an emerging concept. A very few studies have compared the efficiency of rotary instrumentation for canal preparation in primary teeth. Hence, this study was performed to compare the obturation quality and instrumentation time of two rotary files systems – Protaper, Mtwo with hand files in primary molars.

Materials and Methods:

Forty-five primary mandibular molars were randomly allotted to one of the three groups. Instrumentation was done using K-files in Group 1; Protaper in Group 2; and Mtwo in Group 3. Instrumentation time was recorded. The canal filling quality was assessed as underfill, optimal fill, and overfill. Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey test.

Results:

No significant difference was observed in the quality of obturation among three groups. Intergroup comparison of the instrumentation time showed a statistically significant difference between the three groups.

Conclusion:

The use of rotary instrumentation in primary teeth results in marked reduction in the instrumentation time and improves the quality of obturation.

Assessment of Quality of Obturation, Instrumentation Time and Intensity of Pain with Pediatric Rotary File (Kedo-S) in Primary Anterior Teeth: A Randomized Controlled Clinical Trial

Aim

The purpose of this study was to clinically compare and evaluate the efficiency of pediatric rotary file kedo-S with hand K files and ProTaper rotary files during root canal preparation of primary anterior teeth.

Materials and methods

Forty-five children requiring pulpectomy in any one of the vital primary anterior teeth were included. The children were randomly assigned to one of the three groups (15 per group), where the instrumentation was done using hand files in group 1, ProTaper rotary files in group 2 and Kedo-S rotary files in group 3. The instrumentation time, pain perception and the quality of obturation was assessed, and the statistical analysis was done using statistical package for social sciences (SPSS) software.

Results

Statistically decreased instrumentation time was observed with the use of Kedo-S rotary file system (p < 0.05) when compared to the other two file systems. The intensity of pain experienced during instrumentation was also lesser with Kedo-S rotary file (p < 0.05). No significant difference was noted in the obturation quality with the exclusive pediatric rotary file when compared with the other two groups (p > 0.05).

Conclusion

Kedo-S rotary files decrease the instrumentation time and intensity of the pain perception during canal instrumentation which positively influences the cooperation of the children.

Clinical significance

Use of exclusive pediatric rotary files (Kedo-S) for root canal preparation in primary teeth reduces the fatigue of both the children and the dentists. Also, influences the behavior of the children in a more positive way thereby instilling a positive dental attitude.

How to cite this article

Govindaraju L, Jeevanandan G, Subramanian EMG, Vishawanathaiah S. Assessment of Quality of Obturation, Instrumentation Time and Intensity of Pain with Pediatric Rotary File (Kedo-S) in Primary Anterior Teeth: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent, 2018;11(6):462-467.

Comparative evaluation of instrumentation timing and cleaning efficacy in extracted primary molars using manual and NiTi rotary technique - Invitro study

Aim

To compare the timing of instrumentation and cleaning efficacy between manual K files and NiTi rotary files in extracted primary molars.

Study design

in-vitro study was conducted in 90 root canals of extracted primary molars which were subdivided in three groups viz. Control (No instrumentation), Manual (K files), Rotary (ProFiles) with 30 canals in each group. Mesiobuccal (MB) and Mesiolingual (ML) canals of mandibular molars, and MB and Distobuccal (DB) canals of maxillary molars were included in the test group whereas Distal canals in mandibular molars and Palatal canals in maxillary molars were included in the control group.

Method

Teeth were mounted and canals were injected with India ink to stain the canal walls. Canal preparation was done as per the group. After instrumentation, teeth were demounted, decalcified and cleared to make them transparent for scoring according to the extent of removal of India ink. Timing of instrumentation and cleaning efficacy of canals in coronal, middle and apical thirds were assessed in each sample.

Results

Mean timing of instrumentation in rotary group was 3.54 ± 1.14 min and 4.32 ± 1.04 min in manual group. Mean cleaning efficacy scores in manual and rotary groups were 2.03 and 1.66 in coronal third, 1.08 and 1.18 in middle third and 0.67 and 1.08 in apical third respectively. Inter-group comparisons showed no statistically significant difference in cleaning efficacy among test groups in all thirds of root canals.

Conclusion

NiTi rotary technique has comparable cleaning efficacy, with significantly less timing of instrumentation compared to manual K-files.

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.

Comparative Evaluation of Efficiency of Different File Systems in Terms of Remaining Dentin Thickness Using Cone-Beam Computed Tomography: An In vitro Study

Background

Endodontic therapy treats inside of the tooth and its success is based upon the triad of thorough canal debridement, effective disinfection, and obturation of the canal space. Thus, one of the most important steps is biomechanical preparation, which is the key stage of endodontic treatment with a predictive success factor if performed properly.

Aim

The aim of the study is to evaluate and compare the cleaning efficiency of different file systems in terms of remaining dentin thickness.

Materials and Methods

A total of thirty permanent extracted anterior teeth were taken for the study and was divided into three groups - Group I - Manual Protapers, Group II - Rotary Mtwo, and Group III - Reciprocating WaveOne file systems. Pre-cone-beam computed tomography (CBCT) scan was taken followed by biomechanical preparation by the respective file groups. Post-CBCT scan was taken and the pre- and post-CBCT scans were compared for remaining dentin thickness. Data were analyzed with ANOVA (P = 0.001).

Statistical Analysis Used

ANOVA test was used in this study.

Results

Protaper showed minimum reduction in dentin thickness followed by Mtwo and WaveOne showed maximum reduction in dentin thickness, but the intergroup comparison was found to be highly insignificant.

Conclusion

WaveOne is a highly recommended rotary endodontic instrument which does not cause significant lowering in remaining dentin thickness after biomechanical preparation.

Root Preparation of Deciduous Teeth: Efficacy of WaveOne and ProTaper Systems with and without Passive Ultrasonic Irrigation

INTRODUCTION

The aim of this study was to compare root preparation of deciduous teeth with WaveOne Large (WO) and ProTaper F4 (PT) instruments with or without passive ultrasonic irrigation (PUI).

METHODS AND MATERIALS

Forty-eight deciduous teeth were scanned before and after root preparation and divided in four groups (n=12): WO+EDTA (WO); WO+EDTA with PUI (WOPUI); PTF+EDTA (PT); and PT+EDTA with PUI (PTPUI). Root canal enlargement by micro-computed tomography and root canal cleaning by scanning electron microscopy (SEM) were analyzed. Data were submitted to two-way ANOVA and Tukey's tests to analyze the root canal volume variation, and Kruskal-Wallis followed by Friedman and Wilcoxon tests were used to evaluate the cleaning efficacy. The level of significance was set at 0.05.

RESULTS

No significant difference occurred in total volume between groups (P>0.05). On analysis by thirds of the root canal, there was a difference in volume between WO (cervical) compared to WO and PT (apical), and PTPUI (middle and apical) (P<0.05). When cleaning of the thirds within the same group was compared, there was a significant difference in all groups (P<0.05). Among the groups, in the thirds, in the cervical a difference occurred (P=0.028), and the pairwise comparisons indicated statistically difference between WO and PT, and WO and PTPUI (P<0.05). In the pairwise comparisons among thirds, in the groups, difrences occured in all of them when compared the cervical and apical thirds (P<0.05).

CONCLUSION

Passive ultrasonic irrigation has not improved the smear layer removal in deciduous teeth. Despite the differences in performance between WO and PT instruments, both were suitable for preparation of deciduous teeth.