Assessment of clinical and radiographic efficiency of manual and pediatric rotary file systems in primary root canal preparation: a randomized controlled clinical trial

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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.

Key points

Paediatric rotary files allow for effective root canal preparation and reduced chairside time.

CBCT technique’s simplicity with better image quality makes it comfortable for children.

Less postoperative pain is associated with less debris extrusion into peri-radicular tissues using pediatric rotary files.

Related collections

Most cited references 23

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Clinical recommendations regarding use of cone beam computed tomography in orthodontics. [corrected]. Position statement by the American Academy of Oral and Maxillofacial Radiology.

(2013)

To summarize the potential benefits and risks of maxillofacial cone beam computed tomography (CBCT) use in orthodontic diagnosis, treatment and outcomes and to provide clinical guidance to dental practitioners. This statement was developed by consensus agreement of a panel convened by the American Academy of Oral and Maxillofacial Radiology (AAOMR). The literature on the clinical efficacy of and radiation dose concepts associated with CBCT in all aspects of orthodontic practice was reviewed. The panel concluded that the use of CBCT in orthodontic treatment should be justified on an individual basis, based on clinical presentation. This statement provides general recommendations, specific use selection recommendations, optimization protocols, and radiation-dose, risk-assessment strategies for CBCT imaging in orthodontic diagnosis, treatment and outcomes. The AAOMR supports the safe use of CBCT in dentistry. This position statement is periodically revised to reflect new evidence and, without reapproval, becomes invalid after 5 years. Copyright © 2013. Published by Mosby, Inc.

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Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition.

J Coll, R Sadrian (2015)

This study evaluated factors that affected pulpectomy (PE) success and its effect on the succedaneous tooth's eruption and enamel formation. Sixty-five of 250 patients with PEs met the selection criteria and yielded 81 zinc oxide-eugenol PEs (30 incisors, 51 molars) followed a mean time of 90.8 months. Overall PE success was 77.7% with no difference between molars and incisors (P = 0.53). Enamel defects were observed in 18.7% of succedaneous teeth and were related (P = 0.005) to the pre-existing infection causing excess root resorption (>1 mm preoperative root resorption = 44.4% defects) but were not related to overretention of ZOE filler (P = 1) or length of fill (P = 0.36). The PE procedure was not related to causing succedaneous tooth defects since teeth replacing PEs showed no significant increase in the incidence of defects compared with untreated contralateral controls (P = 0.99). There was a 20% incidence of succedaneous tooth anterior cross-bite or palatal eruption following incisor PEs and 21.6% ectopic eruption of premolars following primary molar PEs. Most PEs (95.9%) were lost at their normal exfoliation time or earlier, but 35.8% needed extraction due to overretention by soft tissue at the time of shedding. Pulpectomy success rates showed that the most important preoperative predictor was the amount of primary tooth root resorption. Greater than 1 mm of root resorption resulted in only a 23.1% success rate, which was significant (P = 0.001). Pulpectomies filled short or to the apex had a significantly greater success (P = 0.011) than long fills. Pulpectomies correctly done do not appear to contribute to adverse effects on succedaneous tooth formation but have a 20% chance of altering the path of permanent tooth eruption.

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Use of nickel-titanium rotary files for root canal preparation in primary teeth.

E Barr, D J Kleier, N V Barr (2015)

This article reviews the use of nickel-titanium rotary files for root canal instrumentation in primary teeth. The pulpectomy technique is described and the advantages and disadvantages of using rotary files are discussed. Specific recommendations for the selection of materials and devices are made.

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Author and article information

Contributors

Shimaa M. Hadwa: shimaa.hadwa@dent.tanta.edu.eg

Rehab F. Ghouraba: rehab_gharabah@dent.tanta.edu.eg

Ibrahim A. Kabbash: Ibrahim.kabbash@med.tanta.edu.eg

Shaimaa S. EL-Desouky: shaimaaeldesouky@dent.tanta.edu.eg

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 23 September 2023

Publication date PMC-release: 23 September 2023

Publication date Collection: 2023

Volume: 23

Electronic Location Identifier: 687

Affiliations

[1 ]Pediatric Dentistry, Oral Health, and Preventive Dentistry Department, Faculty of Dentistry, Tanta University, ( https://ror.org/016jp5b92) Tanta, Egypt

[2 ]Oral Medicine, periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Tanta University, ( https://ror.org/016jp5b92) Tanta, Egypt

[3 ]Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, ( https://ror.org/016jp5b92) Tanta, Egypt

Article

Publisher ID: 3393

DOI: 10.1186/s12903-023-03393-1

PMC ID: 10518081

PubMed ID: 37742023

SO-VID: 15b4879a-6c24-4424-98c4-1189c059e245

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 11 June 2023

Date accepted : 7 September 2023

Funding

Funded by: Tanta University

Open Access :

Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: cone-beam computed tomography,pediatric rotary file,instrumentation,obturation

Data availability:

ScienceOpen disciplines: Dentistry

Keywords: cone-beam computed tomography, pediatric rotary file, instrumentation, obturation

Assessment of clinical and radiographic efficiency of manual and pediatric rotary file systems in primary root canal preparation: a randomized controlled clinical trial

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Abstract

Introduction

Aim

Methods

Results

Conclusion

Key points

Related collections

International Journal of Medicine and Medical Research

Most cited references 23

Clinical recommendations regarding use of cone beam computed tomography in orthodontics. [corrected]. Position statement by the American Academy of Oral and Maxillofacial Radiology.

Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition.

Use of nickel-titanium rotary files for root canal preparation in primary teeth.

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Contributors

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