Comparative Evaluation of Instrumentation Time, Obturation Time, and Radiographic Quality of Obturation Using Two Rotary Systems and Manual Technique for Primary Molar Pulpectomies – In vivo Study

Abstract

Background: Ideal pulpectomy for primary dentition demands fast, simple procedures, with short treatment times and minimal appointments. Recently, exclusive pediatric rotary files are available for use in primary teeth. There is a paucity of literature on the clinical efficacy of pediatric rotary files. Hence, this study was planned to evaluate and compare pediatric rotary files and K-files. Aim: The aim of this study was to evaluate and compare instrumentation time, obturation time, and radiographic quality of obturation using rotary systems (Kedo-S; Pro-AF Baby GOLD files) and manual (K-files) technique in primary molar pulpectomies. Materials and Methods: Forty-five primary mandibular molars from 42 children aged 5–9 were selected. Single-visit pulpectomy was performed after dividing selected teeth into three equal groups: (i) K-files, (ii) Kedo-S files, (iii) Pro-AF Baby GOLD files. Instrumentation and obturation times were recorded during the procedure. Immediate postoperative radiographs were taken and evaluated later for obturation quality by two independent evaluators blinded to the instrumentation technique. The results were then statistically analyzed. Results: Kedo-S (Group II) files required the least instrumentation time followed by Pro-AF (Group III) and K-files (Group I). The superior quality of obturation in lesser time was achieved using Pro-AF files (Group III) followed by Kedo-S (Group II) and K-files (Group I). Conclusion: Pediatric rotary files are efficient alternatives to hand instrumentation and can be considered as the standard of care in pulpectomies of primary teeth.

Evaluation of rotary file system (Kedo-S-Square) in root canal preparation of primary anterior teeth using cone beam computed tomography (CBCT)-in vitro study

“…Usage of hand files in preparation of curved canals frequently causes undesirable aberrations such as elbows, zips and danger zones because of their inherent stiffness [ 35 ]. Consequently, usage of stainless‑steel files in narrow curved canals is considered to be difficult as apical enlargement is limited, hindering good quality obturation [ 36 ].…”

“…Hence, a greater amount of dentin was removed by hand files than by rotary Kedo S Square file,which could be attributed to the non-cutting safety tip of the Kedo S Square files and to the indiscriminate and aggressive cutting action of stainless-steel files [ 36 ]. H type instrument has better cutting efficiency than K type instruments because H file has a positive rake angle where its blade cuts rather than scarps dentin unlike the K file having a negative rake angle [ 53 ].…”

Uso de sistemas rotatórios no tratamento endodôntico em odontopediatria

“…Todos os estudos avaliados neste trabalho demonstraram que o uso das limas rotatórias diminui consideravelmente o tempo de instrumentação dos canais de dentes decíduos, quando comparados ao tempo de instrumentação das limas manuais. Além disso, Shah et al, (2021) A presença dos pais durante o tratamento dentário não influencia no comportamento das crianças. Os pais e os dentistas observaram uma piora no comportamento das crianças quando os pais estavam ausentes.…”

“…Os estudos que abordaram a qualidade da obturação em canais de dentes decíduos mostraram que o preenchimento desses canais obteve melhor qualidade quando foram tratados através de instrumentos endodônticos rotatórios, quando comparados aos instrumentos manuais. (Boonchoo et al, 2020;Govindaraju et al, 2017;Jeevanandan et al, 2021;Lakshmanan et al, 2020;Pawar et al, 2021;Shah et al, 2021).…”

“…Dessa forma, limas rotatórias foram associadas a um menor tempo de instrumentação dos canais, já que ocorreu uma redução de 20% do tempo entre os sistemas de limas. Sobre a qualidade de obturação desses canais, os resultados mostraram que os sistemas de limas rotatórias apresentaram um maior número de obturações de canais ideais em relação aos sistemas manuais.Por outro lado,Shah et al, (2021) compararam o tempo de instrumentação, o tempo e a qualidade de obturação entre sistemas de limas manuais e rotatórias em pulpectomias de molares decíduos. Limas manuais possuíram um maior tempo médio necessário para a instrumentação, com 27,87 minutos, e os dois outros sistemas de limas rotatórias apresentaram tempo médio de 19,25 minutos e 21,89 minutos.…”