Correlation between quality of obturation and outcome of pulpectomized primary molars following root canal instrumentation with pediatric rotary file systems

Abstract

IntroductionThe success of root canal treatment is influenced by several factors including the type and technique of root canal preparation, the type of irrigants used, the quality of obturation, and post-endodontic restoration. Recent systematic reviews have concluded that there is no substantial evidence to establish the superiority of rotary file systems over hand files in terms of clinical and radiographic success in pulpectomized teeth. AimTo determine the correlation between quality of obturation and long-term outcome of pulpectomized primary molars following root canal instrumentation with pediatric rotary file systems and a hand file system. MethodsThe study involved 100 primary molars from children aged 4–7 years that required pulpectomy. The teeth were divided into four groups, each consisting of 25 teeth. In the first, second, third, and fourth groups, root canal instrumentation was carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-SG pediatric rotary files (Group KS), Pro-AF Baby Gold pediatric rotary files (Group BG), and hand nickel titanium K files (Group HF), respectively. Obturation was performed with zinc oxide eugenol cement using an engine-driven Lentulo-spiral. The quality of the root filling was assessed immediately after obturation through radiographic examination. The pulpectomized teeth were then evaluated both clinically and radiographically over a two-year period. ResultsThe quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to hand files. At the end of follow-up period, the clinical success rate was 100% and the radiological success rates were 88%, 92%, 92%, and 80% in Groups PF, KS, BG, and HF, respectively. The optimally filled pulpectomized primary molars resulted in a superior success rate than compared to underfilled or overfilled teeth. ConclusionThe quality of obturation significantly influences the success rate of pulpectomized teeth. Therefore, the use of pediatric rotary files is recommended as rotary files contribute to a greater number of optimally filled canals.