Evaluation of Paste and Aqueous Lubricants on the Incidence of File Breakage, Quality of Obturation and Postoperative Pain in Children after Pulpectomy in Primary Teeth: A Randomised Clinical Trial

Abstract

Introduction: Pulpectomy in primary teeth involves various steps, including tooth isolation, access opening, canal instrumentation, and obturation. Lubricants are commonly used in the biomechanical preparation of root canals to suspend and emulsify debris generated by the mechanical action of hand and rotary files. While paste-type lubricants (Prime Dental RC Help) and aqueous lubricants (17% aqueous Ethylenediaminetetraacetic acid [EDTA]) are available for use, there is a lack of studies in the literature documenting the effects of these lubricants on file fracture, obturation quality, and postoperative pain. Aim: To compare the effects of paste-type lubricants with aqueous lubricants on file breakage, quality of obturation, and postoperative pain in children treated with pulpectomy in primary teeth. Materials and Methods: This randomised clinical trial involved 40 primary teeth, evenly distributed for instrumentation using Kedo-S Plus pediatric rotary files. In Group 1 (n=20), paste-type lubricant was used during canal preparation, while in Group 2 (n=20), aqueous lubricant was used. The clinician recorded data on file fractures, evaluated the quality of obturation using immediate postoperative radiographs, and measured postoperative pain using the Four-point facial pain intensity rating scale. Descriptive statistics were performed once the data was tabulated. Results: Total of 40 primary teeth were included, participants aged 4-9 years, 22 girls and 18 boys. There was no incidence of file fracture in the group-2 treated with aqueous lubricants. Regarding the quality of obturation, the group-1 treated with paste-type lubricant had a higher number of under-fill and over-fill cases (p=0.002, 0.001), while no statistically significant difference was observed between the groups in terms of optimal fill (p=0.661). At 6, 12, 24, and 48 hours, there was no difference in pain experienced by the participants in both groups (p>0.05). Conclusion: During rotary instrumentation in primary teeth, aqueous lubricants were found to be more effective than pastetype lubricants in preventing file breakage, providing optimal obturation quality, and reducing postoperative pain.