Quality Of Obturation Research Articles

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

IntroductionThe 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.Aimto 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).MethodsA 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.ResultsAmong 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).Conclusionthe 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.

Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study.

To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon® (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus® (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow® (SCGF). Pre- and postoperative periapical radiographs were performed to detect the presence of endodontic lesions (PAI classification) and to assess the quality of both the obturation and the restoration. Tooth- and patient-related data were collected. The overall endodontic success rate was 75.4% after a mean observation period of 6.3 years. There were no significant correlations between the type or overall quality of obturation and the treatment outcome. Teeth with preoperative lesions had the highest odds ratio (factor of 4.98) for endodontic failure. Tooth- and patient-related variables had no significant effect on endodontic outcome. The preoperative periapical status of teeth requiring endodontic treatment was a substantial prognostic factor for endodontic outcome, whereas the type of obturation material or technique did not affect it.

Cone-Beam Computed Tomography Evaluation of Rotary MM Files vs Manual K Files in Primary Molars: An In Vitro Study.

Rotary instrumentation in pediatric dentistry is an emerging concept, thus this study was performed to evaluate the remaining dentine thickness (RDT), canal transportation, centering ability, quality of obturation using cone-beam computed tomography (CBCT), and the time efficiency of rotary versus manual instrumentation in mandibular second primary molars. Forty mandibular primary second molars (160 canals) were randomly and equally allocated to four groups. Instrumentation was done using K files in groups I and II; in each group, the obturation was done by two different obturation techniques; incremental technique and disposable syringe technique, respectively. MM rotary files (Innovative Material and Devices, Inc. [IMD], Shanghai, China) were used in groups III and IV; in each group, the obturation was done by incremental technique and disposable syringe technique. Preoperative and postoperative CBCT scans were performed and evaluated for the RDT, centering ability, canal transportation, and the canal filling quality, which was assessed as (underfill, optimal fill, and overfill). Instrumentation time was recorded for groups I and II collectively (manual instrumentation), and groups II and III collectively (rotary instrumentation). Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey tests, at p < 0.05). The MM rotary file removed a significantly less amount of dentine at all levels specifically at the middle section (p = 0.003). The canal transportation was significantly higher in the manual group at the cervical level (p = 0.022). In all sections, the rotary group had significantly higher values of centering ratio than the manual group (p < 0.05), which means a lower deviation of rotary instruments. For both types of files, there was no significant difference between different obturation techniques (p > 0.05). Instrumentation time was significantly lower in the rotary group (p < 0.001). Regarding the dentine removal and the shaping ability of MM files acceptable results were obtained; however, no significant difference between the different obturation techniques. Notable time efficiency was reported in the rotary files as well. The use of rotary files resulted in better conservation of tooth structure, better canal centering, and obturation quality as well as less canal transportation and less instrumentation time compared to manual K files.

Influence of the quality of canal obturation and prosthetic restoration on the peri-apical region

The periapical inflammatory lesion of endodontic origin (LIPOE) is a very common condition and constitutes both a diagnostic and a therapeutic challenge in dentistry. The present study aims to describe the frequency of LIPOE after endodontic treatment consecutive to the quality of root canal fillings and prosthetic restorations of abutment teeth and to identify the qualities of root canal fillings and prosthetic restorations associated with the occurrence of LIPOE. This is a prospective, descriptive and cross-sectional study carried out from March 2019 to August 2022. One hundred and eighty patients wearing Joint Prostheses for at least 2 years with endodontically treated abutment teeth have been recruited; the evaluation of the quality of prosthetic restoration was established according to the criteria of Hickel R while the quality of the root canal filling was judged according to the criteria of Schaeffer MA. The frequency of LIPOE on the abutment teeth was 59.4%. The results highlighted that inadequate quality of prosthetic restoration and root canal filling is associated with the occurrence of LIPOE with a highly significant difference (p˂0.000) In order, to reduce the prevalence of LIPOE and mitigate its effects, it is essential to follow the rules of the art when considering mechanical and biological imperatives during endodontic treatment, as well as good training in prosthetic restoration.

Success Rate and Related Factors of Vitapex Pulpectomy in Primary Teeth: A Retrospective Study.

Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth. This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression. The Kaplan-Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors. In total, 647 Vitapex PE teeth from 448 patients (19-121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate. The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.

Effect of orthodontic treatment on the periapical radiolucency of endodontically treated teeth: a CBCT analysis

BackgroundThis study aimed to evaluate periapical radiolucency of endodontically treated teeth before and after orthodontic treatment using cone-beam computed tomography (CBCT).MethodsPatients who underwent orthodontic treatment at Wonkwang University Daejeon Dental Hospital between January 2009 and June 2022 were included based on the following criteria: root canal treatment, and availability of CBCT images taken before and after orthodontic treatment with an interval of > 1 year between both scans. Patients with primary teeth or orthodontic tooth extractions were excluded. The size of the periapical radiolucency (SPR) of the endodontically treated tooth was evaluated using CBCT. Pre-orthodontic treatment CBCT images and the latest post-orthodontic treatment CBCT images were analyzed. The selected teeth were further categorized based on the orthodontic duration, CBCT interval, the patient sex and age, the tooth type and position (maxilla or mandible), and quality of root canal obturation. Statistical analyses were performed to evaluate changes in SPR using the paired t-test and multiple regression analysis.ResultsIn total, 115 teeth (37 anterior teeth, 22 premolars and 56 molars) from 61 patients (age, 14–54 years) were included, with 39 teeth from male patients and 76 teeth from female patients. The age was ranged between 14 and 54 years old, and mean age was 25.87 years old. The mean CBCT interval and orthodontic treatment period were 43.32 months and 36.84 months, respectively. Seventy-five teeth showed good obturation quality, 80 were not used as anchors during orthodontic treatment, and 71 were maxillary. The SPR size increased after orthodontic treatment for 56 teeth and decreased for 59 cases. The average change in SPR was -0.102 mm and the difference was not significant. Significant decrease of SPR were observed between female patients (p = 0.036) and maxillary teeth (p = 0.040).ConclusionOrthodontic treatment had no significant impact on the changes in the SPR in endodontically treated teeth in most categories. However, there was a significant difference among females and the maxillary teeth. In both categories, the size of radiolucency decreased significantly.

Comparative Evaluation of Instrumentation Time and Quality of Obturation amongst Pediatric Rotary Endodontic System: An In Vivo Study.

This study assesses the instrumentation time and quality of obturation of three pediatric rotary endodontic systems-GT nickel-titanium (NiTi) (Prime Pedo), controlled memory (CM) NiTi (Pro-AF-Baby Gold) and NiTi-titanium oxide (NiTi-TiO) (Kedo SG Blue). A total of 60 children aged 4-8 were chosen at random for the study based on inclusion criteria that required pulpectomy in any of the primary molars and were separated into three groups of 20 samples, each based on the file system employed. The instrumentation time during the preparation of the canal is recorded using a stopwatch. An expert dentist was blinded to the instrumentation type and showed the periapical radiograph, which he or she graded depending on the quality of the obturation by categorizing it as underfill, optimal fill, or overfill. The observations were then recorded, tabulated, and statistically analyzed for the results. The least amount of instrumentation time was needed for NiTi-TiO (group III) files, followed by NiTi-CM (group II) and NiTi-GT (group I). NiTi-TiO (group III) has the most optimally filled and least underfilled obturations among the three rotary endodontic systems mentioned. Also, NiTi-TiO (group III) and NiTi-CM (group II) have the least similar overfilled obturations when compared with NiTi-GT (Group I). We conclude that NiTi-TiO needed the least amount of instrumentation time and generated the maximum optimally filled obturations based on our observations. Pediatric rotary endodontic systems are more convenient to use and reduce chairside time; thus, their use in children with behavior control issues might be more suitable. Kohli A, Chhabra J, Sharma K, et al. Comparative Evaluation of Instrumentation Time and Quality of Obturation amongst Pediatric Rotary Endodontic System: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):338-343.

Comparative Evaluation of Four Different Obturating Techniques in Primary Teeth Using Cone-beam Computed Tomography: An In Vivo Study.

The quality of the obturation plays a significant role in the success of endodontic treatment. To date, various technologies have been used to evaluate the quality of obturation, but all of them have their own limitations. In order to overcome those limitations, recent technological advancements like cone-beam computed tomography (CBCT) can be helpful. To compare and evaluate the efficiency of different root canal obturation techniques in primary teeth using CBCT. A total of 80 root canals in 30 children aged between 4 and 9 years were selected and divided into four groups, with 20 root canals in each. Obturation in group I was performed using the endodontic pressure syringe; group II-hand spreaders; group III-Lentulo spirals mounted on slow-speed handpiece; and group IV-insulin syringe. The quality of obturation was evaluated using a CBCT scan. Group I samples showed the most optimally filled canals followed by II and III; least in group IV. A maximum number of overfilled canals was exhibited in group III samples. Voids were minimal in all four groups and the values obtained were not statistically significant. Obturation with an endodontic pressure syringe reported the highest number of optimally filled root canals and the insulin syringe showed the least number of optimally filled canals. Ali SM, Mukthineni S, Sai Sankar AJ, et al. Comparative Evaluation of Four Different obturating Techniques in Primary Teeth using Cone-beam Computed Tomography: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):218-222.

A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification.

The success of the pulpectomy depends on adequate access, cleaning, shaping, and good-quality obturation. Evaluating the quality of obturation is the major tool that determines the success of the procedure. The present study aimed to assess the quality of obturation in all the canals of primary teeth and suggest a new classification. A total of 1,000 radiographs of the pulpectomy procedure performed in primary molars were evaluated. The quality of obturation was assessed for each canal using the criteria given by Coll and Sandrian. The prevalence of each obturation criterion in every canal was represented in the form of a percentage. It was observed that among the mandibular primary molars, most of the mesial canals were underfilled, and in the distal canal, most of the canals were overfilled. Among the maxillary primary molars, most of the mesial canals were overfilled, more distal canals were underfilled, and with respect to palatal canals, optimal obturation was seen. The pitfalls of the previous classification were revised, and a new classification for assessing the quality of obturation was proposed, which is arch, segment, and canal specific. The new classification will give a more precise assessment for the evaluation of various techniques and materials used for pulpectomy in primary teeth. Jeevanandan G, Govindaraju L, Kotian N, et al. A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification. Int J Clin Pediatr Dent 2023;16(2):376-379.

Laboratory study of the quality of root canal obturation in the application of various techniques of medical treatment

Laboratory study of the quality of root canal obturation in the application of various techniques of medical treatment

Experimental validation of computer-vision methods for the successful detection of endodontic treatment obturation and progression from noisy radiographs

Purpose(1) To evaluate the effects of denoising and data balancing on deep learning to detect endodontic treatment outcomes from radiographs. (2) To develop and train a deep-learning model and classifier to predict obturation quality from radiomics.MethodsThe study conformed to the STARD 2015 and MI-CLAIMS 2021 guidelines. 250 deidentified dental radiographs were collected and augmented to produce 2226 images. The dataset was classified according to endodontic treatment outcomes following a set of customized criteria. The dataset was denoised and balanced, and processed with YOLOv5s, YOLOv5x, and YOLOv7 models of real-time deep-learning computer vision. Diagnostic test parameters such as sensitivity (Sn), specificity (Sp), accuracy (Ac), precision, recall, mean average precision (mAP), and confidence were evaluated.ResultsOverall accuracy for all the deep-learning models was above 85%. Imbalanced datasets with noise removal led to YOLOv5x’s prediction accuracy to drop to 72%, while balancing and noise removal led to all three models performing at over 95% accuracy. mAP saw an improvement from 52 to 92% following balancing and denoising.ConclusionThe current study of computer vision applied to radiomic datasets successfully classified endodontic treatment obturation and mishaps according to a custom progressive classification system and serves as a foundation to larger research on the subject matter.

First Experience of an Undergraduate Dental Student with a Reciprocating System in Simulated Root Canals—A Pilot Study

Rotary instrumentation has been proposed in undergraduate teaching. The aim of this study was to evaluate student’s performance, through the obturation quality and treatment time, in a sequential range of L-simulated root canals. A senior undergraduate dental student sequentially prepared randomly numbered canals from 1 to 40, with the WaveOne Gold glider and primary file, according to the manufacturer instructions. A gutta-percha cone matched with the finishing instrument and epoxy resin-based sealer (AH Plus) was selected for the obturation. Three independent observers evaluated the obturation quality according to both density and length. Active, total instrumentation and obturation times were also measured. Statistical analysis was obtained by Mann–Whitney and Kruskal–Wallis tests with a significance level of p &lt; 0.05. The quality of the obturation was independent of the number of prepared canals with adequate length and density in 87.5% of the prepared canals. Both active and total instrumentation, as well as obturation times, reduced significantly as the number of the prepared canals by the student increased (p ˂ 0.05). The use of WaveOne Gold instrumentation and matched cone obturation by an inexperienced operator provided an adequate obturation quality in most of the curved simulated canals. The working time was significantly reduced through a short learning curve.

Evaluation of Novel Device "Obturagun" as a Root Canal Obturating Technique for Primary Teeth: An In Vitro Study.

Pulpectomy is one of the most commonly rendered treatment modalities in primary teeth wherein the pulp is irreversibly inflamed. To evaluate the sufficiency of calculated obturating material and quality of obturation in primary teeth using an obturagun device. Average root canal volume of 65 and 75 was calculated from cone beam computed tomography (CBCT) scans of children in the age-group of 5-9 years. Based on the average root canal volume and density of obturating material (Vitapex), quantity of obturating material required to obturate a single primary mandibular second molar was calculated. Computer-aided design (CAD)/computer-aided manufacturing (CAM) software was used to design obturagun, which was three-dimensional (3D) printed for study purposes. An in vitro pilot study (pulpectomy) was conducted on 20 extracted primary mandibular second molar to evaluate the efficacy of the obturagun. Average root canal volume of 75 was larger than 65. Approximately 68% of the root canals showed optimal obturation. Distal root canals were more void free as compared to mesial. In 70% of the cases, the calculated obturation material was sufficient to obturate a single primary mandibular second molar. Average root canal volume can be used to determine the quantity of obturating material. Obturagun can be used as an alternate obturating technique for primary teeth. Kalaskar R, Thosar NR, Kalaskar A. Evaluation of Novel Device "Obturagun" as a Root Canal Obturating Technique for Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):107-111.

New Ultrasonic Tip for Root Canal Filling of the Mesial Canals of Mandibular Molars with Isthmus: A Laboratory Evaluation Using Computed Microtomography

IntroductionThe obturation quality of the mandibular molar mesial canals and isthmuses with two thermoplastic techniques, ultrasonic vertical condensation (UVC) and continuous wave of condensation (CWC), was evaluated using computed microtomography (μCT). MethodsThirty-six human mandibular molars had been previously scanned and analyzed using μCT for mesial roots with morphologically similar isthmuses for this study. Coronal access and confirmation of foraminal patency were performed, and the actual length of the teeth was established using a clinical microscope (40X magnification). The canals were prepared using ProTaper Gold instruments up to #F3, with 2.5% sodium hypochlorite as the irrigant solution, followed by a passive ultrasonic irrigation protocol. The specimens were randomly divided into the UVC and CWC groups based on the obturation technique to be used. Obturation was performed with #F3 gutta-percha cones cemented using AH Plus Jet sealer. The μCT scans were performed after 15 days, and the images were evaluated by a calibrated examiner blinded to the experimental groups to determine the filling rate of the entire canal area, including the main canal and isthmus. Student's t-test was used for statistical analysis; P values ≤0.05 were considered significant. ResultsNeither of the thermoplastic obturation techniques achieved complete filling of the canals (86.3% for UVC and 91.4% for CWC), with a statistically significant difference between them (P = .029). Conclusions:Under the conditions of the study, it can be concluded that none of the techniques completely filled the canal/isthmus of the mandibular molars; however, the CWC exhibited better performance.

Comparison of obturation quality in natural and replica teeth root-filled using different sealers and techniques

ObjectivesThis study aims to assess the obturation efficacy of sealers placed with different techniques using microcomputed tomography (µCT) and assess the influence of µCT testing parameters on the obturation data obtained.Materials and methodsIncisors and mesial roots of lower molars with standardized root length were scanned using µCT, and one tooth of each type was 3D printed in acrylic. Two obturation techniques (warm vertical and single cone) and 4 sealer types (AH Plus, BioRoot RCS, Totalfill BC, and Bio-C Sealers) were assessed following storage in Hank’s balanced salt solution for 3 and 6 months by assessing gap and void volume percentages on both natural and replica incisor and molar roots. The storage solution was analysed to assess calcium ion leaching. The influence of temperature, tooth positioning, and moisture content of the teeth while µCT scanning was also investigated.ResultsThe obturation quality in the incisor group was the same using both natural teeth and replicas (p > 0.05). No changes in void volume were identified when comparing the same sealer using different obturation techniques. The premixed sealers used in single-cone obturation exhibited high void volume in the 3D printed replicas in the long term. The temperature, positioning, and moisture content of the teeth did not affect the outcome of µCT testing.ConclusionsBioRoot RCS, Totalfill BC, and Bio-C Sealers are suitable for obturation of both complex and simple root canal systems using different obturation techniques with BioRoot RCS exhibiting the highest calcium ion release. 3D printed acrylic teeth can be used to assess the obturation quality in uncomplicated root canal systems. µCT parameters had no significant effect on the µCT measurement.Clinical relevanceThe single-cone obturation technique with hydraulic sealer is a simple technique that can be used for obturation of all root canal systems.

Single Cone Obturation versus Cold Lateral Compaction Techniques with Bioceramic and Resin Sealers: Quality of Obturation and Push-Out Bond Strength.

This study compared the obturation quality and push-out bond strength of single cone obturation (SCO) and cold lateral compaction (CLC) with AH-Plus and Sure Seal Root (SSR). This in vitro experimental study was conducted on 88 single-rootedsingle-canal teeth with straight roots that were randomly divided into four groups (n = 22). All teeth were decoronated and underwent cleaning and shaping. Obturation was performed with AH-Plus and SCO technique in group 1 (SAH), AH-Plus and CLC technique in group 2 (LAH), SSR and SCO technique in group 3 (SS), and SSR and CLC technique in group 4 (LS). The roots were then sectioned into 3-mm thick slices and underwent digital photography at x25 magnification to assess the quality of obturation in the coronal, middle, and apical thirds by Image J software. The PBS was measured by a universal testing machine. The mode of failure was also determined under a stereomicroscope. The PBS was significantly higher in the LSS group than LAH and SAH groups, and also in the SSS group than the SAH group in all sections. The PBS in the LSS group was significantly higher than SSS in the coronal and middle thirds. Voids were significantly lower in LAH than in the SAH group in all sections. In LSS, voids in the coronal third were significantly lower than in LAH. In the middle third, voids in SSS were significantly lower than in SAH. The groups had no significant difference in the mode of failure (P > 0.05). The mean percentage of gutta-percha in the use of AH-Plus sealer was significantly higher than SSR (P < 0.05). The mean percentage of gutta-percha in the coronal third was lower than that in the middle and apical thirds (P < 0.05). SSR showed higher PBS and less voids than AH-Plus. High PBS of the CLC/SSR group showed that CLC should still be preferred to SCO, and in the case of using SCO, SSR should be preferred to AH-Plus.

Assessment of Modality and Accuracy of Single Root Canal Treatment Performed by Undergraduate Students in Saudi Arabia: A Retrospective Study.

Aim To assess the radiographic quality of root canal treatment (RCT) performed on single-rooted anterior teeth by undergraduate dental students of Imam Abdulrahman Bin Faisal University (IAU). Moreover, the study also aimed to assess the types of procedural errors encountered during root canal treatment and to compare the results between male and female students. Methodology The record of patients who visited the endodontic clinics at IAU between the years 2018 and 2021 was obtained from the medical records department. The inclusion criteria for the study involved: i) RCT performed on anterior teeth with a single root; ii) RCT performed by fourth, fifth, and sixth-year undergraduate dental students; and iii) availability of pre-operative and post-operative peri-apical radiographs. After the inclusion criteria, a total of 278 records were selected. The radiographs were accessed by two calibrated examiners for the length of the obturation, homogeneity, and taper. In addition, procedural errors such as the presence of a ledge, perforation, or fractured instruments were also observed. Analysis was done using the Chi-square test. Results A total of 139 teeth (50%) were found to have an adequate quality root canal treatment. Regarding the length of the obturation, 85.6% were considered acceptable, while 65.1% of the obturations had acceptable radiographic homogeneity. The acceptable taper was found in 71.9% of the obturations. Dental students who participated in this study demonstrated a low rate of procedural errors, with 4.7% ledge formation and 1% perforation. A statistically significant difference was found in the quality of root canal obturation (P=<0.001) performed by fourth, fifth, and sixth-year students. Moreover, a significant difference was also observed between maxillary and mandibular teeth (P= 0.032). Conclusion The quality of RCT performed by undergraduate dental students demonstrated that improvements are required. The teaching methods used in the endodontic courses need to be developed and improved to ensure the best possible learning and treatment outcomes.

Comparative evaluation of quality of obturation and instrumentation time using different file systems in deciduous molars: A randomised clinical trial

Introduction: Multiple systems are available for chemo-mechanical preparation during pulpectomy, but an evolution of the exclusive paediatric rotary single file system has opened new doors in paediatric endodontics. The aim was primarily to compare the quality of obturation and instrumentation time and secondarily to report pain perception between manual files and rotary file systems in deciduous molars. Materials and Methods: Pulpectomy was performed in 60 carious mandibular primary molars indicated for pulpectomy in children aged 4–8 years after considering the selection criteria. These teeth were divided randomly into three groups of 20 each, wherein canals were prepared using Hand K files in Group 1, HeroShaper Rotary File System in Group 2 and Kedo S Square single paediatric rotary file in Group 3. The quality of obturation was assessed using intraoral radiographs, and instrumentation time was recorded in seconds using a stopwatch. Pain during instrumentation was assessed using Wong Baker’s FACES Pain Scale. Collected data were subjected to analysis using the Chi-square test, one-way ANOVA and Honestly Significant Difference posthoc test. Results: Mean instrumentation time was least for the Kedo-S Square file system (57.47 ± 9.26), followed by the HeroShaper group (99.6 ± 23.62), and maximum time was recorded for Hand files (255.99 ± 46.20), and this difference was statistically significant (P = 0.00), whereas there was no significant difference regarding the quality of obturation and pain perception between the three groups. Conclusion: As the Kedo S Square system showed the fastest canal preparation, it can be recommended for pulpectomy procedures in primary teeth because the length of appointment is directly proportional to the behaviour of the child.

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

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&gt;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.

Clinical Efficacy of Kedo S Square Files versus Manual K Files in Root Canal Preparation of Deciduous Molars: A Randomised Clinical Tria

Introduction: The conventional approach to root canal preparation in primary molars involves hand instrumentation. However, the disadvantage of longer instrumentation time poses a challenge for dentists treating paediatric patients. As a solution, rotary file systems have been introduced to reduce chairside time and improve patient cooperation. Among the various rotary file systems available, the "Kedo S Square" rotary files are exclusive single files made of Nickel-titanium (NiTi), offering increased flexibility and variable taper to adapt to the curved canals of deciduous molars. Aim: To assess and compare the instrumentation time and obturation quality of rotary “Kedo S Square” files with manual K files in deciduous molars. Materials and Methods: This randomised clinical trial was conducted from July 2022 to February 2023 included 40 primary molars from four to six-year-old children requiring root canal therapy. The teeth were evenly allocated to two groups: Group 1 underwent instrumentation using “Kedo S Square” files, while Group 2 underwent instrumentation using manual K files. The instrumentation time was recorded, and post-treatment radiographs were taken to evaluate the quality of obturation by a single-blinded investigator. Statistical analysis included the Independent t-test, Levene’s Test for Equality of Variances, Chisquare test, and Fisher’s-exact test. Results: The use of Kedo S Square files resulted in significantly less instrumentation time (p&lt;0.001) with a mean time of 3.91±1.462 minutes. There was no statistically significant difference in obturation quality between the two groups, with a p-value of 0.427. Conclusion: Kedo S “Square” files demonstrated comparable obturation quality with shorter instrumentation time compared to manual K files in root canals of primary molars.