Pulpectomy Of Primary Molars Research Articles

Effect of Adaptive, Rotary, and Manual Root Canal Instrumentation in Primary Molars: A Triple-Armed, Randomized Controlled Clinical Trial.

Simple SummaryUntimely loss of primary molars may lead to undesirable consequences; hence, pulpectomy is considered a rational treatment approach to avoid it. Advances in root canal instrumentation by means of motorized files while treating primary teeth have reduced the chair-side time and have also exhibited better quality of obturation. This helps reduce the patient’s anxiety about pulpectomy procedures. However, root canals in primary teeth exhibit a larger perimeter and are irregular in shape, posing a challenge to currently used motorized endodontic files. Instrumenting root canals in three dimensions is the need of the hour and is vastly explored in the literature, albeit for adult dentition. The application of adaptive root canal instrumentation for pulpectomies in primary teeth is yet to be reported in the literature.This clinical trial focused on collating the instrumentation time and quality of root canal obturation in primary molars treated with three instrumentation techniques: adaptive, rotary, and manual. A triple-armed, randomized controlled clinical trial was performed on 75 primary molars requiring pulpectomy treatment, divided into three groups (n = 25 per group). The teeth in Group 1 were instrumented with an adaptive technique (XP-endo Shaper, FKG Dentaire, La Chaux-de-Fonds, Switzerland), Group 2 with pediatric rotary files (Kedo-S; D1 and E1), and Group 3 with a manual technique (hand K-files). The apical size of the final instrumentation was maintained at #30 for all groups. Instrumentation time and the grade of the root canal obturation were evaluated. Instrumentation duration was recorded, employing a digital stopwatch from the insertion of the first file until the completion of final irrigation. Obturation quality was assessed using radiographs. The criteria taken as a reference for obturation were: optimal (1 mm short of the apex), underfilled (2 mm short of the apex), or overfilled (beyond the apex). The use of an adaptive technique was associated with the lowest instrumentation time (p < 0.0001) when used for instrumenting primary molars and with the highest root canal filling quality of the three groups. The application of the new concept of adaptive instrumentation for pulpectomy of primary molars was a favorable technique, considering the significant reduction in instrumentation time and better obturation.

Pediatric dentists’ preference on usage of hand ϑiles or rotary ϑiles for pulpectomy of primary molars - A retrospective study

Dental caries is the most prevalent chronic condition of the oral cavity. Excessive tooth decay can inflame pulp requiring pulpal intervention. One such endodontic procedure done to treat pulpitis is pulpectomy which is defined as complete removal of coronal and Radicular pulp. It can be done through hand or rotary filing techniques. A rotary filing system is better over hand filing that it gives more conical canal, reduces preparation time and thus enhances child cooperation. To analyse the preference of pediatric dentists in a private dental institution in using rotary and hand filing techniques during pulpectomy procedures in primary molars. All the cases reported between the month of June 2019 to March 2020 for pulpectomy in primary molars in paediatric patients were chosen for this study. Data of pediatric patients who underwent pulpectomy were shortlisted and the instrumentation techniques used were analyzed, tabulated and was subjected to statistical analysis. From the statistical analysis, it can be analysed that paediatric dentists had a higher preference towards rotary filing technique (85.7%), predominantly in male patients (57.2%) between the age group of 2 to 5 years (67%), primarily in mandibular molars (67.1%). Within the limitation of this study, the commonly preferred instrumentation technique by paediatric dentists for pulpectomy of primary molars is rotary over hand filing.

The effect of two different irrigation needles on post-operative pain after pulpectomy in primary molar teeth: A randomized clinical study.

Post-operative pain (PP) following pulpectomy is of concern for endodontic patients and dentists. This study evaluated the intensity of PP following pulpectomy in primary maxillary molars, using two irrigation needles. One hundred patients in ages ranging from 6-9years requiring pulpectomy for asymptomatic primary teeth with non-vital pulp were included in the study. The participants were randomly assigned to two groups of 50 patients each, according to the type of irrigation needle used, that is, a conventional open-ended needle and a double side-vented needle. The teeth were obturated and then permanently restored. The presence of PP was assessed after six, 12, 24, 48, and 72hours, and finally after one week, using a four-point pain intensity scale. The PP scores were then statistically analysed. In 6, 12, and 24hours time intervals, patients who had their teeth irrigated with the open-ended needle exhibited more intense PP than those who had their teeth irrigated with a double side-vented needle (P<.05). After 48hours, 72hours, and 1week, however there was no significant difference between the groups (P>.05). Side-vented needles may be preferred in order to decrease PP at the first 24hours after pulpectomy in primary molars.

Evaluation of Cotton and Polytetrafluoroethylene Tape as Endodontic Spacer martial in pulpectomy of primary molars

Aim: This study aimed to evaluate the sealing ability of cotton and Polytetrafluoroethylene (PTFE) tape as spacer under temporary filling material in between root canal treatment visits . Method and Materials: forty infected primary molars indicated for pulpectomy from twenty children were selected for this study. Two visits root canal treatment were done with temporary restorative material and application of the tested cotton and PTFE as a spacers on each side randomly. Microbiological study was done after pulpectomy by taking sample from the coronal portion of the cavity at the folloing steps, directly after pulpectomy, seven days follow up for both the cavity and the spacer material itself. Results: Cotton fibers group showed bacterial contamination for both the cavity and material itself while PTFE showed the least amount of bacterial growth over their samples. There was contamination of the majority of cotton group samples in contrary to minimal amount for PTFE samples showed bacterial contamination Conclusions: Using PTFE as a spacer material under provisional restoration showed very good results from microbial point of view and it may be used as cotton alternative in the future in the endodontic field

Clinical and Radiographic Evaluation of WaveOne Gold Single-File System in Pulpectomy of Primary Molars: A Randomized Clinical Trial

Clinical and Radiographic Evaluation of WaveOne Gold Single-File System in Pulpectomy of Primary Molars: A Randomized Clinical Trial

Nanosilver Gel Versus Zinc Oxide-Allium Sativum Oil Paste as Obturation Materials following Partial Pulpectomy of Primary Molars: An in vivo study

Nanosilver Gel Versus Zinc Oxide-Allium Sativum Oil Paste as Obturation Materials following Partial Pulpectomy of Primary Molars: An in vivo study

Simplify pulpectomy in primary molars with a single-file reciprocating system: a randomized controlled clinical trial.

To compare the clinical use of a single-file NiTi reciprocal system (sNiTi) to that of stainless steel hand file (SSH) instrumentation in primary tooth pulpectomy. A prospective randomized clinical trial was conducted in 34 healthy children aged 3-7years. Thirty-seven mandibular primary molars were randomly assigned to two groups: sNiTi and SSH. Instrumentation time, obturation time, quality of obturation, and 6- and 12-month clinical and radiographic outcomes were compared between the two groups. The median instrumentation time using sNiTi (3.23min) was significantly shorter than that for SSH (7.38min). Obturation times were not different. The quality of obturation was significantly different only in the mesial root canals; overfilling was seen more in the sNiTi group, while underfilling occurred more in the SSH group. At 6 and 12months, both groups showed comparable clinical and radiographic success regardless of the type of instrumentation. sNiTi shortens instrumentation time with comparable obturation time, overall quality of obturation, and clinical and radiographic outcomes with SSH. Pulpectomy is indicated to prevent premature loss of primary teeth with irreversible inflamed or infected pulp. However, it is complicated and time-consuming. sNiTi reciprocating system is an alternative to hand filing technique, avoiding multiple steps and simplifying pulpectomy procedures.

A Clinical and Radiographic Study of Four Different Root Canal Filling Materials in Primary Molars—An In Vivo Study

Abstract Introduction Pulpectomy helps in preserving a pulpally involved primary tooth by eliminating bacteria and their products and ensures hermetic seal of the root canals, so that the primary teeth can complete their function until normal exfoliation. For the success of endodontic treatment in primary teeth, the resorption of obturating material plays a vital role. The materials used for obturation in this study included zinc oxide propolis (ZOP) as a new paste, Endoflas, Metapex, and zinc oxide eugenol (ZOE). Objective To evaluate the success rate of pulpectomy of primary molars using four different root canal filling materials: ZOP as a new paste, Endoflas, Metapex, and ZOE. Materials and Methods A total of 48 primary molars were divided into four equal groups of 12 molars according to the type of root canal filling paste, that is, ZOE, Endoflas, ZOP, and Metapex. Results When Tukey’s test was applied, out of the four materials, ZOP was the most significant material as its p-value was &lt; 0.05, whereas other materials showed nonsignificant results as their p-value was &gt; 0.05. Conclusion Among the four groups, ZOP showed greater clinical success and its resorbability was similar to that of root.

Pulpectomy of Primary Molars With Rotary Instrumentation Versus Manual Instrumentation

Pulpectomy of Primary Molars With Rotary Instrumentation Versus Manual Instrumentation

Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial.

Cleaning and shaping plays a very important role in success of root canal procedures. There are various instrumentation techniques available for root canal preparation. Recently, an exclusive rotary file for root canal preparation of primary teeth has been introduced. The aim of this in vivo study was to compare the quality of obturation and intensity, and duration of post-operative pain between two rotary file systems with manual files during the pulpectomy of primary molars. Forty five primary mandibular molars were included in this study, which was randomly allocated into one of the three experimental groups (n = 15). Group A: Instrumentation was done using Hand K-file; Group B: Instrumentation was done using Kedo-S rotary file system; and Group C: Instrumentation was done using K3 rotary file system. The quality of obturation was recorded as optimal, underfilled, or overfilled using standardized intraoral periapical radiographs. This study also evaluated the intensity and duration of postoperative pain at different time intervals: 6, 12, 24, 48, and 72 hours following the pulpectomy. With respect to quality of obturation, less underfilling was noticed in Kedo-S rotary files (16.7%) followed by using K3 rotary files (33.3%) and hand K files (43.3%). Kedo-S file showed the least underfilled canals (16.7%) and comparatively more overfilled canals (26.6%) and it was statistically significant (P value of 0.001 and 0.002 respectively). On comparing the intensity and duration of postoperative pain among the three groups, there was no statistically significant difference between these groups (P > 0.05). Kedo-S pediatric rotary file system shows considerably better quality of obturation when compared to that of K3 rotary and hand K file systems without much of any significant difference in relevance to the post-operative pain.

Comparative evaluation of post-operative pain after pulpectomy with k-files, kedo-s files and mtwo files in deciduous molars -a randomized clinical trial

Objective: Despite the tortuous course of primary root canal system, a paradigm shift occurred from conventional hand files to rotary system, which lead to faster, cost-effective, uniform and predictable fillings. One of the many advantages being, reduction in post-operative pain with the use of rotary system. Many rotary file systems were introduced, with the recent one, the Kedo-S. So the present study aimed to compare and evaluate the post – operative pain after pulpectomy using K-files, MTwo files and Kedo-S files in deciduous molars. Material and Methods: 75 teeth were randomly divided into three groups (group A – K-files, group B - Kedo-S files and group C - MTwo files) for pulpectomy of primary molars. Post – operative pain was assessed every 6,12,24,48 and 72 hours using facial pain scale. Results: 44% of volunteers in K-file group had moderate pain followed by Kedo-S group that is 8% and then MTwo files that is 4%. Conclusion: The least post-operative pain was found in Mtwo group followed by Kedo-S group and K-file group.KeywordsPulpectomy; Post-operative pain; MTwo; Kedo-S.

Comment on “Postoperative Pain and Flare-Ups: Comparison of Incidence between Single and Multiple Visit Pulpectomy in Primary Molars”

Comment on “Postoperative Pain and Flare-Ups: Comparison of Incidence between Single and Multiple Visit Pulpectomy in Primary Molars”

Postoperative Pain and Flare-Ups: Comparison of Incidence Between Single and Multiple Visit Pulpectomy in Primary Molars.

Endodontic treatment performed in either single- or multiple visit can be followed by numerous short- and long term complications. One of the short term complications include postoperative pain and flare-ups. The ability to predict its prevalence and forewarn the patient may go some way towards enabling coping strategies and help dentist in pain management treatment decisions. To compare the incidence and intensity of postoperative pain and flare-ups between single- and multiple visit pulpectomy in primary molars. Also, to correlate the preoperative status of the pulp to postoperative pain and flare-ups. Eighty primary molars indicated for pulpectomy were included in the study and divided into two groups. Tooth treated and preoperative status of the pulp vitality was recorded. All the conventional steps in pulpectomy were followed. Teeth in Group 1 (single visit pulpectomy) were obturated on the same visit. Teeth in Group 2 (multiple visit pulpectomy) were obturated in the subsequent appointment. The recording of postoperative pain, flare-ups, use of medication were done after 24 hours, seven days and one month. Four cases in both the groups reported postoperative pain (10%) at 24 hour recall, p=0.74. One flare-up (2.5%) was recorded in each group p=0.67. None of the patients reported pain at seventh day and one month recall. Postoperative pain was recorded in five non-vital teeth (13.5%) and three vital teeth (6.9%). However, it was statistically not significant p=0.53. From the perspective of our study there was a low incidence of postoperative pain. The majority of patients in both groups reported no pain or only minimal pain within 24 hours of treatment. There were no differences between single- and multi visit treatment protocols with respect to the incidence of postoperative pain. No significant correlation could be found between pulp vitality and the incidence of postoperative pain.

Success Rate of Zinc Oxide Eugenol in Pulpectomy of Necrotic Primary Molars: A Retrospective Study

Introduction: Pulpectomy is a conservative treatment plan for primary necrotic teeth and Zinc Oxide Eugenol is still a good choice as root canal filling material but long term studies on poor prognosis molars are limited and almost contradictory. The purpose of this study is to evaluate the clinical and radiographical success rate of pulpectomy of necrotic primary molars using ZOE as the root canal filling material. Methods: 152 records of 76 primary molars on which two-visit pulpectomy had been performed were selected. The records with a complete and enough clinical history and high quality radiographs of before the treatment and follow up sessions were included to the study. The least follow up was 6 months and the most one was 59 months (with the mean follow up of 24 months). The treatments were noted successful if clinically had no signs and symptoms and radiographically, the size of pathologic radiolucencies of before the treatment have been reduced or at least remained without any changes. Then obtained information was analyses in SPSS 17 and by Chi- square and Log Rank tests. Results: From all 76 cases 5 teeth (6.6%) were radiographically failed that all of them were second primary molars and 2 teeth were clinically failed (2.6%) that both were second primary molars. Conclusion: Two-visit pulpectomy of primary molars with ZOE as root canal filling materials is one of the most successful treatments for necrotic teeth

Pulpectomy procedures in primary molar teeth

AbstractPremature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars. Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention. Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge. This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth. In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.

Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth

Paediatric endodontics is an integral part of dental practice that aims to preserve fully functional primary teeth in the dental arch. Pulpectomy of primary molars presents a unique challenge for dental practitioners. Negotiation and thorough instrumentation of bizarre and tortuous canals encased in roots programmed for physiological resorption are the main challenges for this treatment approach. Consequently, numerous in vitro and in vivo studies have been conducted to validate the application of some contemporary endodontic armamentarium for effective treatment in primary molars whilst maintaining favourable clinical outcomes. Electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the forefront of endodontic armamentarium in paediatric dentistry. Hence, this review aims to map out the root and root canal morphology of primary molars, to discuss the application of electronic apex locators in primary molars and to provide an update on the preparation of their root canal systems.

Comparison Between Rotary and Manual Techniques on Duration of Instrumentation and Obturation Times in Primary Teeth

The aim of this study was to compare the duration of instrumentation and obturation times and quality of root canal filling between rotary and manual instrumentation techniques in primary teeth. A randomized, controlled clinical trial was performed that included deciduous teeth with pulp necrotic. Forty necrotic teeth were included; 20 were instrumented with a rotary technique (experimental group) and 20 with a manual technique (control group). The time taken for instrumentation and for obturation were recorded in minutes, and the quality of the root canal filling was recorded as optimal, under-filled, or overfilled. The use of the rotary technique diminished the time of instrumentation to 63% and time of obturation to 68%, and it improved the quality of the root canalfilling. The use of rotary instruments in the pulpectomy of primary molars represents a promising technique; the time is significantly reduced.

Study of root canal accessibility in human primary molars

The aim of the present study was to provide a general scheme for pulpectomy of primary molars that may be useful for decision-making about negotiation of root canals and selection of appropriate instruments. A total of 160 vital primary molars in 85 patients (40 males, 45 females) aged 4-6 years were selected. After taking primary radiographs, local anesthesia was induced, and the teeth were isolated using a rubber dam. Canal accessibility index (CAI) and tooth accessibility index (TAI) were calculated according to initial file size. Mandibular first molars had either three canals (79.2%) or four canals (20.8%), and all second molars had four canals. Maxillary first molars had three canals and second molars had either three canals (70.9%) or four canals (29.1%). Lower accessibility of the mandibular first molar distobuccal root accounted for the lower accessibility of these teeth in comparison with mandibular second molars. While three-canal maxillary second molars were more accessible due to the lower accessibility of the distobuccal canal of the maxillary first molar, poor accessibility of the distal canal in four-canal second molars was responsible for the difficult accessibility of these teeth. In conclusion, it seems that the accessibility of a single canal in each tooth determines the difficulty of accessibility for any given tooth. Moreover, while primary second molars are more accessible than first molars, all of them are negotiable.