Simplify pulpectomy in primary molars with a single-file reciprocating system: a randomized controlled clinical trial
- 38 Downloads
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.
Materials and methods
A prospective randomized clinical trial was conducted in 34 healthy children aged 3–7 years. 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 (3.23 min) was significantly shorter than that for SSH (7.38 min). 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 12 months, 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.
KeywordsPulpectomy Deciduous molar Nickel-titanium rotary system Stainless-steel hand files
The authors would like to acknowledge all staff in Phakpayoon Hospital, Phattalung Province, Southern Thailand and Asst. Prof. Dr. Chulaluk Komoltri, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, for valuable statistic consultation.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board, Faculty of Dentistry and the Faculty of Pharmacy, Mahidol University COA.No.MU-DT/PY-IRB 2016/056.1210, Bangkok, Thailand, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Nagaratna PJ, Shashikiran ND, Subbareddy VV (2006) In vitro comparison of NiTi rotary instruments and stainless steel hand instruments in root canal preparations of primary and permanent molar. J Indian Soc Pedod Prev Dent 24:186–191. https://doi.org/10.4103/0970-4388.28075 CrossRefPubMedGoogle Scholar
- 2.Crespo S, Cortes O, Garcia C, Perez L (2008) Comparison between rotary and manual instrumentation in primary teeth. J Clin Pediatr Dent 32:295–298. https://doi.org/10.17796/jcpd.32.4.l57l36355u606576 CrossRefPubMedGoogle Scholar
- 5.Santhosh D, Devadathan A, Mathew J, Nair M, James B (2019) Comparative evaluation of efficiency of single-file rotary and reciprocating systems in instrumenting severely curved mesial root canals of extracted mandibular first molars: a morphometric study using cone-beam computed tomography. Saudi Endod J 9:19–25. https://doi.org/10.4103/sej.sej_86_18 CrossRefGoogle Scholar
- 9.Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, Pozos-Guillen AJ (2011) Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth. J Clin Pediatr Dent 35:359–363. https://doi.org/10.17796/jcpd.35.4.8k013k21t39245n8 CrossRefPubMedGoogle Scholar
- 13.Prabhakar AR, Yavagal C, Dixit K, Naik SV (2016) Reciprocating vs rotary instrumentation in pediatric endodontics: cone beam computed tomographic analysis of deciduous root canals using two single-file systems. Int J Clin Pediatr Dent 9:45–49. https://doi.org/10.5005/jp-journals-10005-1332 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Makarem A, Ravandeh N, Ebrahimi M (2014) Radiographic assessment and chair time of rotary instruments in the pulpectomy of primary second molar teeth: a randomized controlled clinical trial. J Dent Res Dent Clin Dent Prospects 8:84–89. https://doi.org/10.5681/joddd.2014.015 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Kuo C, Wang Y, Chang H, Huang G, Lin C, Guo M (2006) Application of Ni-Ti rotary files for pulpectomy in primary molars. J Dent Sci 1:10–15Google Scholar
- 28.Subramaniam P, Tabrez TA, Babu KL (2013) Microbiological assessment of root canals following use of rotary and manual instruments in primary molars. J Clin Pediatr Dent 38:123–127. https://doi.org/10.17796/jcpd.38.2.j84265t82u60271u CrossRefPubMedGoogle Scholar