ABSTRACT
Traditional hand instrumentation is a commonly used technique to perform pulpectomy in deciduous teeth by most specialists in pedodontics. Lately, dentists have embraced rotary instrumentation as a safe and effective alternative. This study aimed to compare the efficacy of root canal preparation in extracted primary molars between manual and two rotary file systems using micro-CT. Thirty-six extracted human second primary mandibular molars were divided into three groups according to the instrumentation method: (1) Manually instrumented (MI) group (n = 9) in which the teeth were treated using K-files up to size 30; (2) Kedo-Ssystem (KS) group (n = 9); (3) ProTaper Gold system (PTG) group (n = 10) and control group (n-8). Each tooth was scanned before and after the retrograde root canal preparation. Residual dentin volume was calculated using micro-CT scans to evaluate the technique's efficacy. Additionally, the preparation time and procedural errors were recorded for each tooth preparation. A one-way ANOVA test was carried out to compare the groups' dentin volume and preparation time. The mean preparation time using the manual method (13.14 min) was more than two times longer than that of the rotary techniques (4.62 min and 6.45 min). The manual preparation method using a K-file removed almost half the root canal material when compared with the rotor method (p = 0.025). Conclusion: our results suggest that rotary instrumentation is more efficient for root canal preparation in primary teeth than the traditional manual method. This finding may call for a paradigm shift in current clinical practices, where manual instrumentation is still commonly preferred.
ABSTRACT
Molar incisor hypomineralization (MIH) and deciduous molar hypomineralization (DMH) affect the first permanent molars and second primary molars, respectively, causing a greater dental treatment burden and worse oral health quality of life among affected children. We assessed the prevalence and risk factors of MIH and DMH among 1209 children aged 3-13 years who attended a university dental clinic in Israel in 2019-2020. Clinical examinations were conducted to assess the presence of DMH and MIH. Potential etiological factors of MIH and DMH, including demographics, the mother's perinatal health, and the child's medical history during the first three years of life, were retrieved using a questionnaire. To examine the associations between the demographic and clinical variables and the prevalence of MIH and DMH, continuous variables were tested using the Kruskal-Wallis test with Bonferroni corrections. Categorical variables were analyzed by chi-squared test. Multivariate logistic regression was conducted to evaluate which of the significant variables found in the univariate analysis could predict a diagnosis of both MIH and DMH. The prevalence of MIH and DMH was 10.3% and 6.0%, respectively. Age ≥ 5 years, taking medications during pregnancy and severe lesions were associated with a greater risk for a diagnosis of DMH + MIH. Multivariate logistic regression with adjustment for age showed that the severity of hypomineralization was positively and significantly associated with a diagnosis of MIH + DMH with an odds ratio of 4.18 (95% confidence interval 1.26-17.16), p = 0.03. MIH should be diagnosed and monitored in young children to prevent further deterioration. Moreover, a preventive and restorative program for MIH should be established.
