Comparative evaluation of volumetric changes following rotary and hand files' canal preparation of primary maxillary canine: an in vitro nano-CT analysis.

PURPOSE: To evaluate the volumetric changes of two recently introduced paediatric rotary file systems in comparison with conventional hand file systems in primary maxillary canines using an ultra-high-resolution nano-computed tomography. METHODS: This in vitro study was performed in extracted primary maxillary canines based on certain inclusion and exclusion criteria. Samples were prepared, and working length was determined after the pre-operative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced paediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and hand K-files. All samples were subjected to post-operative scans performed similar to pre-operative scans. Image reconstruction was performed with NRecon software for 3D volumetric visualisation and analysis of the root canals. RESULTS: Kedo-SG blue file systems had the highest mean difference in the canal volume (4.05%). Hand K-files had the least difference at (3.71%) of canal volume. Kedo-S plus file system had a moderate mean canal volume difference (3.82%) which is closer to hand K-files. Intergroup comparison between the three groups showed that the mean difference in canal volume was statistically significant between all three file systems (p = 0.000). CONCLUSION: Within the limitations of the current study, rotary file systems produced a significant enlargement of canals as compared to hand files. Kedo-SG blue created a uniform preparation of the canal cervico-apically. Kedo-S plus files were prepared more coronally with minimal preparation apically as close to the preparation of hand files. TRIAL REGISTRATION: Trial registration number: IHEC/SDC/PEDO-2103/22/651, Date of registration: 2022.

Anti-microbial efficacy of root canal preparation in deciduous teeth with manual and rotary files: A randomized clinical trial.

Background: In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments. Aims: The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars. Materials and Methods: This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III. Results: Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation. Conclusion: Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

Clinical evaluation of instrumentation time and quality of obturation using paediatric hand and rotary file systems with conventional hand K-files for pulpectomy in primary mandibular molars: a double-blinded randomized controlled trial.

AIM: The present study aims to comparatively evaluate the instrumentation time and obturation quality using paediatric manual (Kedo-SH) and rotary (Kedo-S and Kedo-SG Blue) with conventional manual (Hand K-files) instrumentation technique for pulpectomy in primary mandibular molars. MATERIALS AND METHODS: A double-blinded randomized controlled trial was designed, recruiting participants with pulpally involved primary mandibular molars requiring pulpectomy in the age group of 6-9 years old. Sixty primary mandibular molars were randomly allocated to either of the four intervention groups: Group I: 15 teeth were instrumented using hand K-files (control group); Group II: 15 teeth were instrumented with paediatric rotary files (Kedo-S); Group III: 15 teeth were instrumented with paediatric hand files Kedo-SH (experimental group) and Group IV: 15 teeth were instrumented with paediatric rotary file system Kedo-SG Blue. Instrumentation time was recorded during root canal preparation and post-operative quality of obturation in each group was also assessed. Extracted data was subjected to statistical analysis using Chi-square, One-way ANOVA and post hoc Tukey test. RESULTS: Mean instrumentation time was significantly reduced for Kedo-SG Blue (2.7840 ± 0.34217) min-s followed by Kedo-S (3.4827 ± 0.48657), Kedo-SH (5.8800 ± 0.48345) min-s and hand K-files (6.2167 ± 0.30978) min-s (p = 0.0005). A statistically significant difference was found in the obturation quality (p = 0.001) between the four groups with higher percentage of optimal fillings observed with rotary Kedo-SG Blue (80%) followed by Kedo-SH (46.7%); Kedo-S (40.0%) and hand K-files (20%). CONCLUSIONS: On comparative evaluation, a marked reduction in instrumentation time and superior quality of obturation was found with rotary Kedo-SG Blue file system followed by Kedo-SH, Kedo-S and hand K-files.

Comparison of post-operative pain after root canal instrumentation with hand K-files, H-files and rotary Kedo-S files in primary teeth: a randomised clinical trial.

PURPOSE: To compare the post-operative pain after root canal instrumentation with hand K-files, H-files and rotary Kedo-S in primary teeth. METHOD: All 4-6-year-old children were invited and 69 agreed to participate. The participants were randomly divided and distributed for instrumentation with K-file (Group 1), H-file (Group 2) and rotary Kedo-S files (Group 3). After completion of root canal procedure, the post-operative pain was evaluated at intervals of 6, 12, 24, 48, and 72 h using modified Wong-Baker pain scale and compared between the groups. RESULTS: Post-operative pain between three groups at 6, 12, 24, 48 and 72 h was compared using Chi square test. There was decreased post-operative pain with Kedo-S rotary files as compared to other two groups (P value < 0.001). The post-operative pain decreased after 12 h for all the groups with no pain at 24, 48 and 72 h intervals. CONCLUSION: Paediatric rotary files Kedo-S showed significantly less post-operative pain as compared to K-file and H-file at 6 h and 12 h intervals. However, follow-up interval of 24, 48 and 72 h showed no significant difference between the rotary and hand file groups.

Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial.

AIM: This was to compare and evaluate the instrumentation time and quality of obturation between paediatric rotary file (Kedo-S) and manual instrumentation techniques in primary molars. METHODS: A double blinded randomised control trial was performed that included mandibular primary molars in children of age 4-7 years with pulp necrosis. Sixty primary mandibular molars were randomly divided into two groups: 30 were instrumented with paediatric rotary files Kedo-S (experimental group) and 30 with hand K-files (control group). During the preparation of the primary root canals the instrumentation time was recorded in seconds. The quality of obturation was recorded as optimal, under filled or over filled using immediate post-operative radiographs. The instrumentation time and quality of obturation were analysed using independent t-test and Chi-square test. RESULTS: Mean instrumentation time with paediatric rotary files Kedo-S (78.53 s) was significantly less than K-files (95.46 s) (p < 0.05). There was a significant improvement in the quality of obturation (p < 0.05) with paediatric rotary files (Kedo-S). CONCLUSION: Clinical use of paediatric rotary files Kedo-S was effective during root canal preparation of primary teeth with reduction in instrumentation time and better quality of obturation.