Micro-CT evaluation of root canal preparation with rotary instrumentation on prototyped primary incisors

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.

Update in the Diagnosis and Treatment of Root Canal Therapy in Temporary Dentition through Different Rotatory Systems: A Systematic Review

The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to obtain good results in less working time. The objective of this study is to compare the characteristics of the different current rotary systems to favor a correct diagnosis and subsequent treatment. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was carried out in PubMed, Embase Scopus, Cochrane and Web of Science databases, and was completed with a manual search. The following variables were extracted from the selected studies: author, year, sample, rotary systems used (length, diameter, taper, speed), obturation material and irrigant. From the initial electronic search of the five databases, 315 articles were identified. Once the duplicate articles were eliminated, a total of 233 remained. After reading both title and abstract, 200 articles were eliminated, leaving 33. On account of reading the full text, 22 were eliminated for not answering the research question or the inclusion criteria, leaving a total of 11 articles for the systematic review. Rotary systems which are able to adapt to the root anatomy of primary teeth and allow rapid and simple instrumentation, without producing excessive extrusion of debris at the root apex, will be the ones that provide the best results to the pediatric dentist during the performance of pulp treatment in primary teeth. Clinical success will only be achieved through proper prior diagnosis.