Comparative Evaluation of Three Obturating Techniques in Primary Molars: An in Vivo Study

Evaluation of Novel Device "Obturagun" as a Root Canal Obturating Technique for Primary Teeth: An In Vitro Study

Aims and objectives

Pulpectomy is one of the most commonly rendered treatment modalities in primary teeth wherein the pulp is irreversibly inflamed. To evaluate the sufficiency of calculated obturating material and quality of obturation in primary teeth using an obturagun device.

Materials and methods

Average root canal volume of 65 and 75 was calculated from cone beam computed tomography (CBCT) scans of children in the age-group of 5-9 years. Based on the average root canal volume and density of obturating material (Vitapex), quantity of obturating material required to obturate a single primary mandibular second molar was calculated. Computer-aided design (CAD)/computer-aided manufacturing (CAM) software was used to design obturagun, which was three-dimensional (3D) printed for study purposes. An in vitro pilot study (pulpectomy) was conducted on 20 extracted primary mandibular second molar to evaluate the efficacy of the obturagun.

Results

Average root canal volume of 75 was larger than 65. Approximately 68% of the root canals showed optimal obturation. Distal root canals were more void free as compared to mesial. In 70% of the cases, the calculated obturation material was sufficient to obturate a single primary mandibular second molar.

Conclusion and clinical significance

Average root canal volume can be used to determine the quantity of obturating material. Obturagun can be used as an alternate obturating technique for primary teeth.

How to cite this article

Kalaskar R, Thosar NR, Kalaskar A. Evaluation of Novel Device "Obturagun" as a Root Canal Obturating Technique for Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):107-111.

Stainless steel crown vs bulk fill composites for the restoration of primary molars post-pulpectomy: 1-year survival and acceptance results of a randomized clinical trial

BACKGROUND

A key factor for the success and longevity of the endodontic treatment is sealing of the cavity after restorative treatment.

AIM

The aim of this randomised clinical trial was to evaluate the 1-year survival of endodontic treatment in primary molars restored with stainless steel crowns (SSCs) and bulk fill composite resin (BF). As a secondary outcome, the acceptance of both children and parents was evaluated.

DESIGN

Ninety-one 3- to 8-year-old children with at least one primary molar requiring endodontic treatment were selected. Participants were randomized to SSC or BF and evaluated after 1, 3, 6, and 12 months. An acceptance questionnaire was completed immediately after the treatment. The primary outcome was the endodontic treatment success, evaluated in the intention-to-treat (ITT) population using the Kaplan-Meier and non-inferiority Cox regression analyses, with a non-inferiority limit of 15%. Sensitivity analysis between the success rates after 1 year was performed using Miettinen-Nurminen's method. The Mann-Whitney test was used to compare the treatment acceptance (α = 5%).

RESULTS

The survival rate after 1 year was BF = 75% and SSC = 88% (HR = 1.41; 90% CI 0.57-3.43). ITT analysis showed a success rate of BF = 86.7% and SSC = 82.6% (RR = 0.95; 0.78-1.16). The non-inferiority hypothesis between the survival of endodontic treatment could not be proved in both analyses (P > .05). The overall acceptance scores did not differ between the restorative groups (P > .05).

CONCLUSION

This study failed to show non-inferiority of BF compared with the SSC. The materials were well accepted by both children and their parents.

Is lentulospiral the best option for root canal filling of endodontically treated primary teeth? A systematic review and meta-analysis

PURPOSE

To evaluate the quality of root canal filling of primary teeth using lentulospiral in comparison with other instruments.

METHODS

Electronic databases (PubMed/MEDLINE, Scopus, TRIP, LILACS, and CENTRAL Cochrane) were searched up to Jan 2021. Clinical trials that compared the quality of root canal filling of endodontically treated primary teeth using lentulospiral with other instruments were included. Two reviewers independently selected the studies, extracted data, and assessed the risk of bias. Two outcomes were considered: inadequate root canal filling (under or overfilling) and presence of voids. Conventional meta-analyses were performed using a fixed-effects model. Statistical analyses were performed using RevMan5.3 at a significance level of 5%.

RESULTS

Of the 68 potentially relevant studies, eight were selected for full-text analysis, and three were included in the systematic review. The use of syringes resulted in a lower risk of presence of voids in the root canal filling compared to the use of lentulospiral (RR: 0.62 95% CI 0.45; 0.85). However, there was no difference between lentulospiral and bi-directional spiral (RR:1.17 95% CI: 0.90; 1.51). There was no significant difference between lentulospiral and syringes (RR: 1.37 95% CI 1.00; 1.87) considering the length of the root canal filling. The use of bi-directional spiral had a higher risk of inadequate root canal filling compared to the use of lentulospiral (RR: 1.75 95% CI: 1.12; 2.74). Two studies were at "high", and one study at "unclear" risk of bias in the key domains.

CONCLUSIONS

There is insufficient scientific evidence showing the superiority of using lentulospiral for the root canal filling in endodontically treated primary teeth. Due to the limited level of evidence, professionals may opt to choose the instrument based on their preferences.

Primary tooth pulpectomy overfilling by different placement techniques: A systematic review and meta-analysis

Background. This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth. Methods. A systematic search was undertaken by searching PubMed/MEDLINE and Scopus for English language peer-reviewed articles published until February 2018 that reported primary tooth pulpectomy overfilling. Two reviewers independently screened and identified studies in terms of the selection criteria and independently collected the data using a specially designed data extraction form. The overfilling rate was the primary summary measure. The weighted pooled overfilling rates were estimated by random-effects meta-analysis. Results. Twenty clinical and four in vitro studies met the eligibility criteria. In the clinical studies, the pooled overfilling rate for zinc oxide-eugenol (ZOE) was 23.3% with a lentulo spiral mounted on a handpiece, 22.7% with a hand-held lentulo spiral, and 17% with a plugger. The pooled overfilling rate for calcium hydroxide-based materials was 16.7% with a lentulo spiral mounted on a handpiece, 14.7% with a hand-held lentulo spiral, 19.6% with a syringe, and 25.7% with a plugger. In the in vitro studies, neither individual overfilling rates nor two-by-two comparisons were subjected to meta-analysis because of an inadequate number of studies. Conclusion. The lowest overfilling rate in the clinical studies was related to plugger and handheld lentulo spiral techniques for ZOE and calcium hydroxide-based materials, respectively.