"Clinical and CBCT Evaluation of the Quality of Obturation and Time Efficiency of Rotary Versus Manual Instrumentation in Pediatric Endodontics”

Abstract

This study evaluated and compare pulpectomy in primary teeth using MM rotary files to the manual K-files and obturation with ZOE filling material using two different obturation techniques, the incremental technique and the disposable syringe technique. Both manual and rotary instrumentation were compared in terms of the quality of obturation and instrumentation time clinically. Also, a CBCT in-vitro evaluation was done for the remaining dentine thickness, canal transportation, centering ability and quality of obturation in addition to the instrumentation time. First the clinical evaluation was performed in the form of a single-blind randomized controlled clinical trial on 41 healthy children with 48 carious lower primary second molars indicated for pulpectomy. The patients were selected from the outpatient clinic of Pediatric Dentistry department, Faculty of Dentistry, Ain Shams University in the age range of four to seven years old, from the period of September 2019 till December 2021. All patients who fulfilled the eligibility criteria were randomly assigned into 4 groups; manual instrumentation with the incremental and the disposable syringe obturation techniques and rotary instrumentation with the mentioned obturation techniques. All teeth were covered with SSC and received clinical and radiographic evaluations every 6 months for 18 months. The rotary instrumentation showed a marked reduction in the instrumentation time, however no significant difference was found regarding the obturation quality. In the in-vitro evaluation, the study was designed to evaluate the shaping ability of MM rotary files in comparison to the manual K-files via assessment of remaining dentine thickness, quality of obturation, canal transportation and centering ability as well as the instrumentation time. Forty extracted human mandibular second primary molars, with at least two-thirds of their roots remaining with 7 mm minimum length, patent root canals and free of internal resorption, were selected. The selected teeth were mounted in thermacol where each five teeth were arranged together in an arch form. Teeth were randomly divided into four groups, manual instrumentation with the incremental and the disposable syringe obturation techniques and rotary instrumentation with the mentioned obturation techniques.