Evaluation of the Effect of Different Root Canal Preparation Techniques in Primary Teeth Using CBCT

Objectives: The purpose of this in vitro study was to compare and evaluate the cleaning and shaping efficiency of the rotary Ni-Ti, sonic and conventional file systems for root canal preparation in primary teeth under CBCT. Study Design: Seventy five maxillary and mandibular first and second primary molars were divided into three groups of 25 teeth each, according to the canal preparation technique: Group I Rotary file system, Group II Sonic file system, Group III Conventional K files. Canals were scanned using an i-CAT CBCT scanner before and after preparation to evaluate their shaping efficiency. Root canal transportation and centering ratio were evaluated at coronal, middle and apical thirds. The cleaning efficiency was evaluated by the extent of India ink removal from the canal walls under stereomicroscope. The collected data was subjected to statistical analysis. Results: Nickel–Titanium (Ni-Ti) rotary system caused less canal transportation and had better centering ability. Sonic system showed better shaping at the apex, and wider at coronal end. Conventional K-files removed more dentin at coronal than in middle and apex and efficiently cleaned the root canals. There were no significant difference in cleaning and shaping efficiency between Rotary system, Sonic system & Conventional K file system. Conclusion: Rotary instrumentations could be considered as an efficient alternative to conventional hand preparation as it respects the original canal anatomy with no aberrations or resulting failures.

Rotary file, Sonic files, Transportation, Cleaning efficiency, CBCT endodontics

1. Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I, Nakagaki H, Nakamura H. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jan; 97(1):95-9, 2004.

2. A Dafalla A, Hassan Abubakr N, E Ibrahim Y. An in vitro comparison of root canal system prepared with either hand or rotary instruments. Iran Endod J. Fall; 5(4):167-73, 2010.

3. Hülsmann, Michael, Ove A. Peters, and Paul MH Dummer. “Mechan-ical preparation of root canals: shaping goals, techniques and means.” Endodontic topics 10.1: 30-76, 2005.

4. Wycoff RC, Berzins DW. An in vitro comparison of torsional stress properties of three different rotary nickel-titanium files with a similar cross-sectional design. J Endod. Aug; 38(8):1118-20, 2012.

5. Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent.Jan-Feb; 22(1):77-8, 2000.

6. Arora A, Taneja S, Kumar M. Comparative evaluation of shaping ability of different rotary NiTi instruments in curved canals using CBCT. J Conserv Dent.Jan; 17(1):35-9, 2014.

7. Dummer PM, Hutchings R, Hartles FR. Comparison of two sonic handpieces during the preparation of simulated root canals. Int Endod J. May;26(3):159-68,1993.

8. Todd R. Cone beam computed tomography updated technology for endodontic diagnosis. Dent Clin North Am.Jul; 58 (3): 523-43, 2014.

9. Gambill JM, Alder M, del Rio CE. Comparison of nickel-titanium and stainless steel hand-file instrumentation using computed tomography. J Endod. Jul; 22(7):369-75, 1996.

10. Carrotte PV. A clinical guide to endodontics–update part 1. Br Dent J. Jan 24; 206(2):79-84, 2009.

11. Kurthukoti AJ, Sharma P, Swamy DF, Shashidara R, Swamy EB. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars. Int J Clin Pediatr Dent. Sep-Dec;8(3):202-7,2015.

12. European Society of Endodontology Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J, 39, 921-930, 2006.

13. Silva LA, Leonardo MR, Nelson-Filho P, Tanomaru JM. Comparison of rotary and manual instrumentation techniques on cleaning capacity and instrumentation time in deciduous molars. J Dent Child (Chic). Jan-Apr; 71(1):45-7, 2004.

14. Nazari Moghaddam K, Mehran M, Farajian Zadeh H. Root Canal Cleaning Efficacy of Rotary and Hand Files Instrumentation in Primary Molars. Iranian Endodontic Journal.4(2):53-57,2009

15. Pinheiro SL, Araujo G, Bincelli I, Cunha R, Bueno C. Evaluation of cleaning capacity and instrumentation time of manual, hybrid and rotary instrumentation techniques in primary molars. Int Endod J. Apr; 45(4):379-85, 2012.

16. Azar MR, Mokhtare M. Rotary Mtwo system versus manual K-file instruments:efficacy in preparing primary and permanent molar root canals. Indian J Dent Res. Mar-Apr; 22(2):363, 2011.

17. Schäfer E, Zapke K. A comparative scanning electron microscopic investigation of the efficacy of manual and automated instrumentation of root canals. J Endod. Nov; 26(11):660-4, 2000.

18. Selvakumar H, Kavitha S, Thomas E, Anadhan V, Vijayakumar R. Computed Tomographic Evaluation of K3 Rotary and Stainless Steel K File Instrumentation in Primary Teeth. J Clin Diagn Res.Jan; 10(1):ZC05-8, 2016.

19. De Paolis G, Vincenti V, Prencipe M, Milana V, Plotino G. Ultra-sonics in endodontic surgery: a review of the literature. Annali di Stomatologia.1(2):6-10.2010

20. Lumley PJ. Factors affecting the wear of sonic files. Endod Dent Trau-matol.Aug; 12(4):197-201, 1996.

21. Da Costa CC, Kunert GG, da Costa Filho LC, Kunert IR. Endodontics in primary molars using ultrasonic instrumentation. J Dent Child (Chic). Jan-Apr; 75(1):20-3, 2008.

22. George S, Anandaraj S, Issac JS, John SA, Harris A. Rotary endodontics in primary teeth–A review. Saudi Dent J.Jan;28(1):12-7,2016.

23. Fayyad, Dalia Mukhtar, Nihal Ezzat Sabet, and El-Said Mahmoud Abd El-Hafiz. “Computed tomographic evaluation of the apical shaping ability of Hero Shaper and Revo-S.” Endodontic Practice Today 6.2 .2012

24. Musale PK, Mujawar SA. Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCT. Eur Arch Paediatr Dent.Apr;15(2):113-20,2014.

25. Elsherief SM, Zayet MK, Hamouda IM. Cone-beam computed tomography analysis of curved root canals after mechanical prepa-ration with three nickel-titanium rotary instruments. J Biomed Res. Jul;27(4):326-35,2013.

26. Selvakumar H, Anandhan V, Thomas E, Swaminathan K, Vijaya-kumar R. Evaluationof canal transportation and centering ability of K 3 (0.02%) and K 3 (0.04%) withhand K files in primary teeth using spiral computed tomography. J Indian Soc Pedod Prev Dent.Oct-Dec; 32(4):286-91. 2014.