Article Data

  • Views 419
  • Dowloads 163

Case Reports

Open Access

Adaptive instrumentation of root canals in primary teeth using XP-endo shaper: a case series

  • Bhagyashree Thakur1,2
  • Ajinkya M. Pawar3
  • Dian Agustin Wahjuningrum2,*,
  • Rodolfo Reda4,*,
  • Francesco Pagnoni4
  • Luca Testarelli4

1Department of Dentistry, Division of District Early Intervention Centre, Thane Civil Hospital, 400601 Thane, India

2Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, 60132 Surabaya, Indonesia

3Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, 400008 Mumbai, India

4Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy

DOI: 10.22514/jocpd.2023.067 Vol.47,Issue 5,September 2023 pp.170-175

Submitted: 28 December 2022 Accepted: 27 March 2023

Published: 03 September 2023

*Corresponding Author(s): Dian Agustin Wahjuningrum E-mail:
*Corresponding Author(s): Rodolfo Reda E-mail:


Dental caries is indeed the biggest cause of tooth loss, particularly in the primary dentition. In primary teeth with carious pulp involvements, endodontic intervention in the form of pulpotomy (removal of only the coronal pulp) or pulpectomy (removal of coronal and radicular pulp) is advocated. Pulpectomy can be laborious and time-consuming, especially when using traditional hand endodontic files to shape root canals. In paediatric dentistry, motorised nickel-titanium (Ni-Ti) rotary instrumentation has proved significant in enhancing the quality of pulpectomy. In primary dentition, however, these files may leave more than half of the root canals unaltered by instrumentation, just as they do in permanent dentition. The XP-endo® Shaper is a revolutionary heat-dependent endodontic file that uses an asymmetrical rotating motion to address the maximum area of the root canal space, resulting in anatomic root canal instrumentation. The case series describes the use of this novel XP-endo® Shaper file for anatomic root canal instrumentation in primary molars with irreversible pulpitis. The purpose is to demonstrate the efficacy and advantages of this cutting-edge endodontic treatment method. This case series can be an informative resource for other endodontic specialists by providing a practical illustration of how adaptable instrumentation can be utilised to successfully treat a patient. In conclusion, The use of the XP-endo Shaper® for pulpectomy demonstrated faster and instrumentation that was confined with the original shape of the canals, although further research is required to fully utilise these findings.


Anatomic instrumentation; Primary teeth; Pulpectomy; Rotary files; XP-endo® shaper

Cite and Share

Bhagyashree Thakur,Ajinkya M. Pawar,Dian Agustin Wahjuningrum,Rodolfo Reda,Francesco Pagnoni,Luca Testarelli. Adaptive instrumentation of root canals in primary teeth using XP-endo shaper: a case series. Journal of Clinical Pediatric Dentistry. 2023. 47(5);170-175.


[1] Schafer E, Erler M, Dammaschke T. Comparative study on the shaping ability and cleaning efficiency of rotary Mtwo instruments. Part 1. shaping ability in simulated curved canals. International Endodontic Journal. 2006; 39: 196–202.

[2] George S, Anandaraj S, Issac JS, John SA, Harris A. Rotary endodontics in primary teeth—a review. The Saudi Dental Journal. 2016; 28: 12–17.

[3] Kuo CI, Wang YL, Chang HH, Huang GF, Lin CP, Li UM, et al. Application of Ni-Ti rotary files for pulpectomy in primary molars. Journal of Dental Sciences. 2006; 1: 10–15.

[4] Yang S, Rivera EM, Walton RE, Baumgardner KR. Canal debridement: effectiveness of sodium hypochlorite and calcium hydroxide as medicaments. Journal of Endodontics. 1996; 22: 521–525.

[5] Crespo S, Cortes O, Garcia C, Perez L. Comparison between rotary and manual instrumentation in primary teeth. Journal of Clinical Pediatric Dentistry. 2008; 32: 295–298.

[6] Pawar A, Pawar M, Metzger Z, Kokate S. The self-adjusting file instrumentation results in less debris extrusion apically when compared to WaveOne and ProTaper next. Journal of Conservative Dentistry. 2015; 18: 89.

[7] Pawar AM, Pawar BA, Bhardwaj A, Maniangat Luke A, Metzger Z, Kfir A. Apical debris extrusion by adaptive root canal instrumentation in oval canals: full-sequence SAF system vs. the XP-Endo shaper plus sequence. Applied Sciences. 2020; 10: 5684.

[8] Pawar BA, Pawar AM, Bhardwaj A, Wahjuningrum DA, Rahardjo AK, Luke AM, et al. Effect of adaptive, rotary, and manual root canal instrumentation in primary molars: a triple-armed, randomized controlled clinical trial. Biology. 2021; 10: 42.

[9] Pawar BA, Pawar AM, Atram J, Luke AM, Bhardwaj A, Kfir A, et al. Apical debris extrusion during instrumentation of oval root canals in primary teeth using manual versus motorized files: an ex vivo study. Scientific Reports. 2021; 11: 1–7.

[10] Seracchiani M, Donfrancesco O, Relucenti M, Reda R, Zanza A, Gambarini G, et al. In vitro evaluation of a recently developed rotary file: AF rotary. Brazilian Dental Science. 2021; 24: 1–6.

[11] Thakur B, Bhardwaj A, Wahjuningrum DA, Luke AM, Shetty KP, Pawar AM, et al. Incidence of post-operative pain following a single-visit pulpectomy in primary molars employing adaptive, rotary, and manual instrumentation: a randomized clinical trial. Medicina. 2023; 59: 355.

[12] Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs. manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial. European Archives of Paediatric Dentistry. 2018; 19: 273–278.

[13] Siqueira JF, Araújo MCP, Garcia PF, Fraga RC, Dantas CJS. Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. Journal of Endodontics. 1997; 23: 499–502.

[14] JeevananDan G. Kedo-S paediatric rotary files for root canal preparation in primary teeth—case report. Journal of Clinical and Diagnostic Research. 2017; 11: ZR03–ZR05.

[15] Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatric Dentistry. 2000; 22: 77–8.

[16] Pawar AM, Thakur B, Kfir A, Kim HC. Dentinal defects induced by 6 different endodontic files when used for oval root canals: an in vitro comparative study. Restorative Dentistry & Endodontics. 2019; 44: 1–9.

[17] Wang Y, Chang H, Kuo C, Chen S, Guo M, Huang G, et al. A study on the root canal morphology of primary molars by high-resolution computed tomography. Journal of Dental Sciences. 2013; 8: 321–327.

[18] Shukri BM. A comparative study to evaluate canal transportation and centering ability of simulated curved canals prepared by XP-Shaper, WaveOne Gold and ProTaper next files. Mustansiria Dental Journal. 2018; 15: 18–24.

[19] Alfadley A, Alrajhi A, Alissa H, Alzeghaibi F, Hamadah L, Alfouzan K, et al. Shaping ability of XP endo shaper file in curved root canal models. International Journal of Dentistry. 2020; 2020: 1–6.

[20] Elnaghy A, Elsaka S. Cyclic fatigue resistance of XP-endo shaper compared with different nickel-titanium alloy instruments. Clinical Oral Investigations. 2018; 22: 1433–1437.

[21] Silva EJNL, Vieira VTL, Belladonna FG, Zuolo ADS, Antunes HDS, Cavalcante DM, et al. Cyclic and torsional fatigue resistance of XP-endo shaper and TRUShape instruments. Journal of Endodontics. 2018; 44: 168–172.

[22] Elnaghy AM, Elsaka SE. Torsional resistance of XP-endo shaper at body temperature compared with several nickel-titanium rotary instruments. International Endodontic Journal. 2018; 51: 572–576.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

PubMed (MEDLINE) PubMed comprises more than 35 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time