Obturation Quality in Primary Molars
Condition: Necrotic Primary Molars
MeSH terms: Necrosis
Study type: Interventional

Summary: 
      Forty cases of necrotic primary molars in children aged 4-8 years were selected to compare
      the effect of manual versus rotary pulpectomy regarding parental acceptance and obturation
      quality.
    

Detailed description: 
      The present study was performed in the Department of Pediatric Dentistry and Dental Public
      Health Department, Faculty of Dentistry, Cairo University, Egypt.

      Ethical approval was obtained from the Ethical Committee board of Faculty of Dentistry, Cairo
      University, Egypt.

      Written informed consent was taken from the legal guardian of each participating child
      willing to participate in the trial, prior to the start of the clinical procedure after
      explaining the whole procedure in a simple way. The consent form was written in Arabic.

      A sample of 40 primary mandibular second molars of children between 4 and 8 years of age
      indicated for pulpectomy participated in this double-blinded randomized controlled trial.
      Parallel allocation design was adopted for the intervention and control arms with allocation
      ration 1: 1 (i.e. 20 cases each). The sample size was calculated considering the previously
      published studies with 95% power in detecting the true statistical significance among the two
      groups.

      Control group one: Manual pulpectomy using) H files, Mani*) Group two: Rotary pulpectomy
      using (Fanta baby* rotary files and Endo Radar* rotary device).

      Diagnosis:

      Diagnostic chart was filled with personal, medical and dental history.

        1. Intra & extra oral examination was made with aid of mirror and probe to assess the
           clinical inclusion criteria.

        2. Preoperative photographs were taken

        3. Preoperative radiograph were examined

      Intervention:

      Patients were assigned into two groups; Group A (Experimental group) (using rotary files)

        1. Pre-operative radiograph showing all roots and their apices.

        2. Local anaesthetic (to enable use of rubber dam clamp).

        3. Rubber dam isolation.

        4. Removal of caries.

        5. Removal of roof of pulp chamber.

        6. Identify root canals.

        7. Irrigate with concentrated sodium hypochlorite followed by normal saline (0.9%)

        8. Estimate working lengths of root canals keeping 2 mm short of the radiographic apex.

        9. Insert rotary files into canals and debride the canals lightly and gently.

       10. Irrigate the root canals.

       11. Dry canals with pre-measured paper points, keeping 2 mm from root apices.

       12. Canals were dried with paper points, obturated by injecting Metapex. (Meta Biomed -
           Metapex Root Canal Filling Material)

       13. Stainless steel crown was performed

      Group B (control group) (using manual files) All steps as that of group A were done except
      step (j) instead of it; a manual files were inserted into the canals for debridement lightly
      and gently.

      Randomization &Allocation concealment:- Sequence generation Simple randomization was done by
      computer software (www.random.com) for patient's assignment in each group.

      Blinding:

      Blinding to the child participants and legal guardian of each participating child, inter
      examiner and statistician.

      Statistical analysis:

      Categorical data were presented as frequencies (n) and percentages (%). Intergroup
      comparisons were done utilizing Fisher's exact test. while intragroup comparisons were done
      utilizing Cochran's Q tests followed by Dunn's post hoc test. Ordinal data were presented as
      median and interquartile range values and were analyzed using Mann-Whitney U test for
      intergroup comparisons. The significance level was set at p ≤ 0.05 for all tests. Statistical
      analysis was performed with ® SPSS® (SPSS Inc., IBM Corporation, New York, USA) Statistics
      Version 26 for Windows.
    

Intervention name(s): Rotary pulpectomy; Manual pulpectomy
Intervention type(s): Procedure; Procedure
Intervention description(s): Pulpectomy procedures by making cleaning and shaping of root canals of necrotic primary molars using (Fanta AF baby* rotary files and Endo Radar* rotary device).; Pulpectomy procedures by making cleaning and shaping of root canals of necrotic primary molars using Manual H files, Mani*)
Other intervention name(s): (Fanta AF baby* rotary files and Endo Radar* rotary device).; Manual H files, Mani*)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled parallel double blinded study
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rotary instrumentation; pulpectomy; primary molars; obturation quality