Radicular Dentin Remaining, Risk of Perforation and Canal Transportation in Manual Versus Rotary Instrumentation in Primary Molars
Condition: Root Canal Infection
Study type: Interventional

Summary: 
      Background: Root canal preparation techniques using manual instruments have found to be
      time-consuming and may lead to iatrogenic errors such as ledging, zipping, canal
      transportation, and apical blockage. To overcome this, much attention has been directed
      toward root canal preparation using nickel-titanium (NiTi)-rotary instruments. The
      flexibility and the instrument design of NiTi-rotary files allow it to closely follow the
      original root canal path. Aim: This in vitro study aims to compare the amount of dentin
      removal in primary molars instrumented with hand versus rotary files and the root canal
      transportation and risk of perforation using cone beam computed tomography (CBCT). Materials
      and Method: ( 20 ) extracted discarded mandibular second primary molars were selected to
      contribute in the study, having minimal apical resorption with presence of at least two-third
      remaining root structure with absence of visual perforating resorption. The teeth included in
      the study were stored in water or saline till the experimental time. The extracted primary
      molars were divided into two groups of the study: Group I was prepared with rotary
      instrumentation using ProTaper Next (Dentsply, Switzerland) and Group II was prepared by
      manual instrumentation using K type files. All the root canals (n=40) were prepared up to
      size 35 using the step-back technique. The teeth were subjected to CBCT scans for the
      evaluation of thickness of radicular dentin remaining, risk of perforation and canal
      transportation before and after instrumentation in the two groups at three different
      locations (2, 4 and 7 mm from the apex) . Dentin removal was calculated by superimposing
      images using the InVivo 5.1 software. Data were statistically analyzed using independent
      samples t test.
    

Detailed description: 
      Aim of the study:

      To compare the shape & diameter of root canals, risk of perforation and the canal
      transportation after using rotary versus manual instruments on root extracted second primary
      molars.

      Methodology:

      Extracted second primary molars will be collected from the dental clinics of Pediatric
      Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University.

      The teeth are extracted either due to periodontal problems or because they are not restorable
      (beyond restoration) by the conventional coronal restorations or full coverage restorations
      in the case of root caries.

      The teeth will be selected according to our inclusions and exclusion criteria. The teeth will
      be collected, sterilized and stored according to the Occupational Safety and Health
      Administration guidelines and regulations, ultrasonic scaler will be used to clean and remove
      soft tissue debris and calculus attached to the teeth.

      Teeth will be divided into two groups:

      Group (1); ((ProTaper Next, Rotary system). Group (2); K- files, Manual instruments. For
      cleaning and shaping of the canal system and mechanical preparation of root canal treatment.

      Then shape of the canal (Canal transportation), canal diameter and risk of canal perforation
      will be compared in both groups.

      Before and after preparation of the root canal, the shape of the canal will be assessed by
      using cone-beam computed tomography (CBCT) and diameter of the canal will be measured by
      using cone-beam computed tomography (CBCT).
    

Intervention name(s): Endodontic files
Intervention type(s): Other
Intervention description(s): Engine-driven nickel titanium Ni-Ti instruments
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Deciduous teeth; pulpectomy; root canal preparation; canal transportation,; Cone Beam Computerized Tomography.