International Journal of Clinical Pediatric Dentistry

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VOLUME 14 , ISSUE 2 ( March-April, 2021 ) > List of Articles

RESEARCH ARTICLE

Comparative Evaluation of Hand K-flex Files, Pediatric Rotary Files, and Reciprocating Files on Instrumentation Time, Postoperative Pain, and Child's Behavior in 4–8-year-old Children

Rishi Tyagi, Puja Sabherwal

Keywords : Behavior assessment, Hand files, Instrumentation time, Pediatric rotary files, Postoperative pain, Primary dentition, Pulpectomy, Reciprocating files

Citation Information : Tyagi R, Sabherwal P. Comparative Evaluation of Hand K-flex Files, Pediatric Rotary Files, and Reciprocating Files on Instrumentation Time, Postoperative Pain, and Child's Behavior in 4–8-year-old Children. Int J Clin Pediatr Dent 2021; 14 (2):201-206.

DOI: 10.5005/jp-journals-10005-1919

License: CC BY-NC 4.0

Published Online: 30-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: A pulpectomy is regarded as the choice modality of treatment for necrotic teeth. The use of hand files, though popular traditionally as a gold standard, may be challenging due to increased chairside time. Postoperative pain is one of the most common complications of pulpectomy and may be unpleasant for a child/pedodontist. Rotary files were found to reduce instrumentation time, reduce apical extrusion, and in turn reduce pain but there is a lack of studies in primary teeth particularly for pediatric and reciprocating file systems. The increased number of options available today makes it a dilemma for the operator to choose a suitable file system. Aim and objective: The study aimed to evaluate and compare the instrumentation time, postoperative pain, and effect on child's behavior among three groups, i.e., hand K-flex files (group I), pediatric rotary files (group II), and reciprocating files (group III). Materials and methods: A total of 75 primary molar teeth after meeting inclusion criteria were randomly allocated into three groups. During the procedure, step-wise instrumentation time was recorded using a stopwatch. The child's behavior pre- and postoperatively was assessed by an evaluator. The postoperative pain (up to 1 week) was assessed by a questionnaire. Results: The mean age of children taken for the study was 6.03 ± 1.2 years with 46 males and 29 females. The mean biomechanical preparation time was observed to be significantly shorter in the pediatric rotary and reciprocating file groups vs hand K-flex files (p < 0.001**). The postoperative pain after 6 hours had a mean value of 0.88 + 0.9 for the hand K-flex file group which was significantly higher than both rotary file groups (p < 0.05*). The pre- and postoperative behavior revealed no significant difference. Conclusion: The clinical performance of pediatric and reciprocating files was superior, but the choice of file system did not significantly alter behavior.


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  1. Bell RA, Dean JA, Mc Donald RE, et al. Managing the developing occlusion. In: Dentistry for the child and adolescent. 9th ed., Mosby Inc.; 2011. pp. 551–552.
  2. American Academy of Pediatric Dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Pediatr Dent 2012;34(special issue):229–229.
  3. Walton RE, Torabinejad M. Principles and practice of endodontics. 3rd ed., Saunders Company Inc.; 2002. p. 222.
  4. Rosa FM, Modesto A, Faraco-Junior IM. Manual and rotary instrumentation techniques for root canal preparation in primary molars. Dentistry 2014;2(1):1–5. DOI: 10.3390/dj2010001.
  5. Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent 2000;22(1):77–78.
  6. Crespo S, Cortes O, Garcia C, et al. Comparison between rotary and manual instrumentation in primary teeth. J Clin Pediatr Dent 2008;32(4):295–298. DOI: 10.17796/jcpd.32.4.l57l36355u606576.
  7. Drukteinis S, Balciuniene I. A scanning electron microscopic study of debris and smear layer remaining following use of AET instruments and K-flexofiles. Stomatologija 2006;8(3):70–75.
  8. Govindaraju L, Jeevanandan G, Subramanian EMG. Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: a single-blinded randomized controlled trial. Eur J Dent 2017;11(3):376–379. DOI: 10.4103/ejd.ejd_345_16.
  9. Caviedes-Bucheli J, Moreno JO, Carreño CP, et al. The effect of single-file reciprocating systems on Substance P and Calcitonin gene-related peptide expression in human periodontal ligament. Int Endod J 2013;46(5):419–426. DOI: 10.1111/iej.12005.
  10. Kuştarci A, Akpinar KE, Er K. Apical extrusion of intracanal debris and irrigant following use of various instrumentation techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105(2):257–262. DOI: 10.1016/j.tripleo.2007.06.028.
  11. Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod 2011;37(4):429–438. DOI: 10.1016/j.joen.2010.12.016.
  12. Reddy SA, Hicks ML. Apical extrusion of debris using two hand and two rotary instrumentation techniques. J Endod 1998;24(3):180–183. DOI: 10.1016/S0099-2399(98)80179-9.
  13. Kustarci A, Akdemir N, Siso SH, et al. Apical extrusion of intracanal debris using two engine driven and step-back instrumentation techniques: an in-vitro study. Eur J Dent 2008;2(4):233–239. DOI: 10.1055/s-0039-1697386.
  14. Ferraz CC, Gomes NV, Gomes BP, et al. Apical extrusion of debris and irrigants using two hand and three engine-driven instrumentation techniques. Int Endod J 2001;34(5):354–358. DOI: 10.1046/j.1365-2591.2001.00394.x.
  15. Topçuoğlu G, Topçuoğlu HS, Delikan E, et al. Postoperative pain after root canal preparation with hand and rotary files in primary molar teeth. Pediatr Dent 2017;39(3):192–196.
  16. Faul F, Erdfelder E, Lang AG, et al. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175–191. DOI: 10.3758/bf03193146.
  17. Kashefinejad M, Harandi A, Eram S, et al. Comparison of single visit post endodontic pain using Mtwo rotary and hand K-file instruments: a randomized clinical trial. J Dent 2016;13(1):10.
  18. Riba H, Al-Zahrani S, Al-Buqmi N, et al. A review of behavior evaluation scales in pediatric dentistry and suggested modification to the Frankl scale. EC Dent Sci 2017;16:269–275.
  19. Kara Tuncer A, Gerek M. Effect of working length measurement by electronic apex locator or digital radiography on postoperative pain: a randomized clinical trial. J Endod 2014;40(1):38–41. DOI: 10.1016/j.joen.2013.08.004.
  20. Panchal V, Jeevanandan G, Subramanian E. Comparison of instrumentation time and obturation quality between hand K-file, H-files, and rotary Kedo-S in root canal treatment of primary teeth: a randomized controlled trial. J Indian Soc Pedod Prev Dent 2019;37(1):75–79. DOI: 10.4103/JISPPD.JISPPD_72_18.
  21. Morankar R, Goyal A, Gauba K, et al. Manual versus rotary instrumentation for primary molar pulpectomies – a 24 months randomized clinical trial. Pediatr Dent J 2018;28(2):96–102. DOI: 10.1016/j.pdj.2018.02.002.
  22. 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. Eur Arch Paediatr Dent 2018;19(4):273–278. DOI: 10.1007/s40368-018-0356-6.
  23. Makarem A, Ravandeh N, Ebrahimi M. Radiographic assessment and chair time of rotary instruments in the pulpectomy of primary second molar teeth: a randomized controlled clinical trial. J Dent Res Dent Clin Dent Prospects 2014;8(2):84–89. DOI: 10.5681/joddd. 2014.015.
  24. Babaji P, Mehta V, Manjooran T. Clinical evaluation of rotary system over manual system in deciduous molars: a clinical trial. Int J Pedod Rehabil 2019;4(1):13–16. DOI: 10.4103/ijpr.ijpr_27_18.
  25. Katge F, Chimata VK, Poojari M, et al. Comparison of cleaning efficacy and instrumentation time between rotary and manual instrumentation techniques in primary teeth: an in vitro study. Int J Clin Pediatr Dent 2016;9(2):124–127. DOI: 10.5005/jp-journals-10005- 1347.
  26. Madan N, Rathnam A, Shigli AL, et al. K-file vs ProFiles in cleaning capacity and instrumentation time in primary molar root canals: an in vitro study. J Indian Soc Pedod Prev Dent 2011;29(1):2–6. DOI: 10.4103/0970-4388.79907.
  27. Oh SR, Chang SW, Lee Y, et al. A comparison of nickel-titanium rotary instruments manufactured using different methods and cross-sectional areas: ability to resist cyclic fatigue. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(4):622–628. DOI: 10.1016/j.tripleo.2009.12.025.
  28. al-Omari MA, Dummer PM. Canal blockage and debris extrusion with eight preparation techniques. J Endod 1995;21(3):154–158. DOI: 10.1016/s0099-2399(06)80443-7.
  29. Wang C, Xu P, Ren L, et al. Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps: a randomized controlled trial. Int Endod J 2010;43(8):692–697. DOI: 10.1111/j.1365-2591.2010.01748.x.
  30. Torabinejad M, Dorn SO, Eleazer PD, et al. Effectiveness of various medications on postoperative pain following root canal obturation. J Endod 1994;20(9):427–431. DOI: 10.1016/S0099-2399(06)80031-2.
  31. Finn SB. Child management in the dental office. In: Finn SB, ed. Clinical pedodontics. Philadelphia: WB Saunders; 1998. p. 39.
  32. Krishna DRM, Setty JV, Srinivasan I, et al. Comparison between rotary (Mtwo) and manual (H-Files) techniques for instrumentation of primary teeth root canals. Indian J Dent Res 2019;30(6):899–903. DOI: 10.4103/ijdr.IJDR_59_18.
  33. Pathak S. In vitro comparison of K-file, Mtwo, and WaveOne in cleaning efficacy and instrumentation time in primary molars. Chrismed J Health Res 2016;3(1):60–64. DOI: 10.4103/2348-3334.172407.
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