Comparative assessment of dentin removal following hand and rotary instrumentation in primary molars using cone-beam computed tomography

Abstract

Objective: Pediatric endodontics has witnessed many advances in recent years, thus facilitating a faster and efficient treatment option in root canal therapy in children. This in vitro evaluation aims to determine the amount of dentin removal in primary mandibular first and second molars instrumented with hand and rotary files using cone-beam computed tomography (CBCT).

Materials and method: Sixty primary mandibular molars were divided into two groups: Group I was prepared by manual instrumentation using K-type files and Group II was prepared with rotary instrumentation using 0.04 Hero Shaper Classics. Both these groups were further divided into two subgroups, namely (a) primary mandibular first molar and (b) primary mandibular second molar. All the root canals were prepared up to size 30 using the stepback technique. They were mounted on silicone-based impression material and subjected to CBCT scans for the evaluation of dentin removal before and after instrumentation. Dentin removal was calculated by superimposing images using the InVivo 5.1 Anatomage software. Data were statistically analyzed using independent samples t- test.

Results: An average amount of dentin removed was found to be significantly higher in manual instrumentation compared to rotary instrumentation in both primary mandibular first and second molars (P < 0.001).

Conclusions: Rotary technique serves as an efficient alternative to the traditional manual instrumentation by overcoming its shortcomings in terms of conservation of the remaining dentin thickness and the time required for its preparation.

Keywords: Cone-beam computed tomography; dentin removal; primary molars; rotary instrumentation.