Comparison of Detection Rate and Ease of Locating Root Canal Orifices in Primary Molars Using Various Techniques, Namely Magnifying Loupes, Methylene Blue Dye, and Fluorescein Sodium Dye: An In Vivo Study

Abstract

Context: Primary teeth often show bizarre root canal anatomy; this requires the clinician to gain a thorough knowledge of the primary root canal morphology. Complex primary root canal morphology often leads to missed canals, and hence, various strategies can be adapted to reduce this likelihood.

Aim: To compare the detection rate and ease of locating root canal orifices in primary molars using magnifying loupes, methylene blue dye, and fluorescein sodium dye.

Settings and design: Parallel-arm randomized clinical trial.

Materials and methods: A total of 36 primary molars were divided into two groups: Group I: methylene blue; Group II: fluorescein sodium. Both groups utilized magnifying loupes (×2.5). The principal investigator used magnifying loupes, followed by the coinvestigator who used the assigned dye to detect the canal orifices. The principal investigator again examined the dyed canal orifices under magnification. The number of canals found and the ease of locating them with the three different aids were recorded on a five-point Likert scoring scale by both investigators.

Statistical analysis: A comparison of the number of canal orifices and ease of location was performed using one-way analysis of variance (ANOVA) and the Kruskal-Wallis test.

Results: There was a significant difference in ease of detection between loupes, methylene blue dye, and the loupes combination (p-value 0.047); also, between loupes, fluorescein sodium dye, and the loupes combination (p-value 0.040). However, no statistically significant difference was found in detection rate with the three different methods.

Conclusion: The dye and loupes combination was proven more effective than using dye or loupes alone.

How to cite this article: Pharne V, Patil SB, Vishwakarma AP, et al. Comparison of Detection Rate and Ease of Locating Root Canal Orifices in Primary Molars Using Various Techniques, Namely Magnifying Loupes, Methylene Blue Dye, and Fluorescein Sodium Dye: An In Vivo Study. Int J Clin Pediatr Dent 2025;18(1):64-69.

Keywords: Fluorescein sodium; Methylene blue; Primary molars; Pulpectomy; Surgical loupes.

Fig. 1

Flow diagram to show the workflow of the study

Figs 2A to C

Armamentarium used in the study. (A) Magnifying loupes (2.5× magnification); (B) Methylene blue dye (Canal detector, Cerkamed, Stalowa Wola, Poland); (C) Fluorescein sodium (Fluoro Touch, Fluorescein sodium ophthalmic strips, Kashsurg, India)

Figs 3A and B

(A) Shows the pulp chamber of primary maxillary second molar stained with fluorescein sodium dye; (B) Shows the pulp chamber of primary maxillary first molar stained with fluorescein sodium dye

Fig. 4

Shows the pulp chamber of primary mandibular second molar stained with methylene blue dye

Fig. 5

Comparison of ease of detection between three methods

Fig. 6

Comparison of the number of canal orifices detected between three methods