Schachter Dora, Blumer Sigalit, Sarsur Sara, Peretz Benjamin, Sella Tunis Tatiana, Fadela Shada, Kharouba Johnny, Elbahary Shlomo
Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel.
Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel.
Children (Basel). 2023 Apr 28;10(5):792. doi: 10.3390/children10050792.
Traditional hand instrumentation is a commonly used technique to perform pulpectomy in deciduous teeth by most specialists in pedodontics. Lately, dentists have embraced rotary instrumentation as a safe and effective alternative. This study aimed to compare the efficacy of root canal preparation in extracted primary molars between manual and two rotary file systems using micro-CT. Thirty-six extracted human second primary mandibular molars were divided into three groups according to the instrumentation method: (1) Manually instrumented (MI) group (n = 9) in which the teeth were treated using K-files up to size 30; (2) Kedo-Ssystem (KS) group (n = 9); (3) ProTaper Gold system (PTG) group (n = 10) and control group (n-8). Each tooth was scanned before and after the retrograde root canal preparation. Residual dentin volume was calculated using micro-CT scans to evaluate the technique's efficacy. Additionally, the preparation time and procedural errors were recorded for each tooth preparation. A one-way ANOVA test was carried out to compare the groups' dentin volume and preparation time. The mean preparation time using the manual method (13.14 min) was more than two times longer than that of the rotary techniques (4.62 min and 6.45 min). The manual preparation method using a K-file removed almost half the root canal material when compared with the rotor method ( = 0.025). Conclusion: our results suggest that rotary instrumentation is more efficient for root canal preparation in primary teeth than the traditional manual method. This finding may call for a paradigm shift in current clinical practices, where manual instrumentation is still commonly preferred.
传统的手工器械操作是大多数儿童牙科专家在乳牙中进行牙髓摘除术常用的技术。最近，牙医们已接受旋转器械操作作为一种安全有效的替代方法。本研究旨在使用微型计算机断层扫描（micro-CT）比较手工和两种旋转锉系统在拔除的乳磨牙中进行根管预备的效果。三十六颗拔除的人类下颌第二乳磨牙根据器械操作方法分为三组：（1）手工器械操作（MI）组（n = 9），使用K锉处理牙齿直至30号；（2）Kedo-S系统（KS）组（n = 9）；（3）ProTaper Gold系统（PTG）组（n = 10）和对照组（n = 8）。每颗牙齿在逆行根管预备前后进行扫描。使用微型计算机断层扫描计算剩余牙本质体积以评估该技术的效果。此外，记录每颗牙齿预备的时间和操作失误。进行单因素方差分析以比较各组的牙本质体积和预备时间。使用手工方法的平均预备时间（13.14分钟）比旋转技术的时间（4.62分钟和6.45分钟）长两倍多。与旋转方法相比，使用K锉的手工预备方法去除了几乎一半的根管材料（P = 0.025）。结论：我们的结果表明，旋转器械操作在乳牙根管预备中比传统手工方法更有效。这一发现可能需要在目前仍普遍首选手工器械操作的临床实践中进行范式转变。
