Yörel Vecihe İpek, Ocak Mert, Selvi-Kuvvetli Senem
Department of Pediatric Dentistry, Yeditepe University Faculty of Dentistry, Istanbul, Türkiye.
Department of Paediatric Dentistry, Near East University, Near East Boulevard, Nicosia, Cyprus.
BMC Oral Health. 2025 May 26;25(1):803. doi: 10.1186/s12903-025-06208-7.
Mechanical preparation is one of the critical stages of root canal treatment in primary teeth. Therefore, the aim of this study was to compare the effectiveness of root canal shaping in primary molar teeth using EndoArt Pedo Blue, OneShape, Hyflex EDM rotary files and stainless-steel K-files by assessing changes in canal volume, uninstrumented area and apical transportation three-dimensionally with the use of micro-computed tomography (micro-CT) scans.
A sample size of 60 primary maxillary first and second molars were randomly assigned into four subgroups (n = 15/group). A single-trained operator instrumented the root canals using OneShape, Hyflex EDM and Endo-Art Pedo Blue rotary files and stainless-steel K-files. The change in volume, uninstrumented area and apical transportation were then evaluated by comparing the pre-instrumentation and post-instrumentation micro-CT scans of the teeth. The data were analysed using Kruskal Wallis tests for comparisons between groups, followed by post-hoc The Bonferroni test (p < 0.012).
Both EndoArt Pedo Blue and OneShape rotary files lead to more apical transportation than the K-files (p < 0.012). Although EndoArt rotary file caused the largest change in canal volume and Hyflex EDM file resulted in the most uninstrumented areas in the canals, there were no statistically significant differences in change in canal volume and uninstrumented areas among the four experiment groups (p > 0.012).
All instruments tested in this study could safely shape curved and narrow root canals of primary molars, however K-files lead to less apical transportation than OneShape and paediatric rotary EndoArt Pedo Blue files. It may be concluded that it is safe to use rotary instrumentation in root canal shaping of primary teeth that are designed for primary and permanent teeth. However, K-files may provide more tactile sensation than the tested Endo-Art pediatric and OneShape rotary files, which is important in primary root canal shaping to avoid extrusion of material to the permanent teeth germs.
机械预备是乳牙根管治疗的关键步骤之一。因此，本研究的目的是通过使用微型计算机断层扫描（micro-CT）扫描三维评估根管容积、未预备区域和根尖移位的变化，比较使用EndoArt Pedo Blue、OneShape、Hyflex EDM旋转锉和不锈钢K锉对乳磨牙进行根管预备的效果。
将60颗上颌第一和第二乳磨牙随机分为四个亚组（每组n = 15）。由一名经过单一培训的操作人员使用OneShape、Hyflex EDM和Endo-Art Pedo Blue旋转锉以及不锈钢K锉对根管进行预备。然后通过比较牙齿预备前和预备后的micro-CT扫描来评估容积、未预备区域和根尖移位的变化。使用Kruskal Wallis检验对组间进行比较，随后进行事后Bonferroni检验（p < 0.012）。
EndoArt Pedo Blue和OneShape旋转锉导致的根尖移位均比K锉更多（p < 0.012）。尽管EndoArt旋转锉引起的根管容积变化最大，Hyflex EDM锉导致根管内未预备区域最多，但四个实验组在根管容积变化和未预备区域方面无统计学显著差异（p > 0.012）。
本研究中测试的所有器械都能安全地预备乳磨牙弯曲狭窄的根管，然而K锉导致的根尖移位比OneShape和儿童专用旋转锉EndoArt Pedo Blue少。可以得出结论，在为乳牙和恒牙设计的乳牙根管预备中使用旋转器械是安全的。然而，K锉可能比测试的Endo-Art儿童专用锉和OneShape旋转锉提供更多的触觉感受，这在乳牙根管预备中对于避免材料挤压到恒牙胚很重要。
