Pediatric Rotary Endodontic Files in Primary Teeth (2000-2025): A Scoping Review of Design, Evidence, and Clinical Use.

Rotary instrumentation is increasingly popular in pediatric endodontics, but the evidence for pediatric-specific systems remains fragmented. This scoping review aimed to map the design features, clinical outcomes, and evidence gaps of rotary file systems used in primary teeth. We conducted a systematic search of PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025. We included in vitro, clinical, and imaging-based studies, reviews, and case reports. Data on file design, study characteristics, and outcomes were extracted and synthesized. From 424 records, 111 studies were included. The results showed that pediatric-specific rotary systems (e.g., Kedo-S, Pro AF Baby Gold, Kedo-SG Blue) were consistently associated with reduced instrumentation time and improved canal shaping compared to manual techniques. Pediatric-specific rotary files demonstrate clear procedural advantages over manual methods. However, significant heterogeneity in study quality and limited global representation necessitate cautious interpretation. Future research should prioritize multicenter randomized controlled trials with long-term follow-up to provide higher-quality evidence.