Root Canal Cleaning Efficacy of Rotary and Hand Files Instrumentation in Primary Molars In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. Rotary Mtwo system versus manual K-file instruments: efficacy in preparing primary and permanent molar root canals. 'Volumetric analysis of hand and rotary root canal instrumentation and filling in primary teeth using Spiral Computed Tomography' - an invitro study. In vivo antibacterial efficacy of ultrasound after hand and rotary instrumentation in human mandibular molars. Comparative clinical responses related to the use of various periodontal instrumentation. Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments. Bacterial reduction with nickel-titanium rotary instrumentation. The in vivo evaluation of hand/rotary/ultrasound instrumentation in necrotic, human mandibular molars. Microbiological assessment of root canals following use of rotary and manual instruments in primary molars. Efficacy of a new brush-covered irrigation needle in removing root canal debris: a scanning electron microscopic study. Smear Layer Evaluation on Root Canal Preparation with Manual and Rotary Techniques using EDTA as an Irrigant: A Scanning Electron Microscopy Study. Ability of chemomechanical preparation with either rotary instruments or self-adjusting file to disinfect oval-shaped root canals. A new methodology for the comparative study of the root canal instrumentation techniques based on digital radiographic image processing and analysis. A retrospective study of endodontic treatment outcome between nickel-titanium rotary and stainless steel hand filing techniques. An in-vitro Evaluation of canal transportation and centering ability of two rotary Nickel Titanium systems (Twisted Files and Hyflex files) with conventional stainless Steel hand K-flexofiles by using Spiral Computed Tomography. Scanning electron microscope study on the efficacy of root canal wall debridement of hand versus Lightspeed instrumentation.
INTRODUCTION : Pulpectomy of primary teeth is commonly carried out with h and files and broaches ; a tricky and time consuming procedure . The purpose of this in vitro study was to compare the cleaning efficacy and time taken for instrumentation of deciduous molars using h and K-files and Flex Master rotary system . MATERIAL S AND METHODS : In this study , 68 canals of 23 extracted primary molars with at least two third intact roots and 7 - 12 mm length were selected . After preparing an access cavity , K-file size # 15 was introduced into the root canal and India ink was injected with an insulin syringe . Sixty sample s were r and omly divided in to experimental groups in group I ( n=30 ) , root canals were prepared with h and K-files ; in group II ( n=30 ) , rotary Flex Master files were used for instrumentation , and in group III 8 remained sample s were considered as negative controls . After clearing and root sectioning , the removal of India ink from cervical , middle , and apical thirds was scored . Data was analyzed using student 's T-test and Mann-Whitney U test . RESULTS : There was no significant difference between experimental groups cleaning efficacy at the cervical , middle and apical root canal thirds . Only the coronal third scored higher in the h and instrumented group ( P<0.001 ) . Instrumentation with Flex Master rotary files was significantly less time consuming ( P<0.001 ) . CONCLUSION : Although there was no difference in cleanliness efficacy at the apical and middle thirds , the coronal third was more effectively cleaned with h and files . Predictably , time efficiency was a significant advantage with rotary technique This study histologically compared the in vivo debridement efficacy of h and /rotary canal preparation versus a h and /rotary/ultrasound technique in mesial root canals of vital m and ibular molars . Group 1 consisted of 16 teeth prepared with a h and /rotary technique  whereas group 2 consisted of 15 teeth  prepared in similar fashion but followed by 1 min of ultrasonic irrigation , per canal , utilizing an ultrasonic needle in a MiniEndo unit . Five uninstrumented m and ibular molars served as histologic controls . After extraction and histologic preparation , 0.5 microm cross-sections , taken every 0.2 mm from the 1- to 3-mm apical levels , were evaluated for percentage of tissue removal . Nonparametric analysis revealed mean percent canal and isthmus cleanliness values to be significantly higher for group 2 at all levels evaluated , except one . In conclusion , the 1 min use of the ultrasonic needle after h and /rotary instrumentation result ed in significantly cleaner canals and isthmuses in the mesial roots of m and ibular molars AIM To compare the cleaning ability and preparation time of rotary instruments ( Mtwo ) and conventional manual instruments ( K-file ) in preparing primary and permanent molar root canals . MATERIAL S AND METHODS Access cavities were prepared in 70 primary and 70 permanent teeth and  India ink was injected into 120 canals of selected molars . The teeth were r and omly divided into two main subgroups ( n=20 ) and three control groups ( n=10 ) . In each of these main subgroups , either the manual instrument ( K-file ) or the rotary system ( Mtwo ) was used to prepare root canals . After cleaning the canals and clearing the teeth , dye removal was evaluated with the help of a stereomicroscope . In addition , the time needed for root canal preparation was recorded by a chronometer . STATISTICAL ANALYSIS Statistical analyses were done using the Kruskal-Wallis , Mann-Whitney and t tests . RESULTS With regard to the cleaning ability of root canals , there were no significant differences between the K-file and Mtwo rotary system in primary and permanent teeth in the apical , middle or coronal third of the canals . Moreover , there were no significant differences between primary and permanent teeth prepared with K-files and rotary instruments . In all the groups , shorter times were recorded with the rotary technique . The working time was shorter in primary than in permanent teeth . CONCLUSION The Mtwo rotary system showed acceptable cleaning ability in both primary and permanent teeth , and achieved results similar to those of K-files in less time AIM To compare and evaluate the volumetric analysis of pre- and post-root canal instrumentation in primary teeth using h and and rotary files and also to analyse the volume of root canal filling . MATERIAL S AND METHODS A total of 20 primary teeth were divided into two groups r and omly and subjected to spiral computed tomography ( SCT ) analysis before and after instrumentation . For manual technique ( Group 1 ) , teeth were prepared using K files and rotary ( Group 2 ) preparation was performed with Mtwo files .  Volumetric enlargement was calculated using Osirix software . Root canals were then filled with rotary lentulospiral using zinc oxide-eugenol cement ( ZOE ) . The filled volume in each canal was measured using SCT and the percentage of obturated volume was calculated . The data were statistically analysed using paired t-tests . RESULTS There was a statistically significant difference in the volume of root canal enlarged in both the groups . Rotary files showed significant increase in the volume compared to K files . Mtwo instrumented root canals showed good obturated volume compared to manual technique , although voids were common in both the groups . CONCLUSION Rotary root canal instrumentation may be indicated for utilization in primary teeth , for enhancing root canal preparation and good quality of root canal filling The purpose of this prospect i ve , r and omized , single-blind study was to compare the in vivo antibacterial efficacy of a h and /rotary technique versus a h and /rotary/ultrasound technique in mesial root canals of necrotic m and ibular molars . The h and /rotary group consisted of 16 mesial roots prepared with a h and /rotary technique .  The h and /rotary/ultrasound group consisted of 15 mesial roots prepared similarly , followed by 1 minute of ultrasonic irrigation per canal with an ultrasonic needle in a MiniEndo unit and 15 mL/canal of 6.0 % sodium hypochlorite . Canals were sample d before and after instrumentation and after 1 minute of ultrasonic irrigation . Sample s were incubated anaerobically on reduced blood agar for 7 days at 37 degrees C , and colony-forming units ( CFUs ) were counted . The addition of 1 minute of ultrasonic irrigation result ed in significant ( p = .0006 ) reduction in CFU count and positive cultures ( p = .0047 ) . Logistic regression analysis indicated the addition of ultrasonic irrigation was 7 times more likely to yield a negative culture AIM The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of a power-driven mechanism compared with h and instruments and ultrasonic insert alone with a split-mouth design after 3 and 6 months . METHODS Healing events after initial periodontal therapy were investigated in 20 patients with moderate-to-severe adult periodontitis .  Plaque index ( PlI ) , bleeding on probing ( PBI ) , probing pocket depth ( PPD ) , probing attachment level ( PAL ) and number of moderate and deep pockets ( NMP , NDP ) were recorded at baseline and 3 and 6 months after treatment . Oral hygiene instruction was provided for each patient . R and omly assigned quadrants per patient were scaled and root planed with h and instrumentation ( curettes , hoes and files ) , with reciprocating power-driven instruments , with ultrasonic scaler alone and with the combined use of ultrasonic scaler and power-driven inserts . The Friedman test was applied to test the significance of difference between the various methods of root instrumentation . Repeated measures of analysis of variance ( manova ) were used to analyse the time effect on the different treatments . RESULTS At the 6-month evaluation , all groups in the scaling and root planing treatment presented with an improvement in the measured clinical parameters , as compared with baseline . No statistical differences ( p>0.05 ) were observed in the assessed periodontal indices among the study sites between the four groups for either treatment . CONCLUSIONS Under our experimental conditions , this clinical study demonstrates that mechanized root planing with power-driven instruments , as effective as the usual procedures ( h and and sonic instruments ) , represents a satisfactory and alternative means of nonsurgical root therapy AIM To investigate instrumentation time , working safety and the shaping ability of two rotary nickel-titanium ( NiTi ) systems ( Alpha System and ProTaper Universal ) in comparison to stainless steel h and instruments . METHODOLOGY A total of 45 mesial root canals of extracted human m and ibular molars were selected . On the basis of the degree of curvature the matched teeth were allocated r and omly into three groups of 15 teeth each . In group 1 root canals were prepared to size 30 using a st and ardized manual preparation technique ; in group 2 and 3 rotary NiTi instruments were used following the manufacturers ' instructions . Instrumentation time and procedural errors were recorded . With the aid of pre- and postoperative radiographs , apical straightening of the canal curvature was determined . Photographs of the coronal , middle and apical cross-sections of the pre- and postoperative canals were taken , and superimposed using a st and ard software . Based on these composite images the portion of uninstrumented canal walls was evaluated . RESULTS Active instrumentation time of the  Alpha System  was significantly reduced compared with ProTaper Universal and h and instrumentation ( P < 0.05 ; anova ) . No instrument fractures occurred in any of the groups . The Alpha System revealed significantly less apical straightening compared with the other instruments ( P < 0.05 ; Mann-Whitney U test ) . In the apical cross-sections Alpha System result ed in significantly less uninstrumented canal walls compared with stainless steel files ( P < 0.05 ; chi-squared test ) . CONCLUSION Despite the demonstrated differences between the systems , an apical straightening effect could not be prevented ; areas of uninstrumented root canal wall were left in all regions using the various systems The purpose of this study was to compare intracanal bacterial reduction on teeth instrumented with 0.04 tapered nickel-titanium ( NiTi ) rotary instrumentation to bacterial reduction when using a stainless-steel K-file step-back technique using sterile saline irrigation .  Forty-eight patients with apical periodontitis were r and omly assigned treatment type . The canals were sample d before , during , and after instrumentation . The sample s were incubated anaerobically for 7 days at 37 degrees C , colony-forming unit numbers calculated , and a log transformation performed to normalize the counts . Teeth exhibiting apical periodontitis were uniformly infected , whereas vital control teeth were not . A similar and uniform reduction occurred with progressive filing , regardless of technique ( p < 0.0001 ) . There was no detectable difference in colony-forming unit count after NiTi rotary or stainless-steel h and instrumentation ( p = 0.42 ) . Neither technique could predictably render canals free of bacteria . The results of this study indicate NiTi rotary and stainless-steel h and K-file step-back instrumentation techniques were not significantly different in their ability to reduce intracanal bacteria This in vivo , prospect i ve , r and omized , single-blinded study histologically compared biofilm/necrotic debridement efficiency of a h and /rotary technique versus a h and /rotary/1 min ultrasound technique in the mesial roots of necrotic , human m and ibular molars . The h and /rotary group consisted of 20 mesial roots . The h and /rotary/ultrasound group consisted of 20 mesial roots  prepared with the same h and /rotary technique followed by 1 min of ultrasonic irrigation , per canal , utilizing an ultrasonic needle in a MiniEndo unit . Following extraction , histologic preparation and staining , 0.2 mum cross-sections from the 1- to 3-mm apical levels were evaluated for percentage of biofilm/necrotic debris removal . Cleanliness results at the 1- , 2- and 3-mm levels for the h and /rotary and h and /rotary/ultrasound techniques , respectively , were : Canals , 80 % versus 95 % , 92 % versus 99 % , and 95 % versus 100 % ; Isthmuses , 33 % versus 83 % , 31 % versus 86 % , 45 % versus 91 % . Statistical analysis revealed mean percent canal and isthmus cleanliness values to be significantly higher for h and /rotary/ultrasound technique at all levels evaluated AIM To assess the microflora of root canals in primary molars following use of rotary NiTi files and conventional h and NiTi and stainless steel files . STUDY DESIGN This r and omized clinical trial consisted of a total of 60 first and second primary molars requiring root canal treatment , who were selected from children aged 5 - 9 years . Based on type of root canal instrumentation , the teeth were r and omly assigned to three groups of twenty teeth each ; Group A : Rotary NiTi files , Group B : H and NiTi files and Group C : H and stainless steel files . Following administration of local anesthesia , isolation with rubber dam was carried out . For the purpose of instrumentation and sampling , the palatal canal of maxillary molars and the distal canal of m and ibular molars were selected . Prior to sampling , the orifices of other canals in these teeth were sealed , so as to prevent any contamination . Instrumentation was carried out in each group using respective instruments along with intermittent saline irrigation . Root canal sample s were obtained both before and after instrumentation , using sterile absorbent paper points and transferred to a sterile vial with transport fluid . Serial dilutions were prepared and cultured on suitable agar media . Both aerobic and anaerobic microbial counts were made . Data obtained was subjected to statistical analysis using Wilcoxon signed rank test and one-way Analysis of variance . RESULTS In all three groups , there was a significant reduction in both aerobic and anaerobic mean microbial count following root canal instrumentation . ( p < 0.001 ) . CONCLUSION Rotary NiTi files were as efficient as conventional h and instruments in significantly reducing the root canal microflora The usefulness of NaviTip FX , a brush-covered irrigation needle , in endodontic therapy has never been reported . Therefore , the purpose of this investigation was to evaluate the cleaning efficacy of this new brush-covered irrigation needle , the NaviTip FX .  Thirty single-rooted teeth were r and omly divided into two equal groups and instrumented using the crown-down technique with 0.04 taper ProFile . Following each file use , the canals were irrigated with 1 ml of 5.25 % NaOCl using the NaviTip FX needle for group 1 or using the same needle without the brush for group 2 . At the end of instrumentation , the roots were cut longitudinally and each half was divided into three equal parts . The specimens were then routinely prepared for scanning electron microscopic evaluation . The results showed that using the NaviTip FX produced cleaner coronal thirds of instrumented root canals compared to the control group . On the other h and , the middle and apical thirds were not statistically significantly different between the two groups . Further development of this irrigation technique to improve cleanliness of the apical and middle thirds is required before the NaviTip FX can be recommended for routine use during root canal therapy INTRODUCTION The aim of any root canal treatment is to achieve a canal free of micro organisms , residual pulp remnants , debris and smear layer for the long term success of the procedure . Manual and automated instrumentation techniques along with proper irrigation regime is used to arrive at the aforementioned goal . Many authors focused on the preparation capabilities of various manual and rotary instruments but very few investigators stressed on the actual cleaning abilities of these instruments . AIMS AND OBJECTIVES This study was undertaken to evaluate the cleaning efficiency of manual K flex files and rotary Pro File systems in the root canals using a scanning electron microscope . MATERIAL AND METHODS Thirty single rooted m and ibular first premolars were divided into two groups and r and omized ( the manual group-M and the ProFile group-P ) with respect to the preparation technique . The Manual group was h and instrumented with stainless steel K- Flexofiles by means of a conventional filing technique . The Pro File group was instrumented according to the manufacturer 's instructions using a rotary h and piece . All canals were shaped and cleaned under frequent irrigation with EDTA . Final irrigation was carried out with 3 mL of normal saline solution to neutralize the action of the irrigant . The roots were split , one half of each tooth was selected for further SEM technique analysis and examined under the scanning electron microscope . The canal walls were quantitatively evaluated for the amount of debris and smear layer . The apical , middle and coronal regions of the canal surface , were grade d ( 1 - 5 ) for debris and smear layer . A statistical analysis was performed using a Mann-Whitney Rank Sum test . ProFile performed least effective cleaning . Manual K-Flexofiles led to a grooved pattern . RESULTS AND CONCLUSION A statistically significant difference was observed ( p<0.05 ) between the two instrumentation techniques concerning the amount of debris and smear layer at the apical level . The manually filed canals had less debris and smear layer than those using a rotary technique . It was concluded from this study that none of the instrumentation techniques employed , produced the canal walls which were free of surface debris and smear layer . The manual instrumentation technique was better in cleaning the canals compared to the ProFile rotary Ni-Ti instruments despite the step-back technique used for manual instrumentation . How to cite this article : Manjunatha M , Kini A , Sudhakar V , Sunil K V C , Hiremath V K , Shah A. Smear Layer Evaluation on Root Canal Preparation with Manual and Rotary Techniques using EDTA as an Irrigant : A Scanning Electron Microscopy Study . J Int Oral Health 2013 ; 5(1):66 - 78 INTRODUCTION Oval-shaped root canals might represent a great challenge for proper disinfection . This study compared the capability of a newly developed instrument , the self-adjusting file ( SAF ) , and rotary nickel-titanium ( NiTi ) instrumentation to eliminate Enterococcus faecalis population s from long oval root canals of extracted human teeth . As a secondary purpose , the ability of a modification in sampling technique to recover bacteria lodged in recesses of oval canals was evaluated . METHODS Long oval canals from m and ibular incisors and maxillary second premolars were infected with E. faecalis ( ATCC 29212 ) for 30 days and then r and omly distributed into 2 experimental groups . In group 1 , canals were prepared up to a 40/04 rotary BioRaCe instrument by using irrigation with NaviTip needles ; in group 2 , canals were prepared by using the SAF system with continuous irrigation . NaOCl and ethylenediaminetetraacetic acid were used as irrigants . Bacteriologic sample s were taken before ( S1 ) and after preparation ( S2a and S2b ) . RESULTS Reduction in the bacterial population s was highly significant in both groups ( P < .001 ) . Preparation of long oval canals with the SAF was significantly more effective than rotary NiTi instrumentation in reducing intracanal E. faecalis counts ( P = .01 ) . Frequency of positive cultures in S2 sample s was 11 of 20 ( 55 % ) for rotary instrumentation and 4 of 20 ( 20 % ) for SAF instrumentation ( P = .048 ) . S2b sample s ( modified method ) yielded more positive sample s than S2a ( 12/40 vs 5/40 ) , but this difference reached no statistical significance ( P > .05 ) . CONCLUSIONS The SAF system was significantly more effective than rotary NiTi instrumentation used with syringe/needle irrigation in disinfecting long oval root canals in vitro . A modified sampling technique might be necessary for oval canals OBJECTIVE The objective of this study was to evaluate the utility of digital image processing and analysis procedures for the study and comparison of the efficiency of 2 root canal instrumentation techniques . STUDY DESIGN Forty m and ibular incisors with a single canal were r and omly divided into 2 groups of 20 teeth . A step-back technique was followed for the instrumentation of the root canals of Group 1 teeth using h and stainless steel Hedström files ( Dentsply Maillefer , Switzerl and ) , while a crown-down technique using ProFile engine-driven nickel-titanium instruments ( Dentsply Maillefer ) was followed for the instrumentation of the Group 2 root canals . Radiographs of each tooth were taken in bucco-lingual and mesio-distal projections , both before and after instrumentation , under constant conditions and by using a direct digital intraoral radiography system . The postoperative radiographs were digitally subtracted from their respective preoperative radiographs . A contrast enhancement process was applied to the result ant digital subtractive images . The enlargement of the root canals created by each instrumentation technique regarding the apical 6 mm was assessed through the application of region segmentation and area measurement processes . RESULTS Using this methodology no significant difference between the 2 preparation techniques was found in terms of configuration and enlargement of the root canals . CONCLUSIONS The application of this methodology provided the ability to ( 1 ) visualize dentin lost during root canal instrumentation , ( 2 ) simultaneously compare root canal morphology before and after instrumentation , and ( 3 ) quantitatively evaluate the enlargement of the root canal area induced by each of the instrumentation techniques AIM The purpose of this study was to compare the periapical healing of molar root canal treatment using two instrumentation techniques . METHODS A total of 225 maxillary and m and ibular first and second permanent molars endodontically treated by undergraduate or postgraduate students were r and omly selected from a computerized hospital data base of which 110 molars had been prepared using a hybrid rotary technique with nickel-titanium instruments ( group NR ) and 115 with h and stainless steel files ( group HF ) . Patients were recalled and the teeth were examined both clinical ly and radiographically for signs of periapical inflammation . RESULTS Some 19 % and 39 % of teeth in the NR and HF group , respectively , were judged to have some form of procedural errors . A higher rate of periapical healing was noted for NR ( 77 % ) than the HF group ( 60 % ) ( p < 0.05 ) . Factors contributing favorably to treatment outcome included the use of rotary technique , maxillary molar , experienced operator , and absence of preoperative radiolucent lesion . CONCLUSION There was a higher incidence of procedural errors and a lower success rate for primary root canal treatment of teeth prepared with stainless steel files compared with the use of NiTi instruments in a continuous reaming action BACKGROUND The purpose of this in-vitro study was to compare canal transportation and centering ability of Twisted and Hyflex Rotary Files with stainless steel h and k-flexofiles by using Spiral Computed Tomography . MATERIAL S & METHODS A total of 90 freshly extracted human m and ibular single rooted Premolar teeth were selected . The crowns were flattened with steel disks and a final dimension of 18-mm WL was achieved for each tooth . Canals were divided r and omly into 3 groups of 30 teeth each . Group I : Hyflex files , Group II : Twisted files , Group III : stainless steel h and k-flexofiles . Three sections from apical , mid-root , and coronal levels of the canal were recorded . All the teeth were scanned before and after instrumentation by using Spiral Computed Tomography . RESULTS K-files showed highest transportation and less centered when compared to the Twisted and Hyflex rotary files . No significant difference was found between TF and Hyflex CM instruments . CONCLUSION TF and Hyflex files shaped curved root canals without significant shaping errors when compared to the H and stainless steel k-flexofiles . How to cite this article : Kumar BS , Pattanshetty S , Prasad M , Soni S , Pattanshetty KS , Prasad S. An in-vitro Evaluation of canal transportation and centering ability of two rotary Nickel Titanium systems ( Twisted Files and Hyflex files ) with conventional stainless Steel h and K-flexofiles by using Spiral Computed Tomography . J Int Oral Health 2013;5(5):108 - 15 AIM The aim of this in vitro study was to compare the efficacy of root canal wall debridement following h and versus LightSpeed instrumentation . METHODOLOGY Twenty recently extracted single-rooted teeth were paired and r and omly placed into two treatment groups of 10 teeth each . In group 1 , a step-back instrumentation without initial coronal flaring with stainless steel Hedstroem files was used ; group 2 was instrumented with Ni-Ti LightSpeed instruments . Both groups had the same irrigation regimen : 2.5 % NaOCl and a 15 % EDTA solution . The teeth were then decoronated and each root split longitudinally into two halves to be examined using the scanning electron microscope ( SEM ) . The presence of superficial debris and smear layer was evaluated by a st and ardized grading system , and the result ing scores su bmi tted to nonparametric statistics . RESULTS Under the conditions of this study , the removal of superficial debris was generally excellent with both canal preparation techniques . Both techniques result ed in variable presence of residual smear layer , with a canal wall covered by smear layer as the predominant characteristic . Generally , the amount of smear layer was greater in the apical than in the middle third of the root , however , this difference was statistically significant ( P < 0.005 ) only in h and -instrumented teeth . The use of LightSpeed instruments was associated with significantly more ( P < 0.05 ) smear layer presence in the middle region of the root when compared with h and instrumentation . In addition , less smear layer was present in the apical region following LightSpeed instrumentation than stainless steel h and files , but this difference was not statistically significant . Differences in debridement between the two halves of the same root were more evident with LightSpeed than manual instrumentation , however , there was no statistical significance . CONCLUSIONS It may be inferred that the choice between h and and LightSpeed instrumentation should be based on factors other than the amount of root canal debridement , which does not vary significantly according to the instruments used
Conclusion Rotary instrumentation shows equivalent cleaning efficiency than h and files depending on the system of instrumentation and techniques used .
However , use of rotary in primary teeth leads to improved shaping of canals providing better quality of treatment in less time .
Aim To develop a scientifically current and evidence based protocol on the efficacy of rotary and h and root canal instrumentation in primary teeth .
How to cite this article Panchal V , Jeevan and an G , et al. Comparison between the Effectiveness of Rotary and Manual Instrumentation in Primary Teeth : A Systematic Review .