Evaluation of Volumetric Changes between Pediatric Rotary Files and Manual Files during Canal Preparation of Primary Mandibular Canine: A Nano-CT Analysis

Abstract

Abstract Objective  Pediatric endodontics has become popular due to advancements in cleaning, shaping, and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular canine using nano-computed tomography (nano-CT). This study aims to evaluate the efficacy of rotary file systems (Kedo S plus, Kedo SG blue) against traditional hand files in root canal preparation of primary mandibular canines using nano-CT. Materials and Methods  This in vitro study was performed in extracted primary mandibular canine based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the preoperative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo S plus, Kedo SG blue, and hand K-files. A postoperative scan was performed similar to preoperative scan. Image reconstruction was performed with NRecon software for three-dimensional volumetric visualization and analysis of the root canals. Results  Kedo S plus displayed significant alterations in volumetric, surface area, and instrumented areas postpreparation compared with Kedo SG blue and hand files. Statistical analysis revealed significant differences in volumetric and surface changes between Kedo S plus and hand files. Conclusion  Rotary file systems, especially Kedo S plus, resulted in increased canal volume and surface area with minimal uninstrumented areas, showing promise for primary dentition root canal preparations. Further clinical assessments are warranted to validate these findings.