23 October 2019

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Endodontic treatment in deciduous teeth: How to reduce time

Alessandra Abbà

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Dental pulp in deciduous teeth can be involved earlier than in permanent teeth in the progression of carious lesions. In addiction it is also known that traumatic injuries, especially in anterior teeth, occur frequently. When the deciduous pulp is compromised, endodontic treatment should be performed to preserve the integrity and function of the tooth until the physiological exfoliation. The instrumentation of the root canal may be performed with manual or mechanical tools.
Endodontic treatment with rotary systems can contribute significantly to reducing the duration of the procedure for pediatric patients. This study published on International Journal of Clinical Pediatric Dentistry in 2019 aims to demonstrate the potential applications of technological advances in endodontics in pediatric dentistry. 

Materials and Methods 
The sample comprised artificial deciduous teeth divided into three groups:
-  group I:  instrumented with a manual technique (G1), performed with the Kerr type files 1st series 21 mm.
-  group II: rotary technique (G2), performed Mtwo files of sizes 10/0.4, 15/0.5, 20/0.6, 25/0.6–21 mm
-  group III: reciprocating instrumented technique (G3), performed with RECIPROC file Reciproc 25/0.08.

Access to the root canal was performed by with a round bur, scouting of canal with a file Pilot # 10 0.2, 21 mm, to the working length (CT) without resistance, and widening the entrance of the conduits with Gates Glidden drills no. 2–4. A stopwatch was used to measure the instrumentation time in each root canal. 

Results
The comparisons between the groups showed that manual instrumentation, rotary and reciprocating systems techniques were efficacy in the shaping of the canals. The average time for the manual technique was 4.4 minutes, while for the rotary and reciprocating systems was 3.4 minutes.

Conclusions
Results showed that current systems can facilitate endodontic treatment in one session. Reducing treatment time is essential with pediatric patient. Rotary and reciprocating techniques had identical effects in reducing the treatment time.  Both techniques required significantly less time compared to manual instruments. Then rotary instrumentation offers several advantages as flexibility, cutting power, better maintenance of the original canal shape. However further statistical investigation are necessary to perform endodontic treatment in primary teeth.

For additional informations: Endodontic Treatment in Artificial Deciduous Teeth through Manual and Mechanical Instrumentation: A Pilot Study