Assessment of the combined effect of root canal instrumentation systems and obturating materials on postoperative pain in pulpectomized primary molars: A comparative randomized clinical trial

Girish Babu KL¹ image, Kavyashree Gururaj Hebbar2 image, Geeta Maruti Doddamani3 image

Highlights

Previous studies have mainly assessed the effects of instrumentation type and  obturating materials separately on
postoperative pain in primary  molars.

Identifying the optimal combination of instrumentation systems and obturating materials is essential for minimizing postoperative pain during pulpectomy of primary molars.

The combination of manual files and zinc oxide-eugenol was associated with the highest level of postoperative pain, followed by rotary files with zinc oxide-eugenol.

Abstract

Aim: To evaluate and compare the combined effect of different  root canal instrumentation systems and obturating materials  in postoperative pain in pulpectomized primary molars.  Methods: A total of 288 primary molars were randomly divided into three treatment groups (Group KS, Group HS, and Group MF), with 96 teeth in each group. In Group KS, root canal instrumentation was performed using Kedo-SG Blue pediatric  rotary files; in Group HS, HERO Shaper rotary files were used; and in Group MF, manual NiTi K-files were used. Following instrumentation, each group was further subdivided into three subgroups of 32 teeth each, based on the obturating material used: zinc oxide eugenol, Endoflas®, or DiaPex Plus®. The quality of obturation was assessed radiographically, and postoperative pain was evaluated using a questionnaire. Data were statistically analyzed using the Chi-square test. Results: The quality of obturation was superior in root canals instrumented with rotary file systems compared to those instrumented with manual files. Postoperative pain was lower when rotary file systems were combined with Endoflas® or DiaPex Plus® compared to manual instrumentation combined with zinc oxide eugenol. Conclusions: The combination of rotary file systems with Endoflas® or DiaPex Plus® as obturating materials was associated with a significantly reduced incidence of postoperative pain following pulpectomy in primary molars.

Keywords: Endodontics; Root Canal Filling Materials; Root Canal Preparation; Postoperative Pain; Zinc Oxide-Eugenol Cement

Author Affiliations

  1. Prof., Department of Dentistry, Hassan Institute  of Medical Sciences, Hassan,  India (Correspondence:docgirish77@gmail.com)
  2. Junior Resident, Department of Dentistry, Hassan Institute of Medical Sciences, Hassan, India
  3. Prof., Department of Orthodontics, Dr. Syamala Reddy Dental College Hospital and Research Centre, Bengaluru, Karnataka, India
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Article Info

Contemp Pediatr Dent 2025:6(1):38-55

Received: 17 January 2025

Accepted: 24 April 2025 

Online First: 28 April 2025

DOI: 10.51463/cpd.2024.61

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					Girish Babu KL, Kavyashree Gururaj Hebbar, Geeta Maruti Doddamani. Assessment of the combined effect of root canal instrumentation systems and obturating materials on postoperative pain in pulpectomized primary molars: A comparative randomized clinical trial. Contemp Pediatr Dent 2025:6(1):38-55

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