Comparative evaluation of two pediatric rotary file systems in primary teeth: A scanning electron microscope study

Original Research

Contemp Pediatr Dent 2022:0(0):1-7

Comparative evaluation of two pediatric rotary file systems in primary teeth: A scanning electron microscope study

OrcidPriya Subramaniam1, Orcid Neetu Raveendran2✉, Orcid Madhusudhan K.S3


1. Professor, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, India

2. Former Post Graduate Student, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, India ( Correspondence:

3. Reader, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, India


Rotary file systems having instruments of shorter length, variable taper and individual files for anterior and posterior teeth make them suitable for routine use in pulpectomy.

Kedo-S and Pro AF Baby Gold rotary files were significantly better than manual Ni-Ti K files when the smear layer was evaluated by a scanning electron microscope.

These new file systems can be used in endodontic practice in primary teeth for faster and better instrumentation.


Aim: The objective of this in-vitro study was to evaluate and compare the smear layer formed using Kedo-S, Pro AF Baby Gold rotary files and manual Ni-Ti files in the root canals of primary anterior teeth. Methods: Sixty primary maxillary incisors which fulfilled the inclusion criteria were randomly assigned into 3 groups of 20 teeth each; Group 1: Kedo-S rotary files, Group 2: Pro AF Baby Gold rotary files and Group 3: manual Ni-Ti K files. The root canals in each group were instrumented for 3 minutes and irrigated intermittently with 0.9% saline. The teeth were then longitudinally sectioned and examined under a scanning electron microscope for smear layer formation at different thirds of the root canals. Scores obtained were then subjected to statistical analysis. Results: Inter-group comparison showed a significant difference between the coronal and middle third in all three groups. A statistically significant difference was also noted in the three groups at the different thirds of the root canals on the intra-group comparison. Conclusions: Both Kedo-S and Pro AF Baby Gold rotary files were significantly better than manual Ni-Ti K files in effectively debriding the root canal walls of primary teeth as evaluated by the smear layer.

Keywords: Deciduous Tooth; Pulpectomy; Root Canal Therapy; Smear Layer

Copyright © 2022 Contemporary Pediatric Dentistry


1. American Association of Endodontists. Glossary: Contemporary Terminology for Endodontics. 6th ed. Chicago: American Association of Endodontists; 1998

2. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 2006;39:921- 30

3. Pintor AV, Dos Santos MR, Ferreira DM, Barcelos R, Primo LG, Maia LC. Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review. J Clin Pediatr Dent 2016;40:1-7

4. Khadivi Nia Javan N, Mohajeri Baradaran L, Azimi S. SEM Study of Root Canal Walls Cleanliness after Ni-Ti Rotary and Hand Instrumentation. Iran Endod J 2007;2:5-10

5. Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent 1999;21:453-464

6. Bahrololoomi Z, Tabrizizadeh M, Salmani L. In vitro comparison of instrumentation time and cleaning capacity between rotary and manual preparation techniques in primary anterior teeth. Front Dent 2007;4:59-62

7. Dey B, Jana S, Chakraborty A, Ghosh C, Roy D. A Comparison of Ni-Ti Rotary and Hand Files Instrumentation in Primary Teeth: A Review Article. Int J Oral Health Med Res 2016;3:59-62

8. Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomized clinical trial. Eur Arch Paediatr Dent 2018;19:273-278

9. Thakkar TK, Naik S, Ghule K. Advances in rotary endodontics in pediatric dentistry.EC Dent Sci 2019;18:1320-1330

10. Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, Pozos-Guillen AJ. Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth. J Clin Pediatr Dent 2011;35:359-363

11. Mortazavi M, Abbasi A, Khodadadi E. Comparison of canal cleansing time and pulpectomy success rate in deciduous molars by use of hand and rotary files. Dental Journal of Shiraz University of Medical Science 2006;2:111-119

12. Govindaraju L, Jeevanandan G, Emg S, Vishawanathaiah S. Assessment of Quality of Obturation, Instrumentation Time and Intensity of Pain with Pediatric Rotary File (Kedo-S) in Primary Anterior Teeth: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2018;11:462-467

13. Musale PK, Mujawar SA. Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCT. Eur Arch Paediatr Dent 2014;15:113-120

14. Ramezanali F, Afkhami F, Soleimani A, Kharrazifard MJ, Rafiee F. Comparison of Cleaning Efficacy and Instrumentation Time in Primary Molars: Mtwo Rotary Instruments vs. Hand K-Files. Iran Endod J 2015;10:240-243

15. Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation. J Endod 1997;23:301-306

16. Cohen S, Hargreaves KM. Pathways of the pulp. 9th ed. St. Louis: Elsevier Mosby; 2006

17. Elnagar MH, Ghoname NA, Ghoneim WM. Cleaning efficacy of rotary versus manual system for root canal preparation in primary teeth. Tanta Dent J 2018;15:14-18

18. Panchal V, Jeevanandan G, Subramanian E. Comparison of instrumentation time and obturation quality between hand K-file, H-files, and rotary Kedo-S in root canal treatment of primary teeth: A randomized controlled trial. J Indian Soc Pedod Prev Dent 2019;37:75-79

19. Jeevanandan G. Kedo-S Paediatric Rotary Files for Root Canal Preparation in Primary Teeth – Case Report. J Clin Diagn Res 2017;11:3-5

20. Hariharan VS, Nandlal B, Srilatha KT. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: a scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2010;28:271-277

21. Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. J Endod 1983;9:137-142

22. Berg MS, Jacobsen EL, BeGole EA, Remeikis NA. A comparison of five irrigating solutions: a scanning electron microscopic study. J Endod 1986;12:192-197

23. Violich DR, Chandler NP. The smear layer in endodontics – a review. Int Endod J 2010;43:2-15

24. Reddy KB, Dash S, Kallepalli S, Vallikanthan S, Chakrapani N, Kalepu V. A Comparative Evaluation of Cleaning Efficacy (Debris and Smear Layer Removal) of Hand and Two NiTi Rotary Instrumentation Systems (K3 and ProTaper): A SEM Study. J Contemp Dent Pract 2013;14:1028-1035

25. Reddy JM, Latha P, Gowda B, Manvikar V, Vijayalaxmi DB, Ponangi KC. Smear layer and debris removal using manual Ni-Ti files compared

with rotary Protaper Ni- Ti files – An In-Vitro SEM study. J Int Oral Health 2014;6:89-94

26. Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endod Dent Traumatol 1990; 6:142-149

27. Schäfer E, Lohmann D. Efficiency of rotary nickel-titanium FlexMaster instruments compared with stainless steel hand K-Flexofile: Part 2. Cleaning effectiveness and instrumentation results in severely curved root canals of extracted teeth. Int Endod J 2002;35:514-521

Full Text





Article Info


21 December 2021


08 March 2022

Online First:

16 March 2022