Quantitative assessment of the efficacy of three different file systems in reducing the bacterial load in primary canals

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Nikitha Suzanne Varghese
Ganesh Jeevanandan


mechanical preparation, Rotary NiTi, microflora, K files


Aim: To quantitatively assess the efficacy of reducing the bacterial load in the root canals of primary molars using K hand files and two NiTi rotary filing systems- Kedo S Square and Kedo S Plus. Methodology: This study was a randomized clinical trial which comprised of 60 children with primary mandibular first and second molars requiring pulpectomy treatment. The samples were randomly allocated into three groups with 20 samples each; Group 1: K hand files, Group 2: Kedo S Square NiTi Rotary files, Group 3: Kedo S plus NiTi Rotary files. Mechanical preparation was done and samples were obtained before and after cleaning and shaping using absorbent paper points and transferred to a suitable agar media. The cultures were counted and the data was subjected to statistical analysis using the SPSS system (IBMSPSS Statistics, Version 20.0, Armonk, NY: IBM Corp). Kruskal wallis test was used to compare the mean microbial load of before and after filing values (Pre and Post) between the groups. The test used to compare the mean microbial load of pre and post values within the groups was done using Wilcoxon sign rank test. Results: In all the groups there was a statistical significant reduction of micro flora following mechanical instrumentation but Kedo S plus had a better potential of reducing the microflora in the canals when compared to Kedo Square and K hand files.
Conclusion: Rotary filing systems are as efficient as conventional hand files in reducing bacterial load in primary canals.

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1. Alves, Flávio R. F., Pâmella L. Paiva, Marília F. Marceliano-Alves, Laura J. Cabreira, Kenio C. Lima, José F. Siqueira Jr, Isabela N. Rôças, and José C. Provenzano. 2018. “Bacteria and Hard Tissue Debris Extrusion and Intracanal Bacterial Reduction Promoted by XP-Endo Shaper and Reciproc Instruments.” Journal of Endodontia 44 (7): 1173–78.
2. Asif, Ahsana, Ganesh Jeevanandan, Lavanya Govindaraju, R. Vignesh, and E. M. G Subramanian. 2019. “Comparative Evaluation of Extrusion of Apical Debris in Primary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study.” Contemporary Clinical Dentistry 10 (3): 512–16.
3. Bertrand, M. F., X. Collet, C. Augros, and E. Medioni. n.d. “Modifications of the Quantec System: Effects on Root Canal Configuration.” Journal of Dental Research.
4. Byström, A., and G. Sundqvist. 1981. “Bacteriologic Evaluation of the Efficacy of Mechanical Root Canal Instrumentation in Endodontic Therapy.” Scandinavian Journal of Dental Research 89 (4): 321–28.
5. Figdor, D., and G. Sundqvist. 2007. “A Big Role for the Very Small--Understanding the Endodontic Microbial Flora.” Australian Dental Journal 52 (1 Suppl): S38–51.
6. Govindaraju, Lavanya, Ganesh Jeevanandan, and E. M. G. Subramanian. 2017. “Comparison of Quality of Obturation and Instrumentation Time Using Hand Files and Two Rotary File Systems in Primary Molars: A Single-Blinded Randomized Controlled Trial.” European Journal of Dentistry 11 (3): 376–79.
7. Haapasalo, Markus, Unni Endal, Homan Zandi, and Jeffrey M. Coil. 2005. “Eradication of Endodontic Infection by Instrumentation and Irrigation Solutions.” Endodontic Topics 10 (1): 77–102.
8. Jayachandar, Danalakshmi, Deepa Gurunathan, and Ganesh Jeevanandan. 2019. “Prevalence of Early Loss of Primary Molars among Children Aged 5–10 Years in Chennai: A Cross-Sectional Study.” Journal of the Indian Society of Pedodontics and Preventive Dentistry 37 (2): 115.
9. Jeevanandan, Ganesh, and Eapen Thomas. 2018. “Volumetric Analysis of Hand, Reciprocating and Rotary Instrumentation Techniques in Primary Molars Using Spiral Computed Tomography: An in Vitro Comparative Study.” European Journal of Dentistry 12 (1): 21–26.
10. Karamifar, Kasra, Afsoon Tondari, and Mohammad Ali Saghiri. 2020. “Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities.” European Endodontic Journal 5 (2): 54–67.
11. Lakshmanan, L., and G. Jeevandan. 2020. “Evaluation of Quality of Obturation and Instrumentation Time Using Kedo-S Square File, H File and K File in Primary Molars-a Randomized Controlled Trial.” Int J Pharm Res. https://www.researchgate.net/profile/Ganesh-Jeevanandan-2/publication/349669970_Evaluation_Of_Quality_Of_Obturation_And_Instrumentation_Time_Using_Kedo-S_Square_File_H_File_And_K_File_In_Primary_Molars-A_Randomized_Controlled_Trial/links/603ba43e92851c4ed5a36c9a/Evaluation-Of-Quality-Of-Obturation-And-Instrumentation-Time-Using-Kedo-S-Square-File-H-File-And-K-File-In-Primary-Molars-A-Randomized-Controlled-Trial.pdf.
12. Marsh, S. J., and M. D. Largent. 1967. “A Bacteriological Study of the Pulp Canals of Infected Primary Molars.” Journal of Dentistry for Children 34 (6): 460–70.
13. Oz, Esra, Berna Gulseren Timur, Emel Sesli Cetin, and Goksel Bilir. 2023. “Effectiveness of Pediatric Rotary, Rotary and Reciprocating Instrumentations on Bacterial Load Reduction in Primary Molars: An Ex Vivo Comparative Study.” The Journal of Clinical Pediatric Dentistry 47 (2): 30–39.
14. Panchal, V., G. Jeevanandan, and E. M. G. Subramanian. 2019. “Comparison of Post-Operative Pain after Root Canal Instrumentation with Hand K-Files, H-Files and Rotary Kedo-S Files in Primary Teeth: A Randomised Clinical Trial.” European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry 20 (5): 467–72.
15. Pediatric Dentistry, American Academy of, and Others. 2008. American Academy of Pediatric Dentistry Reference Manual. American Academy of Pediatric Dentistry.
16. Pitchiah, P. A., and P. G. Shivashankarappa. 2020. “Rotary Files in Pediatric Dentistry: From Then Till Now.” J Sci Dent. https://www.researchgate.net/profile/Prathima-G-S-2/publication/349432877_Rotary_Files_in_Pediatric_Dentistry_From_Then_Till_Now/links/638f0f1111e9f00cda21a2e4/Rotary-Files-in-Pediatric-Dentistry-From-Then-Till-Now.pdf.
17. Priyadarshini, P., G. Jeevanandan, L. Govindaraju, and E. M. G. Subramanian. 2020. “Clinical Evaluation of Instrumentation Time and Quality of Obturation Using Paediatric Hand and Rotary File Systems with Conventional Hand K-Files for Pulpectomy in Primary Mandibular Molars: A Double-Blinded Randomized Controlled Trial.” European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry 21 (6): 693–701.
18. Punathil, Sameer, Sham S. Bhat, S. Vidya Bhat, and Sundeep K. Hegde. 2014. “Microbiolgical Analysis of Root Canal Flora of Failed Pulpectomy in Primary Teeth.” Int. J. Curr. Microbiol. App. Sci 3 (9): 241–46.
19. Sankar, Pavithiraa, and Ganesh Jeevanandan. 2021. “Microbiological Evaluation of Root Canals after Biomechanical Preparation with Manual and Rotary File System—randomised Clinical Trial.” Int J Dent Oral Sci 8: 2841–44.
20. Seema, Thakur, Haseeb Ahammed, Singhal Parul, and Jayam Cheranjeevi. 2020. “Comparative Evaluation of Dentin Removal and Taper of Root Canal Preparation of Hand K File, ProTaper Rotary File, and Kedo S Rotary File in Primary Molars Using Cone-Beam Computed Tomography.” International Journal of Clinical Pediatric Dentistry 13 (4): 332–36.
21. Sjögren, U., D. Figdor, L. Spångberg, and G. Sundqvist. 1991. “The Antimicrobial Effect of Calcium Hydroxide as a Short-Term Intracanal Dressing.” International Endodontic Journal 24 (3): 119–25.
22. Subramanyam, D. G. J., G. Jeevanandan, and D. Subramanyam. n.d. “Microbiological Evaluation of Root Canals after Biomechanical Preparation with Manual and Rotary File system‑An in Vivo Study.” Biomedical Journal.