Evaluation of microcrack formation during root canal preparation using hand, rotary files and self-adjusting file in primary teeth: An in vitro study

Background. Pediatric endodontics is a field with constant evolution, resulting in the shifting of paradigms from the use of conventional hand files to rotary files for biomechanical preparation in primary teeth. Biomechanical preparation plays a crucial role in the success of root canal treatment. Primary teeth need special attention since they differ from permanent teeth in root canal morphology. Cleaning and shaping of the canals damage the root dentin, leading to dentinal cracks. Newer techniques for root canal preparation, including Ni-Ti rotary files and SAF system, have been developed for use in pediatric endodontics to overcome the drawbacks of conventional methods. The present study compared dentinal defects formed by rotary systems in primary teeth. Methods. Eighty primary teeth were included. The teeth were decoronated with a diamond disc. All the roots were inspected for any pre-existing cracks or craze lines under transmitted light under a stereomicroscope. The specimens were then divided into four groups (n=20): group 1: control, group 2: hand files (HF), group 3: ProTaper files, and group IV: SAF files. The samples were instrumented according to the group they were assigned to. Results. The HF and SAF groups exhibited fewer microcracks. Dentinal microcracks were observed in roots prepared with rotary ProTaper files. There were significant differences between HF/SAF and rotary files (P <0.05). Conclusion. Stainless steel hand K-files and SAF instruments resulted in fewer dentinal damage than the ProTaper Universal files. SAF exhibited satisfactory results with minimal or no crack formation.