Comparative Evaluation of Obturation Quality, Instrumentation Time, and Postoperative Pain following Pulpectomy using Different File Systems: A Randomized Controlled Trial

Aim: To comparatively evaluate the effectiveness of Kedo-S+ pediatric rotary files, ProTaper Next rotary files, and hand K files in pulpectomy of primary posterior teeth by assessing instrumentation time, obturation quality, and postoperative pain. Materials and methods:The study included 60 children requiring pulpectomy in primary mandibular teeth, who were allocated into three groups of 20 each based on the instrumentation technique used: Kedo-S+ rotary files, ProTaper Next rotary files, and hand K files.The parameters evaluated included instrumentation time, recorded using a stopwatch; pain perception, assessed using a four-point pain scale at 6, 12, 24, 48, and 72 hours postoperatively; and obturation quality, which was evaluated immediately after completion of obturation using the Coll and Sardian criteria.The collected data were subjected to statistical analysis using SPSS software.Results: Kedo-S+ showed the highest optimal fill rate (70%), followed by ProTaper Next (55%) and Hand K file (45%).Mean instrumentation times were: Kedo-S+ 57.50 seconds, ProTaper Next 78.95 seconds, and Hand K file 214.45 seconds.ANOVA revealed significant differences among groups, p < 0.000.Postoperative pain assessment showed no pain in groups A and B, with mild pain in one sample from group C after 72 hours of follow-up. Conclusion:The Kedo-S+ rotary system provided better root canal filling quality, reduced postoperative pain, and shorter instrumentation time compared to ProTaper Next and manual techniques.Clinical significance: Efficient and child-friendly instrumentation is essential for successful pulpectomy in primary posterior teeth.Evaluating different file systems aids clinicians in selecting appropriate instruments to optimize treatment efficiency, obturation quality, and patient comfort in pediatric endodontic practice.