ROTARY ENDODONTICS IN PEDODONTICS

1. ROTARY ENDODONTICS
IN PEDODONTICS

2. CONTENTS
 Introduction
 Development of rotary systems
 Rotary instrument design
 Movements in rotary instruments
 Types of endodontic systems in primary teeth
 Instrumentation technique
 Advantages and disadvantages
 NiTi instruments usage and Fracture prevention
 Basic rule for rotary instrumentation
 Precautions for rotary systems
 Cleaning of rotary NiTi endodontic files

3. INTRODUCTION
 Endodontics in primary teeth can be challenging and time
consuming, especially during canal preparation which is
considered as one the most important steps in root canal
therapy
 Barr in 2000 introduced rotary endodontics in pediatric
dentistry
 Considering that rotary files are more convenient to use and
can facilitate root canal treatment, their application may be
more appropriate in children with behavior management
problems

4. Development of rotary systems
OLMATARE-
1st described
rotary devices
1889- WILLIAM.
H.ROLLINS
developed
endodontic hand
piece for
automated root
canal preparation
1928 - ‘cursor
filing contra
angle’ was
developed by
Australian
company (W&H)
1958-
endodontic
hand piece
became
popular in
Europe with
marketing of
Racer hand
piece (W&H)
1964 -
endodontic
hand piece by
Geromatic was
introduced in
France
Modified
endodontics with
the introduction
of ‘Canal Finder
System’ by LEVY
2000 - BARR
Introduced
rotary
endodontics
in dentistry

5. Rotary instrument design

6. TIP DESIGN:
 A rotary cutting instrument may have an active or a
non-active tip
 Active tips: It has cutting edges on its surface and can
help to shape the narrow, calcified canals
Disadvantage - accidental apical perforation or
transportation
Eg.Quantec file
 Non-active tip: No cutting edges present and create a
concentric circle at the end of the root
Eg.Profile, ProTaper, M two file etc

7. Helical angle
 It is the angle formed by the cutting edge with the long axis
of the file
 It can be of two types
1. Variable helical angle:helps in moving debris up the canal
and the file will be less likely to screw into the canal
Eg.RaCe, GT files, ProTaper etc
2. Constant helical angle:it is more prone for debris
accumulation, leading to the need for increased torque and
potential separation
Eg.Profile, Quantec etc

8. Pitch
Constant Pitch  “sucking down into” the canal 
Crackformation
Variable pitch is preferred

9. Taper
 It is the amount of increase in the file diameter
with each millimeter along its working surface
from the tip towards the file handle
 Varies from 2% to 12%
Constant taper
• Same taper but
varying apical
tip diameters
• Eg.Profile
system
Varying or
graduating taper
• same apical
diameter but
varying
taper(4% to
12%)
Progressive
taper
• progressive
taper along the
shank.

10. Rake angle
 On perpendicular sectioning of a file, the angle which the leading edge
forms with the radius of the file is known as the rake angle. If it forms an
obtuse angle, then the rake angle is considered to be positive. An acute
angle is termed negative rake angle.
Positive rake
angle
• leading edge
and the surface
to be cut –
obtuse angle
• “Positive or
cutting”
• Eg.K3, Quantec
systems
Negative rake
angle
• leading edge
and the surface
to be cut is
acute
• “negative or
scraping”.
• Eg.Profile,
ProTaper, M two
Neutral or Zero
rake angle
• When the face
of the blade
coincides with
the radial line
• neutral or zero
rake angle
• Eg.LightSpeed,
GT file systems

13. Radial land
 It is defined as the surface projecting axially from the
central axis as far as the cutting edge between flutes
 Functions:
1. Reduces the tendency of the file to screw into the canal
2. Reduces transportation of the canal
3. Supports the cutting edge
4. limits the depth of cut
Full radial land – ProFile, GT
Recessed land – Quantec
Modified radial land – K3
No radial land – ProTaper,
Race, Endowave, Hero 642

14. Movements of Rotary instruments
 Reciprocal rotational movement
(Giromatic)
 Lifting combined with quarter turn
rotation (Kerr endo lift)
 Pure rotational (Endocursor)
 Oscillating ( Ex-calibur)

15. Shaping movement of NiTi
 1960- novel NiTi alloy was developed by WILLAIM BUELLER in silver
spring, Maryland at the US Naval Ordinance Laboratory (NiTiNOL)
 1988- WALIA et al. , proposed NiTiNOL for shaping canals , as it is 2-3
times more flexible compared to stainless steel.
 Mid 1990’s – 1st commercially available NiTi rotary files had come to
market
Bansode, P., Wavdhane, M.B., Pathak, D.D., Khedgikar, S.B. and Rana, H., 2006. Evolution
of Rotary NI-TI File Systems: A Literature Review. Indian J Appl Res, 6(12), pp.91-4.

16. Classification
Based on the system
NiTi systems
Light speed Protaper K3
Profile 0.04
and 0.06
HERO 642
Ultrasonic systems
Cavi-endo
Sonic systems
Sonic AIR 3000 Endo star5
Flexible systems
Encalibur Endoplanner Canal finder system
Conventional system
Racer Giromatic Endo-gripper Endo lift

22. Generations of rotary system
FIRST GENERATION
 1st rotary instrument was designed by Dr. John McSpaden with
0.02% taper and was marketed in 1992
 1994- Dr. Johnson introduced the PROFILE line with 0.04 and 0.06%
tapered instrument series and the ORIFICE SHAPERS
 They were made from machining of 3 U shaped grooves around a
tapered NiTi wire, with an unground space remaining between the
grooves, providing the so called ‘RADIAL LAND’ area
 Fixed taper of 4% and 6% over the length of the file
Haapasalo, M. and Shen, Y., 2013. Evolution of nickel–titanium instruments: from past to
future. Endodontic topics, 29(1), pp.3-17

23.  By late 1990’s , greater taper files –GT rotary system by Dr.
Buchanan was available- with fixed taper of 6%, 8%, 10%, and
12% on a single file
 Single most important design feature: PASSIVE RADIAL LAND
 This encouraged the file to stay centered in the canal
curvatures during work but these systems required a
considerable number of files to achieve preparation
objectives

24. Second generation
 Marketed in 2001
 Different from 1st generation in their cutting edges and the absence
of radial lands
 It required reduced number of instruments to fully prepare a canal
by this system
 Files has file lines with alternating contact points
 This helps to discourage taper lock and resultant screw effect
associated
 They still have a fixed tapered design over their active portions

25.  Critical break through occurred when ProTaper came into market
 They have multiple increasing or decreasing percentage of tapers on
a single file
 This allows to limit the cutting action to a specific region of canal
and affords a short sequence of files to safely prepare the canal
 To increase the resistance to file separation, some manufactures
electro polished their files to remove surface irregularities produced
from traditional grinding process
 However electro polishing dulls the cutting edges
Haapasalo, M. and Shen, Y., 2013. Evolution of nickel–titanium instruments: from past to
future. Endodontic topics, 29(1), pp.3-17

26.  Therefore, undesirable inward movement was necessary
to advance the file up to the length
 Causing taper lock and screw effect and excessive
torque on a rotary file during work

27. Third generation
 Improvement in the NiTi metallurgy gave rise to 3rd generation files
 In 2007, manufacturers began to focus on utilizing heating and
cooling methods to reduce cyclic fatigue and improve safety when
NiTi instruments work in more curved canals
Haapasalo, M. and Shen, Y., 2013. Evolution of nickel–titanium instruments: from past to
future. Endodontic topics, 29(1), pp.3-17

28. Fourth generation
 They comprise instruments crafted as single file techniques
which means they can be used as the only tool to perform the
whole shaping phase
 Re-Dent-Nova introduced the SELF ADJUSTING FILES (SAF)
 It has a open tube design, with abrasive surface
 It exerts uniform pressure on the dentinal walls
 It is mechanically driven by a hand piece that produces both a
short 0.4mm vertical amplitude stroke and vertical vibrating
movement with constant irrigation
Haapasalo, M. and Shen, Y., 2013. Evolution of nickel–titanium instruments: from past to
future. Endodontic topics, 29(1), pp.3-17

29. Bansode, P., Wavdhane, M.B., Pathak, D.D., Khedgikar, S.B. and Rana, H., 2006. Evolution of Rotary
NI-TI File Systems: A Literature Review. Indian J Appl Res, 6(12), pp.91-4.

30. Fifth generation
 They have wave motion along the active parts of the
files
 They are designed such that the center of the mass and
the center of rotation are offset that conveys
mechanical rotation in wave motion
 This offset design serves to further minimize the
engagement between the file and the dentin
 It also enhances auguring debris out of the canal and
improves flexibility along the active portion of the life

31. Rotary endodontics in primary
teeth
Objective:
Root canal debridement is the primary objective of root
canal instrumentation in primary molars, whereas in a
permanent teeth it is biomechanical preparation
leading to ideal shaping of canals to receive gutta
purcha
Lin, C.P., Li, U.M. and Guo, M.K., 2006. Application of Ni-Ti rotary files for
pulpectomy in primary molars. J Dent, 1(1), p.10.

32. Ideal requisites of pediatric rotary
files
1. It should have optimum length for preparation of canals
with no excess length
2. It should be flexible to maintain the canal centricity
3. Effective debridement of root canal without weakening
the tooth structure or endangering the underlying
permanent teeth
Lin, C.P., Li, U.M. and Guo, M.K., 2006. Application of Ni-Ti rotary files for
pulpectomy in primary molars. J Dent, 1(1), p.10.

33. Common rotary systems used

34. Profile system
 Introduce by Dr.Johnson in 1994
 Suggested rotational speed – 150-300 RPM
 Cross section: central parallel core with 3-U shaped grooves along the
parallel radial land
 Negative rake angle – Cuts dentin in planning motion
 19mm length and ISO sized tips

35.  Technique :
Straight line access to
canal orifice
Estimate working
length from pre
operative radiograph
Create glide path
before using orifice
shapers. Establish this
with #15 or #20
Orifice shapers sizes 4
, 3, 2, 1in coronal
1/3rd
Perform crowndown
technique using profile
instruments of taper
0.06/30, 0.06/25 and
0.04/30, 0.04/25
Determine the exact
working length using
2% taper #15 K file
Complete crown down
procedure until the
working length
Use 0.04/25 0.04/30
for apical preparation
Final flaring done
using 0.06/25 short of
working length to
merge coronal and
apical preparation

36. Protaper files
 Triangular cross section with variable taper
 The progressive taper improves the flexibility, cutting efficiency and the
safety of these files
 Also they have modified guiding tip, varying tip diameter, new shorter
handle of the file
 They consist of 3 shaping and 3 finishing files

37.  Shaping files:
1. Sx : shorter length of 19mm (D0=0.19mm
D14=1.20mm)
2. S1 : D0= 0.17mm D14=1.20mm- used to
prepare the coronal part of the root
3. S2 : D0=0.20 D14=1.20- used to prepare
the middle third of the root
 Finishing files:
1. F1 : D0=20 apical taper=0.07
2. F2 : D0=25 apical taper=0.08
3. F3 : D0=30 apical taper=0.09

38.  Technique:
Gain straight line
access
Establish smooth
glide path before
doing any
instrumentation
Prepare
coronal1/3rd of
canal by inserting
S1, by passive
pressure
Irrigate and
recapitulate using
#10 K file
Use S2 to
estimated canal
length
Confirm the
working length
using #15 k file
Use F1, F2, F3
finishing files up to
established WL and
complete apical
preparation

39. K3 Rotary file system
 Designed by Dr. John McSpadden
 Available in taper of 0.02, 0.04, 0.06 with ISO tip sizes
 Positive rake angle - effective cutting surface
 Variable core diameter - enhances flexibility
 Safe ended cutting tip
 K3 “body shaper” files –act as canal shaping files, orifice openers and deep body
cleaning files

40. Light Speed System
•Named so because “light” touch is needed as “speed” of
the instrumentation is increases
•Short cutting heads and long non cutting taperless shafts
•Non cutting tip with Gates Glidden in configuration
•Operated at a speed of 1500-2000 rpm

41. Hybrid concept of NiTi rotary files
 “The idea is to combine instruments of different file systems and
use different instrumentation techniques to manage individual
clinical situations to achieve the best biomechanical cleaning and
shaping results and the least procedural errors”

42. Advanced rotary systems for
primary teeth

43. 1. Kedo S File system
2. PEDO Prime
3. PRO-AF-BABY-GOLD

44. Kedo S File system
 Introduced by Ganesh Jeevardhan
(Reeganz Dental Care Pvt. Ltd. India) in
2016
 It is a single file system consisting of D1,
E1, and U1 files
 Total length -16mm
 Working length- 12mm
• KedO SH
Hand
files
• Kedo S
• Kedo SG
• Kedo SG blue
Rotary
files

45.  Uniqueness: variable taper (4-8%) with varying tip diameter
D1=0.25mm
E1=0.30mm
U1= 0.40mm
D1 :designed tomprepare narrow canals of primary teeth namely mesiobuccal and
mesiolingual canals
E1 :designed to prepare wider canals namely distal and palatal canals of the primary
molar teeth
U1 :designed to prepare upper and lower anterior teeth
 Recommended to be used with endodontic motor in clock wise rotation at 300
RPM AND 2.2N/cm torque

46.  Only to be used in well irrigated and lubricate canals of
primary teeth
 In order to prevent instrument deformation and
separation, Kedo S rotary files are recommended to be
used till the entire working length 1-2 times and for not
more than 3-4 seconds

47. Technique
Access opening
Canal location with
K file
Initial canal
patency with #15 K
file
#15 loose fit
in molar canal
Wider canal
E1- shaping
wider canal
#15 snug fit in
molar canal
narrow canal
D1- shaping
wider canal
https://www.ecronicon.com/ecde/pdf/ECDE-18-01053.pdf

48. Technique for anteriors:
#30 H file –canal
patency and pulp
extirpation in
anterior canal
U1- shaping
anterior canal

49.  This was to compare and evaluate the
instrumentation time and quality of obturation
between paediatric rotary file (Kedo-S) and manual
instrumentation techniques in primary molars.
 There was a significant improvement in the quality
of obturation with paediatric rotary files (Kedo-S).
 Clinical use of paediatric rotary files Kedo-S was
effective during root canal preparation of primary
teeth with reduction in instrumentation time and
better quality of obturation.
Jeevanandan, G. and Govindaraju, L., 2018. Clinical comparison of Kedo-S paediatric
rotary files vs manual instrumentation for root canal preparation in primary molars: a
double blinded randomised clinical trial. European Archives of Paediatric
Dentistry, 19(4), pp.273-278.

50. Prime Pedo files
 Developed and produced in 2006
 Offers 3 file system:
1. starter -12% , 16mm #17
2. P1 - 6% , 18mm #15
3. P2 – 6% taper , 18mm #25
Features:
1. Can align stopper without using measuring scale
2. New alloy (M Wire technology) offers pre-shaping features in
rotary files and increases its durability
3. Controlled memory files
4. Short length of ease of use in children
5. Intelligent stopper marking ring
6. 2 file system
7. Increased durability and fatigue resistance
https://www.ecronicon.com/ecde/pdf/ECDE-18-01053.pdf

51.  Technique: Establish access cavity
and WL 1-1.5mm short of
apex
Enlarge coronal 1/3rd or
orifice of canal using
starter file
Identify canal type
Thin
canal
P1 file
regular/
large canal
P2 file

52. PRO-AF-BABY Files
 Consist of 5 files made up of NiTi CM wire
 Constant taper of 4% and 6%
 B0- to enlarge orifice

53. Features:
1. Specially designed and registered short 17mm files
2. More safety with comfort to both dentist and patient
3. Unique short orifice enlarger to prevent canal ledging
4. Advance NiTi M wire with heat treatment for better
canal centricity
5. High flexibility with minimum chances of separation
6. A versatile rotary file system suitable for conservative
preparation of canals
7. Improved shaping of canals
8. Less number of files per canal, most canals require only
2 files for preparation
https://www.ecronicon.com/ecde/pdf/ECDE-18-01053.pdf

54. Govindaraju, L., Jeevanandan, G. and Subramanian, E.M.G., 2017. Clinical evaluation of
quality of obturation and instrumentation time using two modified rotary file systems with
manual instrumentation in primary teeth. Journal of clinical and diagnostic research:
JCDR, 11(9), p.ZC55.
 To compare the quality of obturation and instrumentation time
during root canal preparation using hand files and modified rotary
file systems in primary molars
 No significant differences were noted with regard to the quality of
obturation .However, a statistically significant difference was noted
in the instrumentation time between the groups .
 ProTaper rotary system had significantly lesser instrumentation time
when compared to that of K3 rotary system and hand file system.

55. Bahrololoomi, Z., Tabrizizadeh, M. and Salmani, L., 2007. In vitro comparison of instrumentation time and
cleaning capacity between rotary and manual preparation techniques in primary anterior teeth. Journal of
Dentistry of Tehran University of Medical Sciences, pp.59-62.
 The aim of this study was to evaluate and compare the
cleaning ability and instrumentation time of manual and rotary
methods used for preparation of primary anterior teeth.
 There was no significant difference in cleaning capacity
between the two techniques. Therefore regarding the shorter
working time for rotary instrumentation and the similar
cleaning ability of the two techniques, the application of the
rotary system is suggested for preparation of deciduous root
canals during pulpectomy.

56. Radhika, E., Reddy, E.R., Rani, S.T., Kumar, L.V., Manjula, M. and Mohan, T.A., 2017. Cone
Beam Computed Tomography Evaluation of Hand Nickel-Titanium K-Files and Rotary System in
Primary
Teeth. Pediatric dentistry, 39(4), pp.319-323
 The purpose of this study was to compare canal transportation,
centering ability, and removed dentin thickness (RDT) using hand
nickel-titanium (NiTi) K-flex files and rotary systems in primary
molars and using cone beam computed tomography (CBCT)
 Rotary files showed less canal transportation, more conservation of
tooth structure, and superior centering ability compared to hand
nickel-titanium K-flex files.

57. Musale, P.K., Jain, K.R. and Kothare, S.S., 2019. Comparative assessment of dentin removal
following hand and rotary instrumentation in primary molars using cone-beam computed
tomography. Journal of Indian Society of Pedodontics and Preventive Dentistry, 37(1), p.80.
 aims to determine the amount of dentin removal in
primary mandibular first and second molars instrumented
with hand and rotary files using cone-beam computed
tomography (CBCT).
 An average amount of dentin removed was found to be
significantly higher in manual instrumentation compared
to rotary
 It was concluded that rotary technique serves as an
efficient alternative to the traditional manual
instrumentation by overcoming its shortcomings in terms
of conservation of the remaining dentin thickness and the
time required for its preparation.

58. Musale, P.K. and Mujawar, S.A.V., 2014. Evaluation of the efficacy of rotary vs. hand files in root
canal preparation of primary teeth in vitro using CBCT. European Archives of Paediatric
Dentistry, 15(2), pp.113-120
 This in vitro study aimed to evaluate the efficacy of rotary ProFile,
ProTaper, Hero Shaper and K-files in shaping ability, cleaning efficacy,
preparation time and instrument distortion in primary molars.
 Instrument distortion was observed in k files while none of the rotary files
were distorted.
 Rotary files prepared more conical canals in primary teeth than manual
instruments. Reduced preparation time with rotary files enhances patient
cooperation especially in young children.
•The use of rotary files in primary teeth has several advantages when
compared with manual K files: the efficiency in both, preparation
time and root canal shape.
• 1.A decreased working time, that helps maintain patient
cooperation by diminishing the potential for tiredness. 2. The shape
of the root canal is more conical, favoring a higher quality of the root
canal filling, and increasing clinical success.
Crespo, S., Cortes, O., Garcia, C. and Perez, L., 2008. Comparison between rotary and manual
instrumentation in primary teeth. Journal of Clinical Pediatric Dentistry, 32(4), pp.295-298.

59. Moghaddam, K.N., Mehran, M. and Zadeh, H.F., 2009. Root canal cleaning efficacy of rotary and
hand files instrumentation in primary molars. Iranian endodontic journal, 4(2), p.53.
Although there was no difference in cleanliness efficacy at the
apical and middle thirds, the coronal third was more effectively
cleaned with hand files. Predictably, time efficiency was a
significant advantage with rotary technique
The aim of this study was to compare instrumentation time
and cleaning efficacy of manual instrumentation, rotary
systems and reciprocating systems in the preparation of
primary molar root canals
The reciprocating and the rotary systems showed better
cleaning efficacy when compared to manual instrumentation
especially, in coronal and middle one third.
Katge, F., Patil, D., Poojari, M., Pimpale, J., Shitoot, A. and Rusawat, B., 2014. Comparison
of instrumentation time and cleaning efficacy of manual instrumentation, rotary systems
and reciprocating systems in primary teeth: an in vitro study. Journal of Indian Society of
Pedodontics and Preventive Dentistry, 32(4), p.311.

60. NiTi Instrument Usage and Fracture Prevention
 2 distinct fracture mechanisms
1. Torsional load : transferred into the instrument through friction against th
canal wall
2. Cyclic fatigue: with rotation in curved canals
 These factors work in concert to weaken the instrument
General rule: flexible instruments are not very resistant to
torsional load but are resistant to cyclic fatigue
Conversely , more rigid files withstand more torque but are
susceptible to fatigue
Acute canal curvature more coronally is more likely to lead to
instrument fracture than a gradual apical curvature
Peters, O.A. and Paqué, F., 2010. Current developments in rotary root canal instrument
technology and clinical use: a review. Quintessence International, 41(6).

61. Basic rule for rotary
instrumentation
Peters, O.A. and Paqué, F., 2010. Current developments in rotary root canal instrument
technology and clinical use: a review. Quintessence International, 41(6).

62. Precautions for rotary system
1. Irrigation and keeping a moist canal is most important in rotary
endodontics
2. Frequently check each file for flute unwinding or distortion and
discard the files immediately. If no flute unwinding, discard the file
after every 5 use in primary teeth
3. Always use straight line access
4. Use minimal/no pressure on hand piece while filing
5. No skipping of files should be done and should be used in correct
sequence
6. The file should be inserted and ejected from the canals while in
rotation

63. Reduction of intracanal bacteria
 There was no detectable difference in colony-forming unit count after NiTi rotary
or stainless-steel hand instrumentation. Neither technique could predictably
render canals free of bacteria. The results of this study indicate NiTi rotary and
stainless-steel hand K-file step-back instrumentation techniques were not
significantly different in their ability to reduce intracanal bacteria.
Dalton BC, Ørstavik D, Phillips C, Pettiette M, Trope M. Bacterial reduction with nickel–titanium
rotary instrumentation. J Endod 1998: 24: 763–767.

64. It was found that hand and rotary files techniques were equally
effective in removing bacteria from the main canal (outside the
standard apical groove), although both were unable to achieve
complete elimination of the microbes. However, it appeared that
the rotary files were capable of achieving better removal of
biofilm bacteria within the apical groove than the hand files
Lin, J., Shen, Y. and Haapasalo, M., 2013. A comparative study of biofilm removal with hand,
rotary nickel-titanium, and self-adjusting file instrumentation using a novel in vitro biofilm
model. Journal of endodontics, 39(5), pp.658-663.
To assess the microflora of root canals in primary molars following use of
rotary NiTi files and conventional hand NiTi and stainless steel files.
In all three groups, there was a significant reduction in both aerobic and
anaerobic mean microbial count following root canal instrumentation.
Rotary NiTi files were as efficient as conventional hand instruments in
significantly reducing the root canal microflora.
Subramaniam, P., Tabrez, T.A. and Girish Babu, K.L., 2013. Microbiological assessment of root
canals following use of rotary and manual instruments in primary molars. Journal of Clinical

65. Cleaning of rotary NiTi
endodontic instrument
a 20 second rinse in running tap water.
15 minutes ultrasonication in the same solution
a 30 minute pre-soak in an enzymatic cleaning solution
The protocol comprises 10 vigorous strokes in a scouring sponge soaked
in 0.2 per cent chlorhexidine solution
Parashos, P., Linsuwanont, P. and Messer, H.H., 2004. A cleaning protocol for rotary
nickel‐titanium endodontic instruments. Australian dental journal, 49(1), pp.20-27.

66. Advantages of NiTi rotary
system
1. Tissues and debris are more easily and quickly removed
2. Flexibility of NiTi allows easy access to all the canals
3. Do not need to be pre-curved
4. Follows original root anatomy
5. Prepared canals are funnel shaped, resulting in a more predictable uniform
paste fill
6. Shorter instrumentation time, which is a relevant factor in pediatric dentistry
since it allows faster procedure while maintaining quality and safety there by
reducing operator as well as patient fatigue
7. Probability of canal deformation is reduced due to its elastic memory, radial
aspect which keeps the file centered and inactive tips

67. Disdvantages of NiTi
rotary system
1. Cost of endomotor , hand piece and NiTi rotary files
2. Cyclic fatigue of rotary files
3. Learning technique
4. primary dentin is softer and less dense
5. Root tip resorption
6. Ribbon shaped canals
7. Ribbon shaped canals- dilema- use of rotary and hand
instruments
8. Reduced tactile sensitivity
Hinder the use
of NiTi rotary
sysytem

68.  The objective of this study was to evaluate the knowledge
and practice of NiTi rotary instruments' usage in primary teeth
by the Indian dentists
 About 50% of the practitioners used rotary instrumentation of
root canals in primary teeth, of which majority were
postgraduates. ProTaper was the commonly used rotary system
in primary teeth. The practitioners felt both taper and length
of the existing rotary file to be the limitation for its use in
primary teeth.
 It is concluded that there is a need for comprehensive
education programs to be conducted to increase the
awareness and use of rotary files for pulpectomy in primary
teeth. In addition, there is a need for an exclusive pediatric
rotary system for convenience in using it in children.
Govindaraju, L., Jeevanandan, G. and Subramanian, E.M.G., 2017. Knowledge and
practice of rotary instrumentation in primary teeth among Indian dentists: a
questionnaire survey. Journal of International Oral Health, 9(2), p.45.

69. Conclusion
The removal of organic debris is the main purpose of pulpectomies in primary
teeth. The goal can be achieved with manual or rotary Ni–Ti instruments.
Considering that preparation time is an important clinical factor in pediatric
patient management, the use of rotary instruments for pulpectomies in
primary teeth is highly recommended.