Assessment of the combined effect of root canal instrumentation systems and obturating materials on postoperative pain in pulpectomized primary molars: A comparative randomized clinical tria

Aim: To evaluate and compare the combined effect of different root canal instrumentation systems and obturating materials in postoperative pain in pulpectomized primary molars. Methods: A total of 288 primary molars were randomly divided into three treatment groups (Group KS, Group HS, and Group MF), with 96 teeth in each group. In Group KS, root canal instrumentation was performed using Kedo-SG Blue pediatric rotary files; in Group HS, HERO Shaper rotary files were used; and in Group MF, manual NiTi K-files were used. Following instrumentation, each group was further subdivided into three subgroups of 32 teeth each, based on the obturating material used: zinc oxide eugenol, Endoflas®, or DiaPex Plus®. The quality of obturation was assessed radiographically, and postoperative pain was evaluated using a questionnaire. Data were statistically analyzed using the Chi-square test. Results: The quality of obturation was superior in root canals instrumented with rotary file systems compared to those instrumented with manual files. Postoperative pain was lower when rotary file systems were combined with Endoflas® or DiaPex Plus® compared to manual instrumentation combined with zinc oxide eugenol. Conclusions: The combination of rotary file systems with Endoflas® or DiaPex Plus® as obturating materials was associated with a significantly reduced incidence of postoperative pain following pulpectomy in primary molars