2.1. Patient Recruitment and Allocation
WL, tooth, caries, abscess
ACUTE APICAL PERIODONTITIS, CARIES, ABSCESS, CAVITY, NECROTIC PULP, LOCAL ANESTHETICS
The current study was carried out in accordance with the Consolidated Standards of Reporting Trials (CONSORT) group’s standards for clinical trial planning and reporting (Acute apical periodontitis, necrotic pulp, more than three root canals, and individuals with abscess were disqualified. Patients who took medications up to six hours before the treatment were also barred from participating in the study. Children with a lack of cooperative capacity, those with a systemic ailment, or those with particular healthcare needs were also excluded from the study. A total of 8 individuals were disqualified because they did not match the inclusion criteria.The block randomization strategy was employed to divide the individuals The pulpectomy treatment was executed by the same operator (B.T.) and completed in a single visit. Non-pharmacological behavior management approaches were employed to change the child’s attitude and seek cooperation. Local anesthetic (2% lignocaine and 1:200,000 adrenaline; LIGNOX, Indoco Remedies Limited, Mumbai, India) inferior alveolar (I.A.) nerve block that enables a reasonably long-lasting anesthesia was performed, proceeded by rubber dam isolation of the tooth (CricDental Rubber Dam Kit, Mumbai, India). This was continued by caries removal and access cavity creation utilizing a high-speed no.4 round diamond point (Dentsply Maillefer, Tulsa, OK, USA). The root canal orifices were then recognized using the DG-16 explorer (Hu-Friedy, Chicago, IL, USA) only after de-roofing the entire pulp chamber. For standardized groups, teeth with only 3 root canal orifices were included in the current clinical trial. The root canal patency was checked for all the canals located using a size #10 (0.02%) k-file (NiTi flex; Dentsply Sirona, Charlotte, NC, USA) followed by estimation of the working length (WL) as 1 mm short of the apex using an electronic apex locator (ProPex Pixi; Dentsply Sirona, Charlotte, NC, USA) and the root canal instrumentation was initiated.The randomization procedure was used to select the kind of instrumentation for the specific tooth. The adaptive XP-endo Shaper (tip size #30; FKG Dentaire, La Chaux-de-Fonds, Switzerland) was used for root canal instrumentation in Group 1; for Groups 2 and 3, Kedo-SG Blue pediatric rotary files (E1 tip size #0.30; Reeganz Dental Care Private Limited, Chennai, India) and a hand K-file (Dentsply Maillefer, Tulsa, OK, USA) up to #30 were used, respectively. The rotary files were powered with the aid of X-smart Plus endo-motor (Dentsply Sirona, Charlotte, NC, USA) according to the manufacturer’s instructions. The XP-endo Shaper was operated at 800 rpm and 1 Ncm torque, while the Kedo-S file was used at 250 rpm and 2.2 Ncm torque.