Comparative Evaluation of Rotary and Hand File Systems for Optimal Obturation in Primary Molar Root Canal Treatment: A Pediatric Perspective.

Background/objectives Rotary instrumentation has gained significant importance in the endodontic preparation of primary teeth. Shorter appointment durations improve pediatric patient compliance while maintaining the original root canal anatomy is essential to preserve the integrity of the developing permanent tooth germ. Rotary files facilitate this process by reducing treatment time. This study aimed to compare the obturation quality achieved using hand files versus a rotary file system in the root canal treatment of primary molars. Materials and methods A total of 316 patients aged 4-10 years with symptomatic pulpitis (duration ≤7 days) were enrolled. Teeth with sinus tracts or mobility graded 2 or higher were excluded. Patients were randomly assigned into two equal groups: Group A (rotary file system) and Group B (hand files) via sealed, opaque envelopes. Following endodontic treatment, intraoral periapical radiographs were taken using the bisecting angle technique, and obturation quality was evaluated. Results The mean ages were 6.73 ± 1.53 years in Group A and 6.78 ± 1.55 years in Group B. Most patients (n = 214, 67.72%) were aged 4-7 years, with a male-to-female ratio of 1:1.4 (130 males, 186 females). Obturation quality was achieved in 111 patients (70.25%) in the rotary file group compared to 74 patients (46.84%) in the hand file group, with a statistically significant difference (p = 0.0001). Conclusion The rotary file system demonstrated superior obturation quality in the root canal treatment of primary molars compared to hand files, highlighting its efficacy and potential benefits for pediatric endodontic care.