INTRODUCTION:

               Pulpectomy is a root canal procedure for pulp tissue that is irreversibly infected or necrotic due to caries or trauma. The root canals are debrided, disinfected and filled with resorbable material (AAPD 2015). Treatment objective of pulpectomy is to maintain the tooth free of infection contamination, biomechanically cleanse and obturate the basis canals, promote physiologic root resorption. Obturated teeth is then restored with a restoration to prevent microleakage, aid in healing and sustained health of the peri-radicular tissue. But there is a difficulty in obturating primary root canals as Zinc oxide-eugenol pastes sets to hard mass and Metapex shows hallow tube effect. These materials have been traditionally used for a long time but cannot be said to be ideal. (Gurlal Singh Brar et.,) Now, various new materials have been introduced to overcome the drawbacks of ideal material, which lead to the search for friendlier root filling resorbable pastes.

OBJECTIVES:

To comparatively evaluate clinical and radiographic success of three obturating materials in mandibular 2^nd primary molars- RC FILL, ENDOFLAS, and ZINC OXIDE POWDER WITH 10% SODIUM FLUORIDE.

To assess the radiographic infectious process resolve in six months evidenced by bone deposition in the pretreatment radiolucent areas.

To assess the pretreatment clinical signs and symptoms should resolve within a few weeks.

SAMPLE SIZE:

60 Primary mandibular 2^nd molars.

Age group – 4 to 9 years old

SOURCE OF SAMPLE TO BE TAKEN:

ü  Outpatients from the Department of Pediatric and Preventive dentistry, Pediatric dental outPatients in medical college, school dental camps.

MATERIALS:

Samples Divided into 3 groups as;

Group 1- Rc fill (20 numbers)

Group 2- Endoflas (20 numbers)

Group 3- Zinc oxide-10% sodium fluoride (20 numbers)

 INCLUSION CRITERIA

1. Dental caries with intra-oral and/or extraoral swelling or draining sinus tract
2. Dental caries with irreversible pulpitis
3. Dental caries with inter-radicular or periapical radiolucency.
4. Teeth with two-thirds of root length intact.
5. Patient/ Parent willing for the treatment

 EXCLUSION CRITERIA

1. Presence of resorption in root (external or internal).
2. Teeth with pulpal floor perforation.
3. Teeth with pathologic/ pre shedding mobility.
4. H/0 allergic to LA or to the components of the test materials.
5. Presence of medically compromising systemic conditions.
6. Teeth with less than 2/3^rd of root length.

 METHODOLOGY:

·        The study will adhere to ethical guidelines and has been approved by an institutional ethics committee. Patient confidentiality will be maintained throughout the study.

·       Detailed informed consent will be obtained from parents, including explanations of the study purpose, procedures, risks, and benefits.

·       Consent will be documented using signed forms. Local anesthesia with 2% lignocaine and 1:80,000 adrenaline (Lignox 2% Indoco) will be administered using standard infiltration techniques.

·       Rubber dam will be placed using a standard technique to ensure isolation. Access cavity will be created with a #6 round bur at a high speed under water cooling. Necrotic pulp will be removed using a sharp spoon excavator. The chamber will be irrigated with saline. The pulp chamber will be deroofed with a non-end cutting bur. Pulp tissue will be extirpated using a barbed broach and a #15 K-file. Canal patency will be checked, and working length will be determined using radiographs and an apex locator.

·       KEDO NANO-PLUS rotary files will be used for biomechanical preparation (BMP) to the working length, following manufacturer guidelines.

·       For obturation, RC Fill (Prime) will be applied with a lentulo spiral in Group I.

·       Endoflas will be placed incrementally and condensed with a hand plugger in Group II.

·       Zinc Oxide powder with 10% sodium fluoride will be mixed and placed with lentulo spirals in Group III.

·       Post-op radiographs will be taken to verify obturation quality. Entrance restoration will be done with type IX GIC cement. Stainless Steel Crown (SSC) will be placed once obturation is satisfactory.

·       The evaluator and outcome assessor will be blinded to the group allocations. Clinical and radiographic evaluations will be conducted immediately post-op and at 1, 3, and 6-month intervals using predefined criteria (Gupta and Das, 2011; Coll and Sadrian).

·       Data will be collected on standardized forms and entered into a secure database. Statistical analysis will be done using SPSS software. Outcomes between groups will be compared using the Chi-square test, with a significance level set at 5% (p<0.05). Descriptive statistics (mean and standard deviation) will be calculated. To compare differences between three groups, we will use REPEATED MEASURES ANOVA or the KRUSKAL-WALLIS test, depending on the normality of the data distribution.

REFERENCES:

1.     Elicherla SR, Bandi S, Saikiran KV, Nunna M, Sahiti PS, Nuvvula S. The clinical and radiographic success of Endoflas compared with other root canal obturating materials in primary teeth: A systematic review. Dent Res J 2022;19:72

2.   Pramila R, Muthu MS, Deepa G, Farzan JM, Rodrigues SJ. Pulpectomies in primary mandibular molars: a comparison of outcomes using three root filling materials. Int Endod J. 2016 May;49(5):413-21. doi: 10.1111/iej.12478. Epub 2015 Jul 4. PMID: 26059708

3.     Clinical and radiographic evaluation of four different zinc-oxide integrated root canal obturating materials used in primary teeth Himani Goel, Shivani Mathur, Vinod SachdevAvailable online at www.sciencedirect.com Pediatric Dental Journal journal homepage: www.elsevier.com/locate/pdj pediatric dental journal xxx (2018) 1 e1 4 https://doi.org/10.1016/j.pdj.2018.06.002

4.     Goel H, Mathur S, Sachdev V. Evaluation of a mixture of zinc oxide–10% sodium fluoride as novel root canal filling material: Apilot study!! J Indian Soc Pedod Prev Dent 2019;37:392-8