Clinical comparison of the obturation quality of primary posterior maxillary teeth treated with pulpectomy using single rotary file, sequential rotary file, and manual file system: an observational study

Background: Pulpal involvement resulting from dental caries is a frequent occurrence and poses a formidable challenge for pediatric dentists. The success of endodontic treatment relies heavily on the quality of obturation. Previously, evaluation was based on the Coll and Sadrian criteria. However, with the introduction of the Kids Endodontic Obturation Quality (KEDOO) classification, a more detailed assessment is now possible. This classification considers various parameters including arch, segment and canal-specific factors, thus addressing previous limitations. The aim of this paper is to evaluate and compare the quality of obturation achieved by the Kedo S Plus, Pro AF Baby Gold and K-file systems in primary maxillary molars using the KEDOO classification system. Methods: In this observational study, thirty intraoral periapical (IOPA) radiographs were obtained for each group of primary maxillary molars treated with pulpectomy: Group A (Kedo S Plus), Group B (Pro AF Baby) and Group C (K-file), resulting in a total of ninety radiographs. The exclusive assessment of obturation quality was conducted utilizing the KEDOO classification system. Results: Statistical analysis was performed employing Kruskal Wallis and Analysis of Variance (ANOVA) tests. Kedo S Plus file system showed more number of optimal obturations (73.3%) in comparison with other groups. There was significant difference between the groups on comparison of quality of obturation. Conclusions: KEDOO classification system assesses outcomes based on the presence and location of voids as well as the extent of material fill. Kedo S Plus, Pro AF Baby file, and Hand K File systems each achieved varying levels of obturation quality. The single rotary file system (Kedo S Plus) is a promising alternative to sequential and manual instrumentation in achieving optimal obturation in primary maxillary molars. Clinical Trial Registration: The study was registered under the Clinical Trials Registry of India (CTRI) with the registration number CTRI/2024/06/069200.