Determination of the Anxiety and Behavior of Children Undergoing Endodontic Treatment Using Manual and Rotary File Systems: A Comparative Clinical Study
KL Girish Babu, Kavyashree Gururaj Hebbar
Citation Information :
Babu KG, Hebbar KG. Determination of the Anxiety and Behavior of Children Undergoing Endodontic Treatment Using Manual and Rotary File Systems: A Comparative Clinical Study. J South Asian Assoc Pediatr Dent 2021; 4 (3):175-184.
Introduction: Many dentists perform extraction of deciduous teeth that could be preserved by pulpectomy, claiming that the tedious and longer duration of endodontic treatment leads to development of anxiety and negative behavior in children.Aim: To determine and compare the anxiety experienced and behavior exhibited by children undergoing endodontic treatment using manual and rotary file systems.Methods: This clinical study comprised 150 children. The pulpectomy procedure was carried out in the two visits. The first visit consisted of administration of local anesthesia, isolation, access cavity preparation, and pulp extirpation. In the second visit, the children were grouped into 3 groups(Group 1, Group 2,and Group 3)consisting of 50 childreneach. In groups 1,2, and 3, rootcanals were instrumented using the Kedo-S pediatric rotary file system,HERO shaper rotary file systems, and manual Ni-TiK files, respectively. Root canal instrumentation time was calculated. Anxiety and behavior of children during root canal instrumentation were assessed.Results: The mean instrumentation time for groups 1,2, and 3 were14.56± 2.89 minutes, 17.93± 3.51 minutes, and 29.00± 2.08 minutes, respectively. The children in groups 1 and 2 experiencedsignificantly less anxiety and exhibited positive behavior than children in group 3.Conclusion: The children treated with rotary file systems experienced less anxiety and exhibited positive behavior compared to children treated with the manual file systems.
Cohen SM, Fiske J, Newton JT. The impact of dental anxiety on daily living. Br Dent J 2000;189:385–390. DOI: 10.1038/sj.bdj.4800777
Abanto J, Vidigal EA, Carvalho TS, et al. Factors for determining dental anxiety in preschool children with severe dental caries. Braz Oral Res 2017;31:1–7. DOI: 10.1590/1807-3107bor-2017.vol31.0013
Tickle M, Jones C, Buchannan K, et al. A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age. Int J Paediatr Dent 2009;19:225–232. DOI: 10.1111/j.1365-263X.2009.00976.x
Santamaria RM, Innes NP, Machiulskiene V, et al. Acceptability of different caries management methods for primary molars in a RCT. Int J Paediatr Dent 2015;25:9–17. DOI: 10.1111/ipd.12097
Cademartori MG, Martins P, Romano AR, et al. Behavioral changes during dental appointments in children having tooth extractions. J Indian Soc Pedod Prev Dent 2017; 35:223–228. DOI: 10.4103/jisppd.jisppd_195_16
Mathur J, Diwanji A, Sarvaiya B, et al. Identifying dental anxiety in children's drawings and correlating it with Frankl's Behavior Rating Scale. Int J Clin Pediatr Dent 2017;10(1):24–28. DOI: 10.5005/jp-journals-10005-1401
Gustafsson A, Broberg A, Bodin L, et al. Dental behavior management problems: the role of child personal characteristics. Int J Paediatr Dent 2010;20:242–253. DOI: 10.1111/j.1365-263X.2010.01046.x
Morgan AG, Rodd HD, Porritt JM, et al. Children's experiences of dental anxiety. Int J Paediatr Dent 2017;27:87–97. DOI: 10.1111/ipd.12238
American Academy of Pediatric Dentistry (AAPD). Guideline on behavior guidance for the pediatric dental patient. Pediatr Dent 2016;38:185–198.
Cademartori MG, Rosa DP, Oliveira LJC, et al. Validity of the Brazilian version of the Venham's behavior rating scale. Int J Paediatr Dent 2017;27:120–127. DOI: 10.1111/ipd.12231
Ten Berge M, Veerkamp JS, Hoogstraten J, et al. Childhood dental fear in the Netherlands: Prevalence and normative data. Community Dent Oral Epidemiol 2002;30:101–107. DOI:10.1034/j.1600-0528.2002.300203.x
Klingberg G. Dental anxiety and behavior management problems in paediatric dentistry—a review of background factors and diagnostics. Eur Arch Paediatr Dent 2008;9:11–15. DOI: 10.1007/BF03262650
Aminabadi NA, Sohrabi A, Erfanparast LK, et al. Can birth order affect temperament, anxiety and behavior in 5 to 7-year-old children in the dental setting? J Contemp Dent Pract 2011;12(4):225–231. DOI: 10.5005/jp-journals-10024-1039
Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent 1999;21:453–454.
Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent 2000;22:77–78.
Subramaniam P, Girish Babu KL, Tabrez TA. Effectiveness of rotary endodontic instruments on Smear layer removal in root canals of primary teeth: a scanning electron microscopy study. J Clin Pediatr Dent 2016;40:141–146. DOI: 10.17796/1053-4628-40.2.141
Subramaniam P, Tabrez TA, Girish Babu KL. Microbiological assessment of root canals following use of rotary and manual instruments in primary molars. J Clin Pediatr Dent 2013;38:123–127. DOI: 10.17796/jcpd.38.2.j84265t82u60271u
Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial. Eur Arch Paediatr Dent 2018;19:273–278. DOI: 10.1007/s40368-018-0356-6
Aminabadi NA, Oskouei SG, Farahani RM. Dental treatment duration as an indicator of the behavior of 3-to 9-year-old pediatric patients in clinical dental settings. J Contemp Dent Pract 2009;10(5):E025–32. DOI:10.5005/jcdp-10-5-23
Getz T, Weinstein P. The effect of structural variables on child behavior in the operatory. Pediatr Dent 1981;3(3):262–266.
Lenchner V. The effect of appointment length on behavior of the pedodontic patient and his attitude toward dentistry. J Dent Child 1966;33(2):61–74.
Davidovich E, Wated A, Shapira J, et al. The influence of location of local anesthesia and complexity/duration of restorative treatment on children's behavior during dental treatment. Pediatr Dent 2013;35(4):333–336.
Soares JP, Cardoso M, Bolan M. Demystifying behavior and dental anxiety in schoolchildren during endodontic treatment for primary teeth—controll clinical trial. Int J Paediatr Dent 2019;29:249–256. DOI: 10.1111/ipd.12468
Bawazir OA, Salama FS. Clinical evaluation of root canal obturation methods in primary teeth. Pediatr Dent 2006;28:39–47.
Morankar R, Goyal A, Gauba K, et al. Manual versus rotary instrumentation for primary molar pulpectomies- A 24 months randomized clinical trial. Pedi Dent J 2020;28:96–102. DOI:10.1016/J.PDJ.2018.02.002
Venham LL, Gaulin-Kremer E, Munster E, et al. Interval rating scales for children’ dental anxiety and uncooperative behavior. Pediatr Dent 1980;2:195–202.
Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? ASDC J Dent Child 1962;29:150–162.
Melamed BG. Methodological needs and behavioral research with child dental patients. Anesth Prog 1986;33:34–40.
Asl AN, Shokravi M, Jamali Z, et al. Barriers and drawbacks of the assessment of dental fear, dental anxiety and dental phobia in children: a critical literature review. J Clin Pediatr Dent 41(6):399–423. DOI: 10.17796/1053-4628-41.6.1
Chellappah NK, Vignehsa H, Milgrom P, et al. Prevalence of dental anxiety and fear in children in Singapore. Community Dent Oral Epidemiol 1990;18:269–271. DOI: 10.1111/j.1600-0528.1990.tb00075.x
Bankole OO, Aderinokun GA, et al. Maternal and child's anxiety – Effect on child's behavior at dental appointments and treatments. Afr J Med Med Sci 2002;31:349–352.
Ten Berge M, Veerkamp JS, Hoogstraten J. The etiology of childhood dental fear: the role of dental and conditioning experiences. J Anxiety Disord 16(3):321–329. DOI: 10.1016/s0887-6185(02)00103-2
Oliveira MM, Colares V. The relationship between dental anxiety and dental pain in children aged 18 to 59 months: a study in Recife, Pernambuco State, Brazil. Cad Saude Publica 2009;25(4):743–750. DOI: 10.1590/s0102-311x2009000400005
Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J 2013;58(4):390–407. DOI: 10.1111/adj.12118
Shapiro DN. Reactions of children to oral surgery experience. J Dent Child 1967; 34:97–107.
Rud B, Kisling E. The influence of mental development on children's acceptance of dental treatment. Scand J Dent Res 1973;81:343–352. DOI: 10.1111/j.1600-0722.1973.tb00337.x
Ripa LW. Children's reaction to the dental experience. In Ripa LW, Barenie JT, (eds.) Management of dental behavior in children. Littleton, Mass: PSG Publishing Co; 1979: pp. 1–11.
Wilson SW. Non-pharmacologic issues in pain perception and control. In Pinkham JR, Casamassimo PS, Fields HW, Mc Tigue DJ, and Nowak A, (eds.) Pediatric dentistry: infancy through adolescence. 4th ed. Philadelphia, Pa: WB Saunders Co; 2005: pp. 96–107.
Suprabha BS, Rao A, Choudhary S, et al. Child dental fear and behavior: the role of environmental factors in a hospital cohort. J Indian Soc Pedod Prev Dent 2011;29:95–101. DOI: 10.4103/0970-4388.84679
Kyritsi MA, Dimou G, Lygidakis NA. Parental attitudes and perceptions affecting children's dental behavior in Greek population. A clinical study Eur Arch Paediatr Dent 2009;10:29–32. DOI: 10.1007/BF03262664
Jamali Z, Najafpour E, Adhami ZA, et al. Does the length of dental procedure influence children's behavior during and after treatment? A systematic review and critical appraisal. J Dent Res Dent Clin Dent Prospects 2018;12(1):68–76. DOI: 10.15171/joddd.2018.011
Taylor MH, Moyer IN, Peterson DS. Effect of appointment time, age, and gender on children's behavior in a dental setting. ASDC J Dent Child 1983;50:106–110.
Wright GZ, Alpern GD. Variable's influencing children's cooperative behavior at the first dental visit. ASDC J Dent Child 1971;38(2):124–128.
Roane JB, Dryden JA, Grimes EW. Incidence of postoperative pain after single – and multiple – visit endodontic procedures. Oral Surg 1983;55:68–72. DOI: 10.1016/0030-4220(83)90308-0
Fava LR. A comparison of one versus two appoints endodontic therapy in teeth with non-vital pulps. Int Endod J 1989;22:179–183. DOI: 10.1111/j.1365-2591.1989.tb00921.x
Eleazer PD, Eleazer KR. Flare-up rate in pulpally necrotic molars in one- visit versus two–visit endodontic treatment. J Endod 1998;24:614–616. DOI: 10.1016/S0099-2399(98)80122-2
Ince B, Ercan E, Dali M, et al. Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent 2009;3:273–279.
Singla R, Marwah N, Dutta S. Single versus multiple visit root canal therapy. Int J Clin Peadiatr Dent 2008;1:17–24. DOI: 10.5005/jp-journals-10005-1004
Allen KD, Stanley RT, McPherson K. Evaluation of behavior management technology dissemination in pediatric dentistry. Pediatr Dent 1990;12(2):79–82.
Allen KD, Hutfless S, Larzelere R. Evaluation of two predictors of child disruptive behavior during restorative dental treatment. J Dent Child (Chic) 2003; 70(3):221–225.
Richardson RW, Richardson LA. Birth order and you: Discover how your sex and position in the family affects your personality, career, relationships, and parenting (Self-Counsel Personal Self-help) (2nd ed). North Vancouver, British Columbia: Self Counsel Press 2000.
Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, et al. Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth. J Clin Pediatr Dent 2011;35(4):359–363. DOI: 10.17796/jcpd.35.4.8k013k21t39245n8
Musale PK, Mujawar Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCTSAV. Eur Arch Paediatr Dent 2014;15:113–120. DOI: 10.1007/s40368-013-0072-1
Makarem A, Ravandeh N, Masoumeh E. Radiographic assessment and chair time of rotary instruments in the pulpectomy of primary second molar teeth: a randomized controll clinical trial. J Dent Res Dent Clin Dent Prospects 2014; 8:84–89. DOI: 10.5681/joddd.2014.015
Silva LA, Leonardo MR, Nelson-Filho P, et al. Comparison of rotary and manual instrumentation techniques on cleaning capacity and instrumentation time in deciduous molars J Dent Child (Chic) 2004;71:45–47.
Crespo S, Cortes O, Garcia C, et al. Comparison between rotary and manual instrumentation in primary teeth. J Clin Pediatr Dent 2008;32:295–298. DOI: 10.17796/jcpd.32.4.l57l36355u606576
Sivakumar P, Gurunathan D. Behavior of children toward various dental procedures. Int J Clin Pediatr Dent 2019;12(5):379–384. DOI: 10.5005/jp-journals-10005-1670
Pai R, Mandroli P, Benni D, et al. Prospective analysis of factors associated with dental behavior management problems, in children aged 7-11 years. J Indian Soc Pedod Prev Dent 2015;33:312–318. DOI: 10.4103/0970-4388.165684
Veerkamp JSJ, Wright GZ. Children's behavior in the dental office. In: Wright GZ, Kupietzky A. Behavior management in dentistry for children (2nd ed.). Lowa: Wiley Blackwell, John Wiley & Sons, Inc. 2014. pp. 23–33.
Subramaniam P, Haqh M, Gupta M. Assessment of trait and state anxiety in 3-6-year-old children during sequential phases of dental treatment. Contemp Pediatr Dent 2020;1(1):22–32.