Volume 30, Issue 174, August 2026

The Role of Rotary and Reciprocating Systems in Primary Molar Pulpectomy: A Literature Review

Gabriela Królczyk^1♦, Stanisław Janczarski², Jakub Papierz², Erwin Górski², Julia Banaszczyk², Katarzyna Cybulska², Aleksandra Pietrzyk³, Mikołaj Cezary Krajewski⁴

¹Zespół Przychodni Specjalistycznych Sp. z o.o. , 1 Skłodowskiej-Curie Street , 33-100 Tarnów, Poland
²Institute of Dentistry of the Central Clinical Hospital of the Medical University of Łódź, Pomorska 251, 92-213 Łódź, Poland
³Centralna Wojskowa Przychodnia Lekarska CePeLek SPZOZ, 78 Koszykowa Street, 00-911 Warszawa, Poland
⁴Independent researcher of the Dentistry, Poland

^♦Corresponding author
Gabriela Królczyk, Zespół Przychodni Specjalistycznych Sp. z o.o., 1 Skłodowskiej-Curie Street, 33-100 Tarnów, Poland

ABSTRACT

Pediatric dentists have begun to use NiTi motorized instruments to address the difficulties of manually instrumenting root canals in primary teeth. Increasing research shows that mechanized canal preparation reduces treatment time, postprocedure pain, and obturation variability compared with traditional hand instrumentation. This study tries to determine the efficacy, mechanical performance, and safety of different engine-driven file systems during pulpectomy procedures for primary molars. By reviewing the existing literature, the objective of this study is to develop practical criteria for the selection between dedicated pediatric rotary files and modified adult rotary files. Studies show that enginedriven instrumentation can be used very effectively in pulpectomy of primary teeth and achieves success comparable to hand K-files. It functions as an extremely efficient technique in reducing working time, which in turn boosts patient cooperation. With the help of heat treatment of the alloy and pediatric design, it is feasible to retain the curvatures of the root canal while averting any root perforations and cracks in the dentine. Yet, debris extrusion at the apex and canal transport are problems with severely curved or resorbed roots. An engine-driven pulpectomy for primary teeth is a reliable and highly efficient method for managing such cases. Expected results can be achieved when pediatric files and conservative tapers with controlled speed are applied. Engine-driven endodontics in pedodontics is one of the most rapidly developing fields that necessitates active involvement of specialists. Current innovations have great possibilities; however, more studies are needed.

Keywords: primary teeth; pulpectomy; pediatric endodontics; rotary instrumentation; reciprocating systems; NiTi files

Medical Science, 2026, 30, e156ms3949

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Published: 18 August 2026