Apical Extrusion of Debris and Irrigant using Novel Preparation Systems

Abstract

Aim:The aim of this in vitro study was to assess the amount of apically extruded debris and irrigant using Reciproc vs self-adjusting file (SAF) and to investigate the effect, if any, of gravitational force via mandibular and maxillary positioning of the teeth. Materials and methods:Forty human mandibular premolars were randomly assigned to four groups of 10 teeth each. The root canals were instrumented according to the manufacturers' instructions using the Reciproc and SAF. Sodium hypochlorite was used as the irrigant. The apically extruded debris was collected in pre-weighted glass vials using the Myers and Montgomery method, and teeth were placed in vials both in downward and upward positions. After drying, the mean weight of debris was assessed with a microbalance and statistically analyzed using two-way ANOVA with Bonferroni correction.Results: All instrumentation techniques and positions caused measurable apical extrusion of debris. A significant difference was observed according to position and instrument used (p < 0.05). The Reciproc extruded significantly more debris than SAF and vial downward position extruded significantly more debris than upward position (p < 0.05). Conclusion:Under the conditions of this study, all systems caused apical debris extrusion, especially in the downward position.Clinical significance: According to results of this study, the SAF was associated with less debris extrusion compared to the Reciproc in both mandibular and maxillary positions.

Efficiency and apical extrusion of debris: a comparative ex vivo study of four retreatment techniques in severely curved root canals

“…On the other hand, when the location of the tooth was considered as the primary variable irrespective of the tested instruments, significantly more debris extrusion was observed for mandibular teeth. This finding is consistent with the results published by Uzunoğlu & Görduysus (), who reported the same observation during primary root canal treatment.…”

“…, Bürklein et al . ) and it has been suggested that gravity may play a role both in access of the irrigants to the apical foramen and their extrusion beyond the canal terminus (Uzunoğlu & Görduysus ). The impact of gravity on debris extrusion during retreatment procedures in severely curved root canals has not been examined.…”

“…There is only one laboratory study in which the effect of gravity on the amount of extruded debris during initial root canal treatment was investigated in permanent teeth with straight root canals. It was demonstrated that significantly more debris was extruded in mandibular teeth than in maxillary teeth (Uzunoğlu & Görduysus ). However, the amounts of extruded debris and the effectiveness of rotary retreatment instruments and H‐files have not yet been evaluated in teeth with severely curved root canals with respect to gravity.…”

Comparative evaluation of apically extruded debris with V-Taper, ProTaper Next, and the Self-adjusting File systems

“…There have been various studies showing the efficacy of SAF in reducing the amount of apical debris extrusion. It has been compared with ProTaper Universal, ProTaper Next, and WaveOne,[ 14 15 ] with Reciproc[ 16 ] wherein the findings of our study are in agreement.…”

Comparative Evaluation of Debris Extruded Apically by Different File Systems during Retreatment of Root Canals with or without Use of Solvent

“…18 Distilled water though not the preferred root canal irrigant was used during the retreatment procedure because the use of saline or sodium hypochlorite may have a positive effect on the weight of debris extruded. 19 No attempt was made to simulate the periapical tissues as the floral foam used may absorb the extruded irrigant and debris and interfere with the results. 7 The Myers and Montgomery model is the most widely accepted and commonly used system for assessing the apically extruded debris and was thus used in this study.…”