Apical extrusion of debris by supplementary files used for retreatment: An ex vivo comparative study

Abstract

Aim:This study evaluated whether using supplementary files for removing root canal filling residues after ProTaper Universal Retreatment files (RFs) increased the debris extrusion apically.Materials and Methods:Eighty mandibular premolars with single root and canal were instrumented with ProTaper Universal rotary system (SX-F3) and obturated. The samples were divided randomly into four groups (n = 20). Group 1 served as a control; only ProTaper Universal RFs D1–D3 were used, and the extruded debris was weighed. Groups 2, 3, and 4 were the experimental groups, receiving a twofold retreatment protocol: Removal of the bulk, followed by the use of supplementary files. The bulk was removed by RFs, followed by the use of ProTaper NEXT (PTN), WaveOne (WO), and Self-Adjusting File (SAF) for removal of the remaining root filling residues. Debris extruded apically were weighed and compared to the control group. Statistical analysis was performed using one-way analysis of variance (ANOVA) and post hoc Tukey's test.Results:All the three experimental groups presented significant difference (P < .01). The post hoc Tukey's test confirmed that Group 4 (SAF) exhibited significantly less (P < .01) debris extrusion between the three groups tested.Conclusion:SAF results in less extrusion of debris when used as supplementary file to remove root-filling residues, compared to WO and PTN.

Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems

“…The HF were associated with higher amount of debris extrusion apically in this study, and this is in agreement with the existing literature. 8,11,12,[21][22][23][24] Our results showed that rotary files used in crown-down fashion extruded more debris than the SAF system. This may be detrimental to the underlying stem cells and lead to alterations in the dental germ, such as hypoplasia, morphological alteration on the dental crown, or total arrest of radicular formation.…”

“…11,14,15 Many studies have been carried out and reported on the amount of apically extruded debris during root canal preparation using these newer instruments in permanent teeth. [1][2][3][4][5][11][12][13][16][17][18] The SAF reportedly is associated with less debris extrusion in studies reported on permanent teeth. 11,12 To the best of our knowledge , debris extrusion after instrumenting primary teeth using the aforementioned methods is yet to be reported.…”

“…[1][2][3][4][5][11][12][13][16][17][18] The SAF reportedly is associated with less debris extrusion in studies reported on permanent teeth. 11,12 To the best of our knowledge , debris extrusion after instrumenting primary teeth using the aforementioned methods is yet to be reported. Hence, the aim of this study was to evaluate and compare the amount of debris extrusion by HF, PTU, PTN, and SAF, when used for instrumenting primary teeth.…”

“…This often results in inflammation, postoperative pain, and delayed healing. [9][10][11][12] Most of the currently used endodontic rotary instruments are intended to be used in the crown-down approach. The use of different motions (rotary/reciprocating), the number of file sequence, and the taper of the files used can influence the amount of debris extrusion.…”

“…The use of different motions (rotary/reciprocating), the number of file sequence, and the taper of the files used can influence the amount of debris extrusion. [11][12][13] Recently developed multiple file rotary instrumentation system, PTN (Dentsply Tulsa Dental, Tulsa, OK) has a unique design with the center of mass and the center of rotation offset creating a wave when in motion that travels along the length of the file. This minimizes the engagement between the file and dentin and also augers debris coronally.…”