Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files

Abstract

(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal–Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.

Impacts of different Nickel–Titanium rotary and reciprocating root canal preparation systems on the amount of apically extruded debris

“…Predin Djuric et al [26] in their study reported that the WOG system produced significantly the highest amount of extruded debris than the other systems. In another previous study, the difference regarding apical debris extrusion between WOG, PTN and Twisted file systems was insignificant [29]. These are inconsistent with the present study's results in which WOG caused significantly less apical debris extrusion than the other groups except for the TN system.…”

“…The statistical analysis of the present study stated that the differences between TS, PTN and RCB regarding debris extrusion were not significant. These findings were similar to other previous studies which compared different types of canal instrumentation systems and stated that the statistical differences regarding apically extruded debris were not significant [15, 18, 29]. The TS, PTN and RCB groups produced significantly the highest amount of extruded debris compared with TN and WOG groups according to the results of this study.…”

A Comparative Evaluation of the Apically Extruded Debris from Root Canals Prepared by R-Motion NiTi File System

“…A recent study by Kharouf et al [ 17 ] agreed with this result and compared PTN in full rotation and reciprocation with WOG, resulting in no significant difference between the tested files sharing a similar rectangular cross section. Another study by Eliasz et al [ 36 ] revealed that PTN and WOG produced the same amount of AED. On the contrary, previous studies found that reciprocating instruments may cause more AED than full rotary instruments [ 37 , 38 ].…”

Comparison of Apically Extruded Debris Created by Four Different Reciprocating Single-File Systems: An in Vitro Study

“…34 Bu nedenle çalışmamızda kullanılan metodoloji, bu tür ölçümler için en pratik ve tekrarlanabilir seçenek olmaya devam etmekte ve ayrıca diğer çalışmalarla karşılaştırmaya olanak sağlamaktadır. 35 Debris ekstrüzyonunun değerlendirildiği çalışmalarda, standardizasyonun sağlanması, deney düzeneğine kolay adaptasyonu, irrigasyon ve preparasyon esnasında meydana gelebilecek olası komplikasyonları azaltmak amacı ile genellikle düz, tek köklü dişler tercih edilmektedir. 12 Ancak literatürde mandibular molar köklerde daha az çalışma yapıldığından ve bu eğe sistemlerinin karmaşık kök anatomilerindeki debris ekstrüzyonuna etkisi değerlendirilmek istendiği için bu çalışmada mandibular molar dişlerin mesiyal kökleri dâhil edilmiştir.…”

“…Üreticiye göre bu yeni ısıl işlem eğenin esnekliğini ve döngüsel yorgunluk direncini artırmaktadır. 17 WaveOne Gold sistemi "small" (20,07), "primary" (25,07), "medium" (35,06) ve "large" (45,05) olmak üzere 4 adet eğeden oluşmaktadır. 18 Gümümüzde resiprokal tek eğe sistemine sahip yeni üretilen birçok eğe sistemi mevcuttur.…”