Apical Extrusion of Intracanal Debris Using Two Engine Driven and Step-Back Instrumentation Techniques: An In-Vitro Study

Abstract

ObjectivesThe purpose of this study was to compare in-vitro the amount of debris extruded apically from extracted teeth, using K3, Protaper rotary instruments and manual step-back technique.MethodsForty five human single-rooted mandibular premolar teeth were randomly divided into 3 groups. The teeth in 3 groups were instrumented until reaching the working length with K3, Protaper rotary instruments and K-type stainless steel instruments with manual step-back technique, respectively. Debris extruded from the apical foramen was collected into centrifuge tubes and the amount was determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests, with P=.05 as the level for statistical significance.ResultsStatistically significant difference was observed between K3, Protaper and step-back groups in terms of debris extrusion (P<.05). Step-back group had the highest mean debris weight, which was significantly different from the K3 and Protaper groups (P<.05). The lowest mean debris weight was related to K3 group, which was significantly different from the Protaper group (P<.05). Conclusions: Based on the results, all instrumentation techniques produced debris extrusion. The engine-driven Ni-Ti systems extruded significantly less apical debris than step-back technique. However, Protaper rotary instruments extruded significantly more debris than K3 rotary instruments.

Evaluation of Apically Extruded Bacteria Associated with Different Nickel-Titanium Systems

“…Therefore, apically extruded bacteria from the apical foramen could be attributed to the properties of the respective instrument used in that particular group. A previously described method was used to collect apically extruded bacteria (7)(8)(9)13). Although the vital periapical tissues are not mimicked, this technique allows a comparison of the file systems.…”

“…A previously described method was used to perform the test apparatus (7)(8)(9). Vials with rubber stoppers were adjusted for use by means of a heated instrument to create a hole through the center.…”

Apical extrusion of bacteria when using reciprocating single‐file and rotary multifile instrumentation systems

“…, Kustarci et al . ), because bacterial formation as a mature biofilm is a complex structure and is much more difficult to eliminate (Shen et al . ).…”

“…Before infection of root canals, a sterile size 15 K‐file was placed 1 mm beyond the foramen to create a hole in the nail varnish that covered the apical foramen (Kustarci et al . ). In this way, a standard size of foramen and apical patency was achieved.…”

Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment

“…The ProTaper system was also compared with K3 system (Kustarci et al 2008c, Madhusudhana et al 2010 and Mtwo (Madhusudhana et al 2010, Tasdemir et al 2010. Kustarci et al (2008c) reported that ProTaper extruded significantly more debris compared with K3, whereas Madhusudhana et al (2010) determined no significant difference. Tasdemir et al (2010), on the other hand, reported that ProTaper extruded significantly higher amount of apical debris compared with other systems tested, one of which was Mtwo.…”