Debris Apically Extruded by Two Reciprocating Systems: A Comparative Quantitative Study

Abstract

Objective The objective of this study was to quantify the amount of debris apically extruded after instrumentation with two reciprocating systems. Materials and Methods Forty-two single-rooted mandibular premolars with only one straight root canal and apical diameter compatible with a no. 15 K-file were randomly divided into two groups (n = 21) according to the instrument used: ProDesign R (Easy Equipamentos; Belo Horizonte, Minas Gerais, Brazil) and Reciproc Blue (VDW; Munich, Germany). Dry Eppendorf tubes were weighed three consecutive times for the initial mean weight. A silicone stopper was then fitted into the mouth of the tube. Each tooth was inserted through the stopper up to the cementoenamel junction and instrumented with one of the two systems to the predetermined working length (18 mm). The root canals were instrumented per root thirds. At each instrumented root third, the canal was irrigated with 3 mL of double-distilled water, followed by patency control. Each stopper was then separated from the tube and tubes were incubated at 70°C for 5 days. Tubes were again weighed, and the amount of extruded debris was calculated by subtracting the initial mean weight from the final mean weight. Statistical Analysis Results were analyzed using the Mann–Whitney test at a 5% significance level. Results No significant difference was observed in debris extrusion between the ProDesign R and Reciproc Blue systems (p = 0.7557). Conclusions The two reciprocating systems tested produced similar amounts of postinstrumentation apically extruded debris.

Analysis of the influence of different kinematic instrumentation in extrusion of apical debris

“…One of the main objectives of the instrumentation of the root canal system is the elimination of irritating etiological factors on the one hand, and the maintenance of healthy periapical tissues, on the other, some of these irritating agents, such as contaminated dentin debris, microorganisms and pulp tissue remains, can, during instrumentation, extrude through the apical foramen to the periapical space. This extruded material when in contact with the periapical tissues also works as an irritating factor, providing, among other occurrences, the painful symptoms to the patient known as flare-up [1,2,3,4]. Some studies have been carried out in order to evaluate the amount of material extruded for the periapical tissues including a variety of factors: kinematics, apical diameter, working length, quantity and type of irrigating substance, irrigation systems, instrument design [5,6,7], but few studies have been carried out to better evaluate this extrusion when using reciprocating systems [8,9].…”

A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants

“…The majority of studies performed by using this methodology utilized incisors (Borges et al, 2016; Bürklein et al, 2014; Ferraz et al, 2001; Karatas et al, 2016; Kfir et al, 2018) and mandibular premolars (Amaral et al, 2019; Cicek et al, 2016; Ehsani et al, 2016; Parirokh et al, 2012; Pawar et al, 2016; Silveira et al, 2019; Tanalp et al, 2006; Topcuoglu et al, 2020; Uzunoglu & Turker, 2016; Yeter et al, 2013), whereas mesiobuccal roots of molars were also included as experimental specimens in some (Adl et al, 2009; Mustafa et al, 2021). In several studies, not only the curved canals of molar teeth were used but also both mesio‐buccal and mesio‐lingual canals were prepared by calculating the radii of curvature, based on the assumption that the type of tooth may also affect the amount of apical extrusion (Kocak et al, 2016).…”

Di̇ş Heki̇mleri̇ni̇n Peri̇api̇kal Radyografi̇ler Ve Koni̇k Işinli Bi̇lgi̇sayarli Tomografi̇ (Cbct) Görüntüleri̇ne Göre Uygulayacaklari Endodonti̇k Tedavi̇ Seçenekleri̇ni̇n Karşilaştirilmasi

“…2,3 During chemo-mechanical root canal preparation, dentin chips, irrigation solutions, microorganisms and their by-products and pulp tissue remnants may extrude into the periradicular tissues. 4,5 The extrusion of these irritating factors may cause postoperative-pain or delayed periapical healing. 6,7 All instrumentation techniques and endodontic files cause the apical extrusion of debris.…”

“…4 There are several factors such as file kinematics and design, glide-path preparation, apical enlargement size, working length, and number of instruments that affect the amount of apically extruded debris. [3][4][5][8][9][10] Nickel-titanium (NiTi) instruments were introduced to enable the optimal root canal preparation in a shorter time and with fewer procedural errors. 3,11 Mechanical and thermal treatments were applied to NiTi files to improve the torsional fracture and cyclic fatigue resistance of these systems.…”