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The purpose of this research was to compare apical debris extrusion and fracture resistance of teeth prepared with OneCurve, WaveOne Gold, or ProTaper Universal. Materials and Methods: Mandibular premolars were prepared with OneCurve, WaveOne Gold, or ProTaper Universal. In the experimental model, debris was recovered by apical section of the root washing with distilled water. The Eppendorf tubes were weighed after 15 days of storage to establish the overall weight of the tubes, including the extruded debris. The dry weight of the ejected material was then computed. After root canal obturation, the apical root ends were trapped in the acrylic up to 2 mm below the cementoenamel junction. The fracture force was calculated and given in Newtons. A one-way ANOVA test was used to compare more than two groups, followed by a Tukey post hoc test. The significance level was set at P≤ 0.05. Results: The results revealed a statistically significant difference in extruded debris between OneCurve, WaveOne Gold, and ProTaper Universal (P

Aim: To compare the amount of extruded debris with three endodontic NiTi engine driven systems, Protaper Next, Hyflex CM and EdgeFile X7. Material and Methods: A total number of 42 freshly extracted human premolars were selected. Teeth were divided randomly into three equal groups (14 teeth each group) according to type of Ni-Ti rotary file system; (A) Protaper Next, (B) Hyflex CM and (C) EdgeFile X7. Standard Access cavity prepared and checked for patency using K file #10 and #15. Root canal instrumentation on the single canal lower premolars was done. Debris was collected after root canal instrumentation in pre-weighed Eppendorf tubes. The Eppendorf tubes were weighed 2 times on the analytical balance. First weight: Before instrumentation. Second weight: After evaporation of moisture and irrigant and incubation. Welch test was used for comparison between the three groups. Results: There was no statistically significant difference between the amounts of debris extrusion of the three groups Conclusion: All endodontic rotary instruments tested produced apical extrusion of debris.

AIM AND OBJECTIVE The aim of this study was to evaluate the apical extrusion of debris during root canal preparation with the use of different Nickel-Titanium (Ni-Ti) file systems. MATERIALS AND METHODS Totally 60 single-rooted human mandibular premolar teeth with fully formed roots were chosen for the study. The coronal access cavity and all other preparations were done with the use of an access cavity kit and then 60 samples were randomly separated into three investigational groups (n = 20); group I: self-adjusting file, group II: WaveOne Gold, and group III: Mtwo rotary system. After instrumentation, the teeth were taken out from the tube and the root surface-adherent debris was collected by washing off the apical area of the tooth with distilled water (1 ml) into a centrifuge tube. The centrifuge tube was kept for 5 days in an incubator at 70°C to permit evaporation of the moisture prior to weighing the dry debris with the aid of an electrical analytical balance. RESULTS The highest quantity of debris extruded was by the Mtwo rotary system (0.0394 ± 0.880) followed by WaveOne Gold (0.0247 ± 1.030) and self-adjusting file (0.0198 ± 0.102). A statistically significant difference (p < 0.001) was found between the various file systems. CONCLUSION After considering the drawbacks of this study, apical debris extrusion could be found with all three groups. However, the self-adjusting file demonstrated a significantly reduced quantity of apical debris extrusion compared to the Mtwo rotary system and WaveOne Gold. CLINICAL SIGNIFICANCE The chief step during the procedure of root canal treatment is the preparation of the infected root canals biomechanically. This preparation may lead to forcing the apical debris into the periapical space through the apical foramen, resulting in host-initiated immunological response which leads to postoperative discomfort and pain. This consequently leads to selection of a specific rotary system for endodontic treatment.

Background. This research aimed to investigate and compare the amount of apically extruded debris after root canal preparation using ProTaper Next, ProTaper Gold, and TruNatomy systems. Methods. Forty-five extracted mandibular premolar teeth with single canals with similar lengths were used. The root canals were prepared using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer, Ballaigues, Switzerland), or TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) files. Apically extruded debris during preparation was gathered into preweighed Eppendorf tubes. Then the Eppendorf tubes were incubated at 70°C for five days. The Eppendorf tubes were weighed again to determine their final weight plus the extruded debris. Results. The TRN system resulted in significantly less debris extrusion than the PTN system (P0.05). Conclusion. All the instrumentation systems caused apical extrusion of debris. However, the TRN system resulted in significantly less debris extrusion than the other systems.

Laser-activated irrigation (LAI) is an activation method that is based on transferring pulsed energy to the irrigation solution by using different fiber tips and generating explosive vapor bubbles with a secondary cavitation effect, causing rapid solution movement through the root canal. This study aimed to compare different types of LAI and ultrasonically activated irrigation (UAI) in terms of cleaning efficacy by using scanning electron microscopy (SEM) images. Sixty straight and single-rooted mature mandibular premolars were prepared with ProTaper Ni-Ti rotary instruments up to F4. According to the final irrigation/agitation protocols, four experimental groups (n = 15) were generated as conventional laser–activated irrigation (group 1: C.LAI), photon-induced photoacoustic streaming (group 2: PIPS), shock wave–enhanced emission photoacoustic streaming (group 3: SWEEPS), and passive ultrasonic irrigation (group 4:UAI). The irrigation protocols were performed for 60 s with 2.5% NaOCl and 17% EDTA. Debridement was evaluated using SEM with a scoring system. Apical extrusion was calculated using cube-shaped flower arrangement foam by subtracting the initial weights from the final weights. All data were statistically analyzed. C.LAI and SWEEPS showed significantly lower debris scores than PIPS and UAI (p

The present study aimed to compare the apically extruded debris produced during glide path preparation using R-Pilot (RP), WaveOne Gold Glider (WGG) and ProGlider (PG) with the subsequent preparation using Reciproc Blue in curved root canals. Mesial roots of mandibular molars with angle of curvature between 25° and 35° were selected (n = 20). The Myers and Montgomery method was used to collect and assess apically extruded debris. The glide path was prepared either manually with K-file, ProGlider, R-Pilot or WaveOne Gold Glider. Manual preparation group produced the highest amount of apically extruded debris (P 0.05), while all groups caused debris extrusion. There were no significant differences among the extruded debris caused by RP, PG and WGG groups (P 0.05). Apically extruded debris produced by engine-driven reciprocational or continuous rotational single file glide path instruments was similar, whereas manual glide path preparation was associated with the greatest amount of extruded debris.

Aim: This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems. Materials and Methods: Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal–Wallis test and Mann–Whitney U test. Results: Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria. Conclusion: All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.

Aim: To evaluate flow, filling ability, and apical extrusion of three calcium silicate-based sealers, Neo MTA Plus (Avalon, USA), Bio-C Sealer (Angelus, Brazil) and Sealer Plus BC (MK Life, Brazil), in comparation with the gold standard based on epoxy resin, AH Plus (Dentsply, Germany). Methodology: The flow was evaluated based on ISO 6876/2012 standard (mm) and in area (mm2 ). For assessment of filling ability and apical extrusion of the sealers, curved artificial canals were prepared up to size 25.06, and filled with the sealers by the single cone technique. The samples were scanned in microcomputed tomography (SkyScan 1272. Bruker, Belgium) after preparation and after filling of the root canals. The percentage of voids throughout the entire extension of the root canals and in the apical third, besides the volume of apical extrusion of each sealer were calculated. Data were statistically analyzed using ANOVA/Tukey tests (α = 0.05). Results: Bio-C Sealer showed the highest flow and NeoMTA Plus had the lowest value (p < 0.05). Bio-C Sealer had lower percentage of total voids than NeoMTA Plus (p < 0.05). AH Plus had greater percentage of voids in the apical third than Bio-C Sealer and Sealer Plus BC (p < 0.05). Bio-C Sealer showed higher volume of extrusion (p < 0.05) than AH Plus and NeoMTA Plus. Conclusion: Bio-C Sealer and Sealer Plus BC had greater flow and proper filling ability in the apical third. However, these sealers presented high volume of apical extrusion. NeoMTA Plus provided less sealer extrusion, low flow, and more presence of voids.

Objective: The Aim of this study was to evaluate the effect of instrument kinematics on the apical extrusion of debris. Materials & Methods: Fourteen single rooted mandibular premolars with single single canals were used in this study. The teeth were divided into to two groups: Group 1: WaveOne Group (Reciprocation Group) and Group 2: OneCurve group (Continuous Rotation Group). The teeth were then accessed and the buccal cusp was reduced so that the external tooth length of all the teeth was 18 mm. The teeth were secured using composite resin in pre-weighed Eppendorf tubes and instrumentation of the canals using the different instruments was done. The teeth were then removed from the tubes and the tubes were incubated for 15 days and then weighed to evaluate the amount of extruded debris. Results: No significant difference in the amount apical extruded debris was found between the WaveOne Gold and the OneCurve instrument. Conclusions: The kinematics of the instruments used in this study did not affect the amount of extruded debris.

The aim of this study was to compare the root canal instrumentation techniques that involve foraminal enlargement versus those not involving it, in regard to the apical extrusion of filling material, using micro-computed tomography (micro-CT). Twenty-two premolars with single canals were instrumented using the ProTaper Universal System and then randomly divided into two groups (n = 11): Group NFE, without foraminal enlargement, and Group FE, with foraminal enlargement. Instrumentation was performed up to 1 mm short of the apical foramen, and foraminal patency was maintained at each instrument change in both groups. Prior to obturation, the apical portion of the specimens was wrapped in adhesive paper to ensure complete separation between apex and extruded material. The canals were filled according to the continuous wave of condensation technique. The apically extruded material was collected and measured using micro-CT. Extrusion in Group FE was significantly higher than in Group NFE (0.928 mm3 vs. 0.148 mm3 ; P < 0.001).

Introduction. Root canal filling material may be extruded during retreatment through the apical foramen and cause flare-up or chronic infection. The aim of this study was to compare the apical extrusion of gutta-percha and resilon filling materials during retreatment using hand and rotary instruments. Methods. Sixty extracted single-rooted teeth with single, straight canal were selected. Canals were prepared with ProTaper Universal rotary system to a size F2. Two groups (30 teeth in each) were filled with gutta-percha or resilon points, respectively. In both groups teeth were randomly divided into the three subgroups (10 teeth in each), based on the instruments used for retreatment: Hedstrom hand files and two rotary groups- ProTaper and Twisted File instruments. Apical extrusion was detected visually, using a 4-degree scoring system. Mean scores were calculated and analyzed statistically (t-test and ANOVA). The level of significance was set at p < 0.05. Results. Under tested experimental conditions, the type of canal filling material did not have significant effect on the results of apical extrusion during retreatment. Significantly more material was extruded in the resilon group when manual, Hedstrom file was used (1.80 ± 1.13) than rotary ProTaper (0.60 ± 0.70) and Twisted File (0.50 ± 0.71). Conclusions. The use of a rotary technique is recomended to minimize apical extrusion, especially when resilon obturation material is removed during retreatment.

Purpose: present study designed to evaluate the influence of coronal preflaring on the amount of debris extruded apically during preparation of the root canal using reciprocating systems,Reciproc and WaveOne Gold.Materials and Methods:Sixty mandibular first molars with canal curvature between 25°-35° used and divided into 2 groups(Ι and ΙΙ) according to the method of preparation of the root (30 samples each); Group I: were prepared with coronal preflaring , Group II: were prepared without coronal preflaring. The groups further subdivided into 2 subgroups (A, B) according to the reciprocating file system used (15 samples each); Subgroup A: instrumented using Reciproc , Subgroup B: instrumented by WaveOne Gold .samples mounted in a model used to measure the amount of debris extruded apically.Results: In Reciproc subgroup, no statistical difference in samples prepared with and without coronal preflaring in the median of debris extruded apically (P>0.05). WaveOne Gold subgroup, samples prepared with coronal preflaring showed lower value of apically extruded debris than samples prepared without coronal preflaring. However,there was no statistical difference between the samples in the median of debris extruded apically (P > 0.05).In group I and II: (with and without coronal preflaring respectively), no statistically significant difference between Reciproc and WaveOne Gold in the median of debris extruded apically (P> 0.05). Conclusions:Reciproc and WaveOne Gold presented similar behavior regarding the amount of debris extruded apically during preparation .Coronal preflaring has no effect on the amount of debris extruded apically during preparation using reciprocating single-file systems,Reciproc and Wave One Gold.

Aim: The aim is to compare the apical extrusion of debris during endodontic instrumentation with continuous rotation and reciprocating motion. Materials and Methods: Sixty extracted single-rooted mandibular premolar human teeth were randomly assigned to four groups of 15 teeth each. The canals were then instrumented with the following instrument systems: ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), 2Shape (TS; MicroMega, Besancon, France), Reciproc Blue (RB; VDW, Munich, Germany) and WaveOne Gold (WOG; Dentsply Sirona, Ballaigues, Switzerland). Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation weight from postinstrumentation weight of the Eppendorf tubes. The data were analyzed using one-way analysis of variance and Tukey's Post hoc tests. Results: Among the instruments tested in the present study, the least amount of extrusion of debris was seen with TS rotary file system (Group IA) followed by RB (Group IIA) and WOG (Group IIB) (P < 0.05), the results, however, were not found to be statistically significant between them. The maximum amount of debris extrusion was observed with PTN (Group IB) with a statistically significant difference when compared to TS, RB, and WOG file system (P > 0.05). Conclusion: All instruments were associated with apical extrusion of debris with TS rotary file system associated minimum extrusion and PTN, resulting in maximum extrusion of debris.

Introduction:The extrusion of apical detritus during the retracting procedure is very important, as, besides eliminating materials of radicular obturation, aggressive agents and products such as the remains of dentin taken out, and microorganisms are generally located in tissue around the roots, producing undesired effects, such as inflammation, acute pain, post-operatory pain and delays in the periapical treatment.Objective:To determine the amount of apically extruded detritus using rotary and reciprocating retreatment systems.Methodology:An experimental comparative study as conducted in which 40 single-rooted human first premolars were analyzed. The instruments used were ProTaper Universal files up to F3 and sodium hypochlorite, and the sealing was made through the hybrid technique Tager. They were then kept at 37ºC and 100% of humidity for 15 days so that the sealing material would seal. For the retracting procedure, experimental tubes previously weighted were used. The sample was divided randomly into two groups of 20 pieces. Group A: ProTaper R, and group B: Reciproc. Then, the irrigating material (distilled water) was evaporated from the tubes for 12 hours in a stove at 105ºC, and the experimental tubes were weighted in an analytical precision weighing scale 10-5g. The data was analyzed through the T Student with a significance level of 5%.Results:Results indicated that groups A and B, retreatment with rotational ProTaper R and reciprocating retreatment system (Reciproc) showed a similar difference of initial and final weights, indicating similar apical extrusion of detritus.Conclusion:Both systems extruded a similar amount of detritus during the retreatment procedures.

The objective of this study is to evaluate the retreatment time and weight of apically extruded debris yielded by two different kinematics during the removal of different root canal filling materials. Forty straight single-rooted extracted teeth were instrumented with HyFlex CM files and obturated with two different techniques: 25.04 HyFlex experimental carrier-based obturators (Coltène/Whaledent, Altstätten, Switzerland) (group 1) or 25.04 single gutta-percha cones (Roeko Coltène/Whaledent, Altstätten, Switzerland) (group 2) and Guttaflow Bioseal as the sealer. Samples were divided into four subgroups (n = 10) according to the used kinematics for the removal of root canal filling materials: continuous rotation (A) or retreatment motion (B) with a Remover and HyFlex EDM Nickel-Titanium instruments activated with a CanalPro Jeni micromotor (Coltène/Whaledent, Altstätten, Switzerland). Time for retreatment was digitally recorded, and debris extruded from the apex was collected in Eppendorf tubes and weighted with an analytical balance. Data on retreatment time and apical extrusion were statistically analyzed with the Kruskal–Wallis test ( p < 0.05 ). Working length was achieved in all the retreated samples. The removal of root filling material resulted significantly faster with the Jeni mode ( p < 0.001 ), and the difference was significant for the removal of both filling materials ( p < 0.05 ). No significant differences on debris extrusion between single cone and experimental obturators groups were noted ( p > 0.05 ), and no significant differences between kinematics (continuous rotation vs. Jeni motion) were observed ( p > 0.05 ). All the tested retreatment strategies lead to an extrusion of material from the apex, and the weight of apically extruded debris was similar. The use of the innovative CanalPro Jeni kinematics accelerates the time for the removal of root filling materials.

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p>0.05) and 1 mm (p>0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p

Introduction: A major objective in root canal treatment is to clean the root canal system. During the process, dentine chips, pulp tissue fragments, necrotic tissue, microorganisms, and intracanal irrigants may be extruded through the apical foramen. This in vitro study was conducted to evaluate the apical extrusion of Enterococcus faecalis with One Shape, F360, WaveOne, and Reciproc endodontic single-file systems. Materials and Methods: Seventy-five human single-rooted mandibular premolar teeth were selected. Endodontic access cavities were prepared. Pulp chamber was accessed, and a pure culture of E. faecalis was used to infect the root canals. Vials with rubber stoppers were selected as the test apparatus. Then, the samples were broadly divided into four main groups with a sample size of 15 teeth. Fifteen previously infected teeth were used as controls. All the root canals were instrumented with the size 25 instruments. A total volume of 2 ml of saline was used for each root canal as irrigant. After 24 h, colonies of bacteria were counted using classical bacterial counting technique as colony-forming units. Statistical Analysis: Data were analyzed statistically using Statistical Package for the Social Sciences, version – 21 (IBM Corp., NY) Software for Windows. Data were expressed in its mean and standard deviation. Results: The results indicated that all the four single-file systems tested caused a measurable apical extrusion of debris. Statistically, significant difference was observed between One Shape, F360, WaveOne, and Reciproc in terms of E. faecalis extrusion, P < 0.05. The highest mean value was with One Shape rotary single-file system and the lowest mean value was with WaveOne reciprocating single-file systems. Conclusion: Within the limitations of the present study, it can be concluded that the reciprocating single-file systems extruded less amount of E. faecalis than compared to rotary single-file systems.

Aim To evaluate the effect of instrumentation kinematics on debris extrusion by comparing the amount of apically extruded debris after canal preparation using ProTaper next in continuous rotation as well as forward reciprocating motion and WaveOne gold in reverse reciprocating motion. Materials and methods We randomly divided ninety buccal roots of maxillary bicuspids with fully formed apices into three groups. After achieving the coronal access, the patency of the root canals was established with a size 10 K file. The canals were then instrumented using ProTaper next in continuous rotation or in a forward reciprocating motion and WaveOne gold in reverse reciprocating motion. Eppendorf tubes were used to collect the debris extruded through the apical foramen. The tubes were placed in a -80° freezer for 8 hours and then in a lyophilizer for 24 hours. The quantity of the apically extruded debris was assessed by subtracting the weights of Eppendorf tubes before and after instrumentation. The analysis was done using a one-way ANOVA test and the Bonferroni test to compare the groups. Results The mean weight of extruded debris with WaveOne gold in reverse reciprocation was significantly lower than ProTaper next in forward reciprocation and ProTaper next in continuous rotation (p value = Conclusion WaveOne gold in reverse reciprocation was associated with a significantly lower amount of apical extrusion of debris than ProTaper next rotary files in forward reciprocation and continuous rotation. Clinical significance According to the results of this study, reciprocating instrumentation technique was associated with a less amount of debris extrusion compared to continuous rotation.

The present study examined the effects of irrigant flow rate and simulated intraosseous sinusoidal pressure on the rate of NaOCl extrusion from the apical terminus of a faux root canal.An extrusion setup was designed to enable irrigant extrusion to be opposed by 30 mm Hg simulated intraosseous pressure. The faux canal apex was opposed by atmospheric + 30 mm Hg pressure (experimental) or atmospheric pressure only (control group). Using five irrigant delivery rates (15.6 8.0, 4.0, 3.4 or 3.0 mL/min), the extrusion rates of 2% NaOCl from the faux apex were measured in both groups (n = 16). Data were analysed with two-factor ANOVA and pairwise comparisons at α = 0.05. Correlation between NaOCl delivery rates and extrusion rates in both groups were analysed with the Pearson product-moment procedure.Irrespective of the presence or absence of simulated sinusoidal pressure, NaOCl extrusion rates were positively-correlated with irrigant flow rates. For the factor "irrigant flow rates", significant differences in NaOCl extrusion rates were identified among all flow rates (p 0.05), except for the pairwise comparison between 4.0 and 3.4 mL/min in the control. For all irrigant flow rates, NaOCl extrusion rate was significantly lower in the presence of 30 mm Hg simulated sinusoidal pressure than that obtained in the absence of opposing pressure (p 0.05).In the presence of 30 mm Hg simulated intraosseous pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min.When opposed by intraosseous sinusoidal pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min.

Aim: This study evaluated the amount of extruded debris after canal preparation using three root canal irrigating substances. Methodology: Thirty human extracted single-rooted lower premolars were randomly assigned into 3 groups (n = 10) according to the chemical substance used for irrigation. G1: 2.5% sodium hypochlorite; G2: 2% chlorhexidine gel; and G3: 0.9% saline solution. The canals were instrumented using Reciproc Blue file (VDW, Munich, Germany). Apically extruded debris was collected into a pre-weighed Eppendorf tube filled with agar gel. Extruded debris were calculated by subtracting the tooth-free apparatus weight from the post preparation weight value. The data were analyzed using the ANOVA test at a 5% significance level. Results: No statistically significant differences were noted between the groups. However, G3 had the largest extrusion weight, and G2 produced less debris when compared to the other groups (p > .05). Conclusion: Within the limitations of this in vitro study, our data suggest that all chemical substances tested caused debris extrusion, although no statistically significant differences were found between the three substances. Objetivo: Este estudio evaluó la cantidad de detritos extruidos después de la preparación del conducto utilizando tres sustancias de irrigación del conducto radicular. Metodología: Treinta premolares radiculares inferiores humanos extraídos se dividieron aleatoriamente en 3 grupos (n = 10) según el químico utilizado para la irrigación. G1- hipoclorito de sodio al 2,5%; G2 - gel de clorhexidina al 2%; y G3- solución salina al 0,9%. Los canales se equiparon con un archivo Reciproc Blue (VDW, Munich, Alemania). Los desechos extruidos apicalmente se recogieron en un tubo eppendorf pesado previamente lleno de gel de agar. La cantidad de residuos e irrigantes extruidos se calculó restando el valor del peso del aparato sin la presencia del diente, del valor del peso posterior a la preparación. Los datos se analizaron mediante la prueba ANOVA con un nivel de significancia del 5%. Resultados: No hubo diferencias estadísticamente significativas entre los grupos. Sin embargo, G3 tuvo el mayor peso de extrusión y G2 produjo la menor cantidad de desechos en comparación con los otros grupos (p> 0.05). Conclusión: dentro de las limitaciones de este estudio in vitro, nuestros datos sugieren que todos los productos químicos probados causaron la extrusión de escombros, aunque no se encontraron diferencias estadísticamente significativas entre las tres sustancias. Objetivo: Este estudo avaliou a quantidade de resíduos extruídos após o preparo do canal usando três substâncias irrigantes do canal radicular. Metodologia: Trinta pré-molares unirradiculares inferiores humanos extraídos foram divididos aleatoriamente em 3 grupos (n = 10) de acordo com a substância química usada para irrigação. G: hipoclorito de sódio 2,5%; G2: gel de clorexidina 2%; e G3: solução salina a 0,9%. Os canais foram instrumentados com lima Reciproc Blue (VDW, Munique, Alemanha). Os detritos estruídos apicalmente foram coletados em um tubo eppendorf pré-pesado preenchido com gel de ágar. A quantidade de resíduos e irrigantes estruídos foi calculada subtraindo o valor do peso antes e após o preparo do canal radicular. Os dados foram analisados ​​pelo teste ANOVA com nível de significância de 5%. Resultados: Não foram observadas diferenças estatisticamente significativas entre os grupos. Porém, o G3 apresentou o maior peso, e o G2 produziu menor quantidade de resíduo quando comparado aos demais grupos (p> 0,05). Conclusão: Dentro das limitações deste estudo in vitro, nossos dados sugerem que todas as substâncias químicas testadas causaram extrusão de detritos, embora não tenham sido encontradas diferenças estatisticamente significativas entre as três substâncias.

OBJECTIVE To compare the amount of apically extruded bacteria between hand-filed preparations, rotary and reciprocation glide path preparations in curved canals of extracted teeth infected with Enterococcus faecalis. METHODS Forty mandibular first molar teeth were decoronated, fitted into rubber stoppers and fixed onto glass vials. The mesiobuccal canals from mandibular first molar teeth were infected with Enterococcus faecalis, then randomly assigned to one of five groups for glide path preparation: manual stainless-steel file (K-files), rotary file (One G), reciprocating file (WaveOne Gold Glider) and two control groups. After glide path preparation, 0.01 mL of saline was taken from the experimental vials. The solution was plated on tryptic soy agar and colonies of bacteria were counted as colony-forming units. The results were analysed statistically using Kruskal-Wallis and post hoc Mann-Whitney U tests. RESULTS The manual K-file group was associated with significantly more bacteria extrusion compared to the rotary and reciprocating groups (P

Aim A laboratory study to determine the apical pressure generated by seven canal irrigation methods in an anterior tooth with an open apex. Methodology Canal irrigation was performed on a 3D-printed central maxillary incisor with an open apex (maximum diameter of 2.1 mm). Ultrasonically Activated Irrigation (UAI), sonic activation (EDDY), negative pressure irrigation (EndoVac), the self adjusting file (SAF) and the XP-endo Finisher were employed at tooth length (TL), TL - 1 mm, TL - 2 mm and TL - 3 mm. UAI was tested at three intensity levels additionally. Hydrodynamic irrigation with RinsEndo was performed in the pulp chamber, at the canal orifice, the coronal third, the middle of the canal and at TL. Er:YAG laser-activation, at four frequency settings, was performed in the pulp chamber and at the orifice of the canal. The pressure of the fluid towards the canal terminus generated by activation was directly transferred to a pressure sensor with a range of 0 to 120 mmHg and a response time of ≤ 0.5 milliseconds. The critical threshold for apical extrusion of the irrigant was set at 5.73 mmHg (lower limit of the central venous pressure: 5.88 ± 0.15 mmHg). Each experiment was repeated ten times. The tests were followed by descriptive analyses (maximum, mean, standard deviation, 95% confidence interval). Results EndoVac, the SAF, the XP-endo Finisher and UAI never exceeded the critical threshold at any insertion depth or intensity level. Er:YAG laser-activation exceeded the critical threshold exclusively at frequency settings varied from the manufacturer's recommendation. EDDY at TL and RinsEndo at any insertion depth exceeded the critical threshold in 100% of the measurements. EDDY at TL - 1, - 2 and - 3 mm crossed the critical threshold in 30%, 10% and 20% of the measurements, respectively. Conclusions In a simulated maxillary central incisor with an open apex, irrigation with EndoVac, Er:YAG laser-activation, UAI, the SAF and the XP-endo Finisher generated apical pressures below the critical threshold of 5.73 mmHg. By contrast, using EDDY and RinsEndo for irrigation produced higher apical pressures that exceeded the critical threshold.

The present study investigated the intracanal decontamination and apical extrusion of bacteria and debris from root canals instrumented with rotary and reciprocating systems (ProDesign Logic or ProDesign R), with different file diameters and using conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI). Eighty extracted mandibular premolars were contaminated with Enterococcus faecalis and randomly assigned to eight experimental groups according to the root canal instrumentation and irrigation technique employed (n = 10): G1: Prodesign Logic 25.06; G2: Prodesign R 25.06; G3 and G4 were instrumented with the same single-file systems, respectively, using 35.05 diameters and CSI. G5, G6, G7, and G8 were instrumented like the previous groups, but with PUI. Apically extruded debris during instrumentation was collected into pre-weighed microtubes. The weight of the empty microtube was subtracted from the final weight to establish the amount of extruded debris. Bacteria from root canals and extruded debris were collected for a microbiological evaluation of colony forming units (CFU/mL). For statistical analyses, the Mann-Whitney and Kruskal-Wallis followed by the Dunn's tests were used (α = 0.05). All instruments caused extrusion of debris. For irrigation techniques, PUI promoted greater debris and bacterial extrusion (p < 0.05). The CFU/mL count indicated that the instrumentation of the experimental groups were equally effective in the decontamination of the root canal (p > 0.05). The systems tested (regarding file diameter and kinematics) were associated with similar amounts of apically extruded debris and root canal decontamination. PUI was associated with greater debris and bacterial extrusion.

Objectives This study was conducted to evaluate the effects of traditional and contracted endodontic cavity (TEC and CEC) preparation with the use of Reciproc Blue (RPC B) and One Curve (OC) single-file systems on the amount of apical debris extrusion in mandibular first molar root canals. Materials and Methods Eighty extracted mandibular first molar teeth were randomly assigned to 4 groups (n = 20) according to the endodontic access cavity shape and the single file system used for root canal preparation (reciprocating motion with the RCP B and rotary motion with the OC): TEC-RPC B, TEC-OC, CEC-RPC B, and CEC-OC. The apically extruded debris during preparation was collected in Eppendorf tubes. The amount of extruded debris was quantified by subtracting the weight of the empty tubes from the weight of the Eppendorf tubes containing the debris. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test. The level of significance was set at p < 0.05. Results The CEC-RPC B group showed more apical debris extrusion than the TEC-OC and CEC-OC groups (p < 0.05). There were no statistically significant differences in the amount of apical debris extrusion among the TEC-OC, CEC-OC, and TEC-RPC B groups. Conclusions RPC B caused more apical debris extrusion in the CEC groups than did the OC single-file system. Therefore, it is suggested that the RPC B file should be used carefully in teeth with a CEC.

Sariyilmaz, Evren/0000-0003-1711-7056 WOS: 000441983900004 Objective: Extrusion of irrigant and debris into the periapical tissues is a potential risk for flare-ups during root canal treatment. The aim of this study was to evaluate the apically extruded debris and sodium hypochlorite during XP-Endo Finisher (XP-Endo) file use and compare with final irrigation techniques. The tested null hypothesis in this study was that there was no difference among the irrigation techniques. Materials and Methods: An agar gel model was prepared for 80 extracted single rooted human mandibular premolar teeth, which were prepared up to the apical size of #40. The samples were divided into four groups according to the final irrigation regime: conventional syringe irrigation, XP-Endo, passive ultrasonic irrigation (PUI), and EndoActivator (EA). The test apparatus was weighed before and after the experiment, and the amount of apically extruded debris and irrigant was calculated. Results: There was minimal irrigant and debris extrusion in all groups. No significant difference among the tested groups was detected (p>0.05). Conclusion: Using the PUI, XP-Endo file, or EA according to the manufacturers' instruction does not increase the extrusion risk.

Grande, Nicola Maria/0000-0003-3407-9768; Plotino, Gianluca/0000-0003-3003-8029 WOS: 000431942400030 PubMed: 29550013 Introduction: The purpose of this study was to investigate the amount of apically extruded debris by Reciproc Blue (REC Blue; VDW, Munich, Germany), HyFlex EDM (HEDM; Coltene/Whaledent, Altstatten, Switzerland), and XP-endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) files during root canal preparation at body temperature. Methods: Sixty extracted single-rooted mandibular premolar human teeth were randomly assigned to 3 groups (n = 20). The canals were instrumented using 1 of the following instruments: REC Blue, HEDM, or XPS. Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. All the procedures were performed at 35 degrees C. The amount of extruded debris was calculated by subtracting the weight value of the tooth-free apparatus from the postpreparation weight value. The data were analyzed using the KruskalWallis test at a 5% significance level. Results: All the instruments tested caused extrusion of some debris from the apical foramen. XPS extruded significantly less debris from the apex than REC Blue (P < .05). The difference among the HEDM group and the other groups was not significant (P > .05). Conclusions: Within the limitations of this in vitro study, the amount of apically extruded debris registered for the different files tested was REC Blue > HEDM > XPS, with a statistical difference only between XPS and REC Blue.

Background/purpose: Extrusion of intracanal bacteria leads to treatment failures. Compare the apical extrusion of intracanal bacteria (Enterococcus faecalis) during canal preparation with three different instrumentation techniques [RECIPROC, One Shape (OS), and Twisted-File Adaptive (TFA)] with different motion types. Materials and methods: Ninety teeth with different canal morphologies were divided into three main groups, each including 30 teeth (10 mandibular incisors, 10 mandibular premolars, and 10 curved roots). Roots were resected until 13-mm working length was obtained and fixed to glass vials filled with brain–heart infusion broth. Each canal was filled with E. faecalis suspension. The three main groups were further grouped into three subgroups. Each group was further subgrouped into three, with each subgroup including 10 roots from each type of teeth (10 incisors/subgroup, 10 premolars/subgroup, and 10 curved canals/subgroup). These subgroups were prepared with one of RECIPROC, OS, or TFA. Bacterial colonies extruded into each vial were incubated in brain–heart infusion agar at 37°C for 5 days and counted using a colony counter as the number of colony-forming units per milliliter. Statistical analyses were performed using one-way analysis of variance, post hoc Tukey honest significant difference, and Kruskal–Wallis tests. Results: Apically extruded bacteria were not statistically different from each other (P > 0.05). The amount of apically extruded bacteria was statistically similar for both different instruments in the same type of tooth (P > 0.05) and same instrument in different types of teeth (P > 0.05). Conclusion: Neither the motion type of instrument nor the canal morphology affected the degree of bacterial extrusion.

The aim of this study was to evaluate if apical negative pressure (ANP) irrigation prevents the apical extrusion of debris and irrigant compared with conventional needle irrigation through a systematic review and meta-analysis. A computer search of dental literature was performed using four different databases. A combination of the terms 'apical negative pressure', 'endovac', 'apical extrusion', 'extrusion' and 'endodontics' was used. Studies that used extracted human teeth with a mature apex and that evaluated the apical extrusion of debris and/or irrigating solution were included. After an evaluation of the full studies according to the eligibility criteria, eight studies were critically analysed and subjected to quality assessment and risk of bias. Only four studies that evaluated extrusion of irrigant were considered as having high methodological quality and were subjected to a meta-analysis. Studies evaluating extrusion of debris did not have sufficient methodological quality to be subjected to the meta-analysis. The forest plot indicated that ANP irrigation prevents the risk of irrigant extrusion compared with conventional irrigation (OR 0.07 [95%CI 0.02-0.20]; P < 0.00001). This systematic review and meta-analysis showed that ANP prevents the apical extrusion of irrigant. There is no evidence if this type of irrigation prevents the extrusion of debris.

Background: Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas. Aim: The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP). Materials and Methods: Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation: Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging. Statistics: One-way ANOVA test was used to compare the different groups. Results and Conclusion: Significantly more apical extrusion was seen in XP (P < 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).

Introduction: The aim was to compare root canal wall cleanliness, amounts of apically extruded debris and irrigant during retreatment using the ProTaper Universal Retreatment (PT) system or balanced force technique (BFT). Materials and Methods: Root canals of extracted mandibular premolar teeth (n=44) were endodontically prepared and obturated, then the teeth were divided into two groups: BFT and PT. Apically extruded material was collected into preweighed Eppendorf tubes using the Myers and Montgomery method. The root halves were photographed under a stereomicroscope. Area of the remnant filling material (coronal, middle, apical thirds and total canal surface) was measured by software. Data were analyzed by Mann-Whitney U test. Results: The BFT and PT system provided similar degrees of canal wall cleanliness (p > 0.05) and amounts of extruded irrigant (p>0.05). The PT system caused less debris extrusion (p

Objective: To evaluate apical extrusion during a novel erbium-doped yttrium aluminum garnet (Er:YAG) laser-activated irrigation (LAI) modality. Background data: A novel double-pulse Er:YAG...

To compare the remaining root canal filling material, dentin removal, apical transportation, and apical extrusion of debris after the retreatment of canals filled with bioceramic or resin-based sealers using the Reciproc or Reciproc Blue instruments. Sixty mandibular molars with severely curved mesial roots were selected. The samples were initially instrumented with Reciproc (R25) and then divided into four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC), BC Sealer/Reciproc Blue (BCRB), AH Plus/Reciproc (AHRC), and AH Plus/Reciproc Blue (AHRB). The procedure time was measured, and an Eppendorf tube was used in each root canal to store the debris extrusion. The samples were scanned by micro-CT before and after retreatment. The apical transportation, volume of dentin, and filling material were evaluated. There were no significant differences in the reduction of the volume of obturator material or dentin removal between groups (p > .05). There were also no differences in the amount of extruded material or apical transportation (p > .05). The retreatment time for the AHRC group was significantly lower than that for the other groups (p = .004). All tested instruments obtained similar efficacy in filling material removal procedures, although no system completely removed the filling material. Retreatment of canals filled with bioceramic BC Sealer may be more time consuming. This study reported that Reciproc and Reciproc Blue can be indicated in retreatment of severely curved root canals filled either with bioceramic or resin-based sealers.

The aim of this study was to evaluate the efficacy of heat-treated nickel-titanium reciprocating instruments and complementary techniques in retreatment of flattened canals. Material and methods: Twenty-six mandibular incisors were prepared up to size 25/.08 rotary file and filled using the single-cone technique. Subsequently, the teeth were divided into 3 groups (n=12) according to retreatment procedures: Reciproc Blue: R25 and R40; ProDesign R: PDR 25/.06 and PDR 35/.05; WaveOne Gold: WOG Primary and WOG Medium. The apically extruded material was collected in microtubes and the volume (mm³) was measured by Micro-CT. After this, the specimens received complementary cleaning with XP-Endo Shaper, PUI and 60° oscillatory instrumentation with #30 Hedströem file. Micro-CT scans were performed before and after removing filling material. After quantification of the volume of remaining filling material, the teeth were sectioned and scanning electron microscopy (SEM) images of the cervical, middle and apical thirds were obtained with a 700X magnification, and evaluated by scores based on the amount of filling material in the surface of dentine walls. Results: No reciprocating instrument promoted complete removal of filling material. All systems showed extrusion, however, WOG25 presented the higher extrusion of material (P .05). Conclusions: The reciprocating instruments studied did not promote complete removal of root canal filling materials. XP-Endo Shaper, used as a complementary instrument in retreatment, improved removal of filling material. O objetivo deste estudo foi avaliar a eficácia de instrumentos reciprocantes em níquel-titânio tratados termicamente e métodos complementares no retratamento de dentes com raízes achatadas. Materiais e métodos: Trinta e seis incisivos inferiores foram preparados com instrumentos rotatórios até o diâmetro 25./08 e obturados pela técnica do cone único. Em seguida, os dentes foram divididos em 3 grupos (n=12) de acordo com os sistemas utilizados para desobturação no retratamento: Reciproc Blue: R25 e R40; ProDesign R: PDR 25./06 e PDR 35/.05; WaveOne Gold: WOG Primary e WOG Medium. O material extruído apicalmente foi coletado em microtubos e o volume (mm³) foi mensurado com Micro-CT. Na sequência, os espécimes receberam limpeza complementar com XP-Endo Shaper ou com irrigação passiva ultrassônica (PUI) ou com instrumentação com lima #30 Hedströem em movimento oscilatório. Escaneamentos em Micro-CT foram realizados antes e após a remoção do material obturador. Após quantificação do volume de remanescente de material obturador, os dentes foram seccionados e imagens com microscópio eletrônico de varredura (MEV), dos terços cervical, médio e apical, foram obtidas com aumento de 700X, e avaliadas através de escores baseados na quantidade de material obturador remanescente nas paredes dentinárias. Resultados: Nenhum instrumento reciprocante promoveu remoção completa do material obturador. Todos os sistemas demonstraram extrusão, no entanto, WOG25 proporcionou maior extrusão (P.05). Os instrumentos reciprocantes estudados não promoveram a remoção completa do material obturador. XP-Shaper, utilizado como instrumento complementar no retratamento, aumentou a remoção de material obturador.

Background: Prevention of the debris from extruding to the periapical region is an important aspect to be taken care of as its extrusion can result in pain, periapical inflammation, and delayed healing owing to the presence of highly infective components in the debris. Aim: The present trial was aimed to compare and assess the amount of debris extruded apically using the single-file reciprocating system - WaveOne GOLD and single file rotary system - OneShape in root canal preparations in vitro. Materials and Methods: Thirty mandibular premolars were divided into two groups (15 samples each) prepared with a single-file reciprocating system - WaveOne GOLD and single-file rotary system - OneShape. Debris extruded was collected and then stored in an incubator. The final weight was calculated after obtaining the mean of three consecutive weights obtained for each tooth. The data were compared using the ANOVA and Turkey's post hoc analysis. Results: Debris extrusions were recorded in both groups and analysis revealed statistical differences in weight before and after the instrumentation procedures in both groups. When compared, reciprocating single file – WaveOne GOLD extruded more debris than rotary single file system – OneShape with a P < 0.001. Conclusions: The rotary instrumentation systems extrude lesser debris apically than the reciprocating instrumentation system. The difference found was statistically significant.

Aim To compare the amount of apically extruded debris and of remaining filling material during the removal of root canal filling material using three rotary NiTi retreatment instruments or Hedstrom files. Methodology Ninety-six severely curved human molars of both jaws were selected. The root canals were prepared to size X2 (tip size 25, .06 taper) using the ProTaper Next system (Dentsply Sirona, Ballaigues, Switzerland), filled with gutta-percha and AH Plus sealer (Dentsply De Trey, Konstanz, Germany) and then randomly divided into four experimental groups (n = 24 each) with two subgroups of maxillary and mandibular teeth each. An experimental model was used as a phantom head to simulate the upper and lower jaws. The root filling materials were removed with one of the following files using a crown-down preparation technique: I. Hedstrom files (H-files) (VDW, Munich, Germany), II. R-Endo (Micro-Mega, Besancon, France), III. Reciproc (VDW) and IV. ProTaper Universal Retreatment system (PTU-R) (Dentsply Maillefer). Apically extruded material was collected in vials, which were weighed with a microbalance (10−5 g) before and after the retreatment. The area of residual filling material in the coronal, middle and apical root level was assessed using digital analysis. These data were analysed statistically using ANOVA and the Kruskal–Wallis test. Results Reciproc was associated with significantly less extruded debris than the H-files (P = 0.009). No significant differences were detected amongst the four retreatment techniques concerning residual filling material (P = 0.082). The amount of extruded debris and areas of remaining filling material were not correlated (P = 0.901). Location of teeth in the maxilla or mandible had no impact on the amount of extruded debris within each instrument group (P = 0.609). However, when teeth were evaluated in general irrespective of the instruments, significantly more debris was extruded in the mandibular location (P

Introduction: We compared the apical extrusion of Chlorhexidine delivered with a 27-G needle, and the EndoVac system (SybronEndo, Orange, CA) during the instrumentation and final irrigation of root canals. Methods: Matched paired single-canal teeth were divided into 2groups. The experimental groups were needle irrigation size #30 (NI30) , and EndoVac size #30 (EV30) Teeth were embedded in 0.2% agarose gel (pH = 7.4) containing 1 mL 0.1% m- Cresol purple (titan media), which changes color at a pH level of 9.0. Root canals were irrigated with Chlorhexidine using 2 different techniques, and the amount of irrigant was controlled. Standardized digital photographs were taken 20 minutes after the first irrigant was used and were analyzed to determine the amount of extrusion (expressed as a percentage of total pixels). Results: The amounts of apical extrusion obtained in the NI30 and EV30, were 50% (10/20), and 10% (2/20), respectively. The EndoVac group showed significantly lower extrusion values than the needle irrigation techniques in terms of the number of teeth and pixels. Conclusion: The risk of apical extrusion is significantly lower with the EndoVac in comparison with the needle irrigation techniques.

Introduction: This study evaluated the amount of apically extruded debris in the retreatment of curved root canals using different nickel-titanium (NiTi) systems: the ProTaper Universal Retreatment (Dentsply Maillefer, Ballaigues, Switzerland), Mtwo Retreatment (VDW, Munich, Germany), D-Race Retreatment (FKG Dentaire, La Chaux-de-Fonds, Switzerland), R-Endo Re treatment (Micro-Mega, Besancon, France), and Reciproc (VDW) systems. Methods: One hundred human mandibular premolars with curved root canals were prepared with the Reciproc #25. 08 NiTi system filled with AN Plus Jet (Dentsply DeTrey, Konstanz, Germany) sealer and gutta-percha and divided into 5 groups (n = 20). The canal filling was removed with the Pro Taper, Mtwo, D-Race, and R-Endo retreatment systems and Reciproc instruments. Final preparation was done with the Reciproc #40.06 NiTi system. Extruded debris was collected in preweighed Eppendorf tubes. The times required for retreatment were recorded. Results: Reciproc produced significantly (P

INTRODUCTION Apical extrusion of debris and irrigants during cleaning and shaping of the root canal is one of the main causes of peri-apical inflammation and postoperative flare-ups. OBJECTIVES: The purpose of this study was to quantitatively measure the amount of debris and irrigants extruded apically using rotary single file system and a multiple file rotary system. METHODOLOGY: Thirty extracted upper six molars were selected. In all teeth the distal roots were sectioned and shortened to a length of 15 mm. The specimens were randomly divided into two groups (n= 15) according to the instrumentation system used. Group A: One shape file (single file system), Group B: Revo-S (multiple-file rotary system). Bi-distilled water was used as the irrigant with traditional needle irrigation delivery system. The apically extruded debris and irrigant were collected into pre-weighed glass vials. The amount of extruded debris and irrigant were assessed with a precision electronic balance. The liquid inside the tubes was dried and the mean weight of debris was assessed. The data were statistically analysed using SPSSS IBM version 22. All statistical analysis was done using two tailed tests and alpha error of 0.05. P-values less than 0.05 were considered significant. RESULTS: The One shape file system produced significantly less amount of debris and irrigant compared with Revo-S file system. CONCLUSION: Although all systems caused apical extrusion of debris and irrigant, the single file system was associated with less extrusion as compared with the use of the multiple-file system. KEYWORDS: Debris, Instruments, Irrigant, Rotary.

The aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented using ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne systems. Eppendorf tubes containing apically extruded debris were weighed three times, and mean values were calculated. The net mass of the extruded debris was calculated by subtracting the initial mass from the final mass. The groups were compared using one-way analysis of variance and Tukey's post hoc tests at a significance level of P

Background: Complete cleaning of the root canal is the goal for ensuring success in endodontics. Removal of debris plays an important role in achieving this goal. In spite of advancements in instrument design, apical extrusion of debris remains a source of inflammation in the periradicular region. Aim: To comparatively evaluate the amount of apically extruded debris with V-Taper, ProTaper Next, and the self-adjusting File (SAF) system. Materials and Methods: Sixty-four extracted human mandibular teeth with straight root canals were taken. Access openings were done and working length determined. The samples were randomly divided into three groups: Group I - V-Taper files (n = 20), Group II - ProTaper Next (n = 20), Group III - SAF (n = 20). Biomechanical preparation was completed and the debris collected in vials to be quantitatively determined. The data obtained was statistically analyzed using ANOVA and post hoc Tukey's test. Results: All the specimens showed apical debris extrusion. SAF showed significantly less debris extrusion compared to V-Taper and ProTaper Next (P < 0.001). Among Groups I and II, ProTaper Next showed lesser debris extrusion as compared to V-Taper, but it was not significant (P = 0.124). Conclusion: The SAF showed least amount of apical debris extrusion when compared to newer rotary endodontic instruments. This indicates that the incidence of inter-treatment flare-ups due to debris extrusion would be less with the SAF.

This study aimed to assess the efficiency of manual and rotary techniques for removing root filling material in endodontic treated canals and to evaluate the extrusion of debris via apical foramen. After access preparation, thirty human lower central incisors were instrumented, filled and divided into two groups (n=15): MN- manual retreatment technique; RT- rotary retreatment technique. The teeth were submitted to micro-computed tomographic scanning before and after the retreatment procedure, for quantifying the remaining filling material by relating the initial and final conditions. The analysis was conducted separately in all root thirds. The volume of material extruded through the apical foramen was also quantified. The data were statistically analyzed using t-test and two-way analysis of variance (ANOVA) at 5% of significance. No significant differences were detected between remaining filling material for the techniques evaluated (p=0.74), even considering the apical third only (p>0.75). Significant differences were found for the remaining filling material verified between the cervical third and middle/apical thirds, with lower values being observed at the cervical third for both groups (p

Introduction: During root canal treatment, canal debris is inadvertently extruded through the apex during shaping and cleaning. This happens not only during the routine endodontic cases, but also during the retreatment cases. Objective: This study analyzed in vitro the amount of debris extruded through the foramen using two instrumentation techniques during endodontic retreatment. Materials and methods: Sixty roots of mandibular first premolars were selected, instrumented with anatomical diameter up to size number 40 International Organization for Standardization (ISO) file, and then obturated with gutta-percha and zinc-oxide eugenol sealer by lateral condensation. They were then divided into two groups of 30 each. The first group was instrumented with ISO K-files for gutta-percha removal and the second group was instrumented with Protaper retreatment files and gutta-percha was removed. All teeth were irrigated with distilled water. The debris extruded through the foramen were collected and weighed by an analytical balance. Results: Group II had the lowest average for material extrusion through the foramen followed by group I. When Tukey test for statistical analysis was applied, significant differences among groups were found (p = 0.02). Conclusion: It can be concluded that Protaper retreatment files produce significantly less debris as compared with K-files.

Objective: All instrumentation techniques and instruments are associated with apical extrusion during chemomechanical preparation, and this causes postoperative pain and flare-up. However, it is controversial whether reciprocal systems or rotary systems cause more apical extrusion. The objective of this in vitro study was to determine the differences in the amounts of apically extruded bacteria (AEB) associated with nickel-titanium rotary and reciprocating systems when used in oval-shaped root canals. Material and Methods: Seventy human mandibular premolar teeth with oval-shaped canals were randomly assigned to four experimental groups (15 teeth in each group) and one control group (10 teeth). The root canals were contaminated with Enterococcus faecalis and instrumented using two full-sequence rotary instruments (ProTaper Universal [PTU] and ProTaper Next [PTN]) and two reciprocating single-file instruments (Reciproc [R] and WaveOne [WO]). A 0.9% NaCl solution was used as an irrigant, and the bacterial extrusion was quantified as the number of colony-forming units for each sample. The results were statistically analyzed using the Kruskal-Wallis one-way analysis of variance and the Mann-Whitney U test, and the statistical significance level was set at p 0.05). Conclusions: All instrumentation techniques caused apical bacterial extrusion. The instrument design and preparation techniques affect the number of extruded bacteria.KEYWORDS Apical extrusion; Bacteria; Endodontics; Root canal preparation.

Aim: The objective of this in vitro study was to assess the effect of different endodontic instrumentation systems on the amount of apically extruded bacteria. Materials and Methods: One hundred and twenty freshly extracted human mandibular premolars with single canal were collected. Endodontic access cavities were prepared and then contaminated with an Enterococcus faecalis suspension (ATCC 29212). After incubation at 37°C for 24 h, the root canals were instrumented with K flare files, F360 Single file system, K3XF files, Heroshaper files, Protaper Next files, and Hyflex EDM Single file system. During instrumentation, apically extruded bacteria were collected in the vials containing 0.9% NaCl. Samples were taken from the vials and incubated in brain–heart infusion agar medium for 24 h. Statistical Analysis: The number of colony-forming units was determined, and data were statistically analyzed using one-way analysis of variance and post hoc Tukey test. Results: Significant difference was found between the rotary and hand instrumentation systems. Conclusions: Both rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen, Group 1 (Hand K Flare files) showed maximum, whereas, Group 5 (Protaper Next) and Group 6 (Hyflex EDM) showed the least extrusion.

Introduction: One of the most important factors which form the foundation of successful root canal treatment is cleaning and shaping without extruding significant amount of debris in periradicular tissues. Aims: The objective of this study is to evaluate and compare the amount of apically extruded debris during root canal preparation with three different instrumentation systems. Materials and Methods: The mesiobuccal canals of ninety mature, human mandibular molars were randomly divided into three groups (n = 30 teeth/group). Each group was instrumented using one of the three different instrumentation systems: WaveOne Gold (WOG), self-adjusting files (SAFs), and Hyflex EDM (HEDM). The canals were irrigated using bidistilled water. Debris extruded was collected in preweighed Eppendorf tubes, and the extruded irrigant was evaporated. The weight of the dry extruded debris was established by comparing the pre- and post-instrumentation weight of Eppendorf tubes for each group. Statistical Analysis: The debris extrusion was compared and statistically analyzed using the analysis of variance and the post hoc Tukey test. Results: The WOG and HEDM file systems produced significantly more debris compared with SAF system (P Conclusions: All instrumentation systems tested produced apical extrusion of debris. SAFs extruded significantly lesser amount of debris than WOG and HEDM.