Apical extrusion of debris and irrigant using hand and rotary systems: A comparative study

Abstract

Aim:To evaluate and compare the amount of debris and irrigant extruded quantitatively by using two hand and rotary nickel–titanium (Ni–Ti) instrumentation techniques.Materials and Methods:Eighty freshly extracted mandibular premolars having similar canal length and curvature were selected and mounted in a debris collection apparatus. After each instrument change, 1 ml of distilled water was used as an irrigant and the amount of irrigant extruded was measured using the Meyers and Montgomery method. After drying, the debris was weighed using an electronic microbalance to determine its weight.Statistical analysis used:The data was analyzed statistically to determine the mean difference between the groups. The mean weight of the dry debris and irrigant within the group and between the groups was calculated by the one-way ANOVA and multiple comparison (Dunnet D) test.Results:The step-back technique extruded a greater quantity of debris and irrigant in comparison to other hand and rotary Ni–Ti systems.Conclusions:All instrumentation techniques extrude debris and irrigant, it is prudent on the part of the clinician to select the instrumentation technique that extrudes the least amount of debris and irrigant, to prevent a flare-up phenomena.

Quantitative Evaluation of Apically Extruded Debris of Different Single File Systems: WaveOne Gold, One Shape, F360, and Reciproc: An in vitro Study

“…WaveOne Gold has a parallel cutting edge. 5,6 Uzun et al, 7 and Hussein and Al-Zaka 6 studied apical extrusion among different file systems. They concluded that Reciproc file system extruded lesser debris than WaveOne file system.…”

Effect of needle insertion depth and apical diameter on irrigant extrusion in simulated immature permanent teeth

“…Several studies have completely neglected the potential effect of periapical tissues by evaluating the amount of extrusion into vials full of air. 19,23,25,26 This approach results in an implausible situation in which there is no periapical tissue resistance, creating an obvious discrepancy with in-vivo conditions because the presence of an apex surrounded by ambient air is unlikely. This issue has been identified by previous studies as causing an overestimation of irrigant extrusion.…”

“…18 There have been a wide range of studies focused on irrigant extrusion. 19,20,21,22,23 Many factors affect the amount of irrigant extrusion, including the use of a high flow rate; destruction of the apical constriction due to over-instrumentation or apicoectomy; perforation of the root canal system iatrogenically or from root resorption; wedging of the needle in the root canal; the presence of a periapical lesion, apical fenestration, or horizontal root fracture; insertion of the needle beyond the apical foramen; the volume and concentration of the irrigant used; and intentional extrusion. 24 However, studies have been limited to teeth with mature root morphologies.…”

Exacerbación Apical Posterior a Tratamiento Endodóntico

“…8,13,[17][18][19] Técnicas de instrumentación: ninguna técnica es efectiva en prevenir la extrusión de restos a través del foramen apical, pero sí se ha reportado que es mayor la cantidad de los mismos cuando se utiliza la técnica de paso atrás. 14,[20][21][22] Número de citas: no se encuentran diferencias en la incidencia de dolor postoperatorio existente entre los tratamientos endodónticos en varias citas y aquellos realizados en una sola cita. 1,[23][24][25] Sobreinstrumentación: ha existido una gran controversia acerca del límite apical hasta el que debe llegar la instrumentación de los conductos radiculares, cuando los dientes se encuentran asociados con lesiones periapicales.…”

“…Los tejidos periapicales traumatizados sirven como nido para el crecimiento y multiplicación de los microorganismos. 2,16,20 Repetición del tratamiento endodóntico: se señala una mayor incidencia de agudizaciones en dientes que requieren la repetición del tratamiento endodóntico Debido a que al tratar de retirar la gutapercha contenida dentro del conducto, ésta tiende a extruir las bacterias y detritus hacia el periápice, donde causarán inflamación aguda y dolor severo. Al igual que el solvente utilizado puede contribuir con un incremento en la respuesta inflamatoria.…”