Dental and Medical Problems
2019, vol. 56, nr 1, January-March, p. 53–57
Publication type: original article
Assessment of the apically extruded debris between a rotary system, a reciprocating system and hand files during the root canal instrumentation of the deciduous molars
Ocena przepchnięcia wierzchołkowego zawartości kanałów po zastosowaniu systemu rotacyjnego, recyprokalnego i pilników ręcznych podczas opracowywania kanałów korzeniowych mlecznych zębów trzonowych
1 Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Syria
2 Department of Orthodontics, Faculty of Dentistry, Damascus University, Syria
Background. One of the factors that most negatively affect the endodontic instrumentation process in primary teeth is the presence of extruded debris in the periapical region. Therefore, different techniques have been evaluated to reach an answer to the question regarding which root canal preparation method produces the least amount of debris extrusion.
Objectives. The main objective of this study was to assess the amount of debris extrusion as well as irrigation associated with 3 different instrumentation techniques: a rotary system (PROTAPER NEXT® – PTN), a reciprocating system (WaveOne® – WO) and hand K-files.
Material and Methods. Forty-eight primary mandibular molars with a single distal canal were selected and randomly divided into 3 groups (n = 16). Three different techniques were used for the canal instrumentation of each group, comprising PTN, WO and hand K-files. Pre-weighed Eppendorf tubes were used for the collection of debris extrusion, then stored in an incubator at 70°C for 5 days. A one-way analysis of variance (ANOVA) test was used for data analysis, followed by Tukey’s post hoc test.
Results. Statistically significant differences were found while comparing the PTN and WO systems with the hand files. Both PTN and WO showed less debris extrusion toward the periapical tissues than the hand files. Still, no statistically significant differences were seen between the PTN and WO groups.
Conclusion. Generally, debris extrusion occurred in all of the 3 experimental groups. The PTN and WO systems showed the least debris extrusion as compared to the hand files during the root canal instrumentation of the primary teeth, and for these reasons along with the shorter operating time, it may be concluded that using rotary and reciprocating systems rather than manual files is highly advisable. However, a clinical assessment is suggested.
extruded debris, hand files, rotary system, primary teeth, reciprocating system
przepchnięta zawartość kanałów, pilniki ręczne, system rotacyjny, zęby mleczne, system recyprokalny
- Kucukyilmaz E, Savas S, Saygili G, Uysal B. Evaluation of apically extruded debris and irrigant produced by different nickel-titanium instrument systems in primary teeth. J Contemp Dent Pract. 2015;16(11):864–868.
- Fuks AB, Eidelman E. Pulp therapy in the primary dentition. Curr Opin Dent. 1991;1(5):556–563.
- Silva LA, Leonardo MR, Nelson-Filho P, Tanomaru JM. Comparison of rotary and manual instrumentation techniques on cleaning capacity and instrumentation time in deciduous molars. J Dent Child (Chic). 2004;71(1):45–47.
- Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent. 2000;22(1):77–78.
- Nagaratna PJ, Shashikiran ND, Subbareddy VV. In vitro comparison of NiTi rotary instruments and stainless steel hand instruments in root canal preparations of primary and permanent molar. J Indian Soc Pedod Prev Dent. 2006;24(4):186–191.
- Adl A, Sahebi S, Moazami F, Niknam M. Comparison of apical debris extrusion using a conventional and two rotary techniques. Iran Endod J. 2009;4(4):135–138.
- Onçağ Ö, Hoşgör M, Hilmioğlu S, Zekioğlu O, Eronat C, Burhanoğlu D. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J. 2003;36(6):423–432.
- Koçak S, Koçak MM, Sağlam BC, Türker SA, Sağsen B, Er Ö. Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems. J Endod. 2013;39(10):1278–1280.
- Pinheiro SL, Araujo G, Bincelli I, Cunha R, Bueno C. Evaluation of cleaning capacity and instrumentation time of manual, hybrid and rotary instrumentation techniques in primary molars. Int Endod J. 2012;45(4):379–385.
- Berutti E, Chiandussi G, Paolino DS, et al. Effect of canal length and curvature on working length alteration with WaveOne reciprocating files. J Endod. 2011;37(12):1687–1690.
- Elnaghy AM, Elsaka SE. Evaluation of root canal transportation, centering ratio, and remaining dentin thickness associated with ProTaper Next instruments with and without glide path. J Endod. 2014;40(12):2053–2056.
- Kim HC, Kwak SW, Cheung GS, Ko DH, Chung SM, Lee W. Cyclic fatigue and torsional resistance of two new nickel-titanium instruments used in reciprocation motion: Reciproc versus WaveOne. J Endod. 2012;38(4):541–544.
- Berutti E, Chiandussi G, Paolino DS, et al. Canal shaping with WaveOne Primary reciprocating files and ProTaper system: A comparative study. J Endod. 2012;38(4):505–509.
- Metzger Z, Teperovich E, Zary R, Cohen R, Hof R. The self-adjusting file (SAF). Part 1: Respecting the root canal anatomy – a new concept of endodontic files and its implementation. J Endod. 2010;36(4):679–690.
- Plotino G, Grande NM, Testarelli L, Gambarini G. Cyclic fatigue of Reciproc and WaveOne reciprocating instruments. Int Endod J. 2012;45(7):614–618.
- Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271–275.
- Huang X, Ling J, Wei X, Gu L. Quantitative evaluation of debris extruded apically by using ProTaper Universal Tulsa rotary system in endodontic retreatment. J Endod. 2007;33(9):1102–1105.
- Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17(6):275–279.
- Bürklein S, Schäfer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod. 2012;38(6):850–852.
- De-Deus GA, Silva EJNL, Moreira EJ, Neves AA, Belladonna FG, Tameirão M. Assessment of apically extruded debris produced by the self-adjusting file system. J Endod. 2014;40(4):526–529.
- Hachmeister DR, Schindler WG, Walker WA III, Thomas DD. The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification. J Endod. 2002;28(5):386–390.
- Nayak G, Singh I, Shetty S, Dahiya S. Evaluation of apical extrusion of debris and irrigant using two new reciprocating and one continuous rotation single file systems. J Dent (Tehran). 2014;11(3):302–309.
- Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod. 2015;41(2):237–241.
- Thakur B, Pawar AM, Kfir A, Neelakantan P. Extrusion of debris from primary molar root canals following instrumentation with traditional and new file systems. J Contemp Dent Pract. 2017;18(11):1040–1044.
- Madalena IR, Carneiro SV, Osório SdRG, et al. Assessment of extruded debris in primary molars comparing manual and reciprocating instrumentation. Pesq Bras Odontoped Clin Integr. 2017;17(1):e3767.
- Ozsu D, Karatas E, Arslan H, Topcu MC. Quantitative evaluation of apically extruded debris during root canal instrumentation with ProTaper Universal, ProTaper Next, WaveOne, and self-adjusting file systems. Eur J Dent. 2014;8(4):504–508.
- Ruddle CJ, Machtou P, West JD. The shaping movement: Fifth generation technology. Dent Today. 2013;32(4):94,96–99.
- Beeson TJ, Hartwell GR, Thornton JD, Gunsolley JC. Comparison of debris extruded apically in straight canals: Conventional filing versus profile .04 Taper series 29. J Endod. 1998;24(1):18–22.
- McKendry DJ. Comparison of balanced forces, endosonic, and step-back filing instrumentation techniques: Quantification of extruded apical debris. J Endod. 1990;16(1):24–27.
- Yeter KY, Evcil MS, Ayranci LB, Ersoy I. Weight of apically extruded debris following use of two canal instrumentation techniques and two designs of irrigation needles. Int Endod J. 2013;46(9):795–799.