• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.33.1-33.10
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• 2020

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.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.16.1-16.11
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• 2021

Objectives: The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods: Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results: No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions: All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.2.1-2.10
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• 2018

Objectives: To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods: Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results: Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions: Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.13.1-13.9
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• 2021

Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37℃. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.

• Restorative Dentistry and Endodontics
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• v.29 no.2
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• pp.147-152
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• 2004

The purpose of this study was to investigate the quantity of debris which was extruded apically after canal instrumentation using different types of enlarging instrument in endodontic resin models. Five groups of 9 endodontic resin models were instrumented using each different technique : hand instrumentation without early coronal flaring. hand instrumentation after early coronal flaring. and three nickel-titanium engine-driven instrumentations (Hero 642, Protaper, $K^$). Debris extruded from apical foramen during instrumentation was collected on preweighed CBC bottle, desiccated and weighted using electronic balance. The results were analyzed using Kruskal-wallis test and Mann-Whitney U rank sum test at a significance level of 0.05. The results were as follows: 1. All of instrumentation techniques produced apically extruded debris. 2. Group without early coronal flaring extruded significant more debris than groups with early coronal flaring. 3. There was no significant difference among early coronal flaring groups. The early coronal flaring is very important to reduce the amount of debris extruded apically.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.580-580
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• 2003

I. Objectives This study investigated the quantity of debris which was extruded apically after canal instrumentation using different types of enlarging instrument in endodontic resin models. II. Materials and Methods Five groups of 9 endodontic resin model were instrumented using each different technique：hand instrumentation without early coronal flaring, hand instrumentation after early coronal flaring, and three nickel-titanium engine-driven instrumentations(Hero 642, Protaper, K3) after early coronal flaring.(omitted)

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.399-407
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• 1999

Apical extrusion of canal debris is occurred inadvertently during root canal preparation and this could produce interappointment discomfort or postinstrumentation pain. The purpose of this study was to investigate the influence of canal preparation methods on the apical extrusion of canal debris by means of comparing the amounts of apically extruded debris with several kinds of instrumentation methods. In the first experiment, 40 incisors were divided into four groups of 10 each. They were instrumented using one of the four techniques: Step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation with Quantec series 2000, and Profile .04 taper series 29. Root canal irrigation was done with 2.52% sodium hypochlorite solution. In the second experiment, 80 incisors were divided into five groups of 16 each and instrumented using step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation such as Quantec SC, Quantec LX, and Profile .04 taper series 29 No irrigation procedure was performed in this second experiment. Extruded debris from each tooth was collected in a container and weighed by the use of an electronic balance after desiccation. With or without canal irrigation, step-back technique produced significantly more amount of apical debris than the other groups (p<0.05). However, there was no significant difference among crown-down pressureless technique, engine-driven instrumentation with Quantec LX, Quantec SC, or Profile. Therefore, either by hand or engine-driven instrumentation, it is concluded that to minimize apical debris, techniques using reaming motion of files should be applied rather than filing motion.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.5.1-5.13
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• 2021

Objectives: The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated. Materials and Methods: Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level. Results: Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05). Conclusions: All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.316-323
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• 2017

Objectives: This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems. Materials and Methods: Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU). Results: The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria. Conclusions: All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.291-304
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• 1997

The purposes of this study were to evaluate the changes in root canal configuration with canal instrumentation using different file types and techniques and to investigate most appropriate instrumentation technique in maintaining the original canal configuration with different file types. Fifty curved mesiobuccal or distobuccal canals of extracted human maxillary molar teeth were instrumented using a step-back technique with stainless steel K-files or nickel-titanium K-files, a crown-down pressureless technique with stainless steel K-files or nickel-titanium K-files and nickel-titanium engine-driven files. Radiographs were taken before and after instrumentation using a specially designed device that allowed for the pre-and postinstrumentation canals to be taken with the same X-ray angulation. Magnified X-ray images on a magnifier screen were traced and post instrumentation canal images were compared with the preinstrumentation ones. Changes in canal curvature and the incidence of procedural accidents were analyzed. The results were as follows : Crown-down pressureless technique with nickel-titanium K-files and nickel-titanium engine-driven filing produced no significant changes in canal curvature (p>0.05), while the step-back technique with stainless steel K-files or nickel-titanium K-files (p<0.01) and the crown-down pressureless technique with stainless steel K-files (p<0.05) produced significant changes. With nickel-titanium K-file, crown-down pressureless technique produced significantly less changes in canal curvature than step-back technique (p<0.05), while there was no significant difference between techniques with stainless steel K-files (p>0.05). File types exerted no significant influences in the changes of canal curvature both in the step-back technique and crown-down pressureless technique (0>0.05). Regardless of the file types used, step-back technique produced more procedural accidents such as ledge or elbow formation, apical zipping and apical transportation than the crowndown pressureless technique and nickel-titanium engine-driven filing. Both with stainless steel K-files and with nickel-titanium K-files, the incidence of apical extrusion of canal debris was higher in step-back technique than in crown-down pressureless technique.