Abstract
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal–Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
Highlights
Root canal treatment procedures constitute a significant part of dental treatment provided worldwide, and allow patients to retain their natural dentition with a success rate similar to implant placement procedures [1,2]
Apical extrusion of debris is another example of such complication, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors since the methodology for measuring the amount of extruded material was introduced by Myers and Montgomery in 1991 [5]
Due to introduction of ProTaper (Dentsply Sirona, Charlotte, NC, USA) rotary system and WaveOne Gold (Dentsply Sirona, Charlotte, NC, USA) reciprocal, and Twisted Files (Kerr Endodontics, Orange, CA, USA), and due to the fact that limited data is available on the topic, and post-operative pain resulting from extrusion of significant amounts of debris can decrease the acceptability of the treatment in patients, we chose to compare the amount of extruded debris after preparation with these three instrument systems and to determine whether the differences are statistically significant
Summary
Root canal treatment procedures constitute a significant part of dental treatment provided worldwide, and allow patients to retain their natural dentition with a success rate similar to implant placement procedures [1,2]. As movement kinematics may play a role in the severity of debris extrusion from the root canal, three, popular groups of instruments used worldwide that use rotary, reciprocal, and adaptive motion, were chosen to the study. Due to introduction of ProTaper (Dentsply Sirona, Charlotte, NC, USA) rotary system and WaveOne Gold (Dentsply Sirona, Charlotte, NC, USA) reciprocal, and Twisted Files (Kerr Endodontics, Orange, CA, USA), and due to the fact that limited data is available on the topic, and post-operative pain resulting from extrusion of significant amounts of debris can decrease the acceptability of the treatment in patients, we chose to compare the amount of extruded debris after preparation with these three instrument systems and to determine whether the differences are statistically significant. The null hypothesis in the study was that there will be no difference in the amount of apically extruded debris after preparation with these three systems
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