Evaluation of apical debris extrusion during root canal preparation using Hand K file, Revo S, Protaper Next and Wave One file system: An in vitro study.

Abstract

Introduction: The key step during the root canal treatment is the biomechanical preparation of the infected root canals. This preparation may result in pushing the apical debris through the apical foramen into the periapical space leading to initiation of immunological response by the host leading to postoperative pain and discomfort. Therefore the aim of the study was to compare the apical debris extrusion during root canal preparation using Hand k file, Revo S, Protaper Next and Wave One file system. 
 Materials and Method: Sixty extracted human mandibular premolars with single canal were selected and randomly divided into four groups (n = 15) for instrumentation with four different files. Group 1: Hand k file, Group 2: Revo S file, Group 3: ProTaper Next, and Group 4: WaveOne single reciprocating file. Debris extruding during instrumentation were collected into pre-weighed Eppendorf tubes. These tubes were then stored in an incubator at 70°C for 5 days and were then weighed to obtain the final weight, with the extruded debris. Weight of extruded debris was calculated by subtracting the initial weight from the final weight. Statistical analysis was performed using one-way analysis of variance and post hoc Tukey’s test.
 Result: For intergroup comparison, significant differences were found for the debris extruded. Instrumentation with hand K files resulted in significantly more debris extrusion apically as compared to other three NiTi groups. Maximum debris extrusion was seen by Hand K file, followed by group 2(Revo S), then group 4(Wave One) and least by group 3(Protaper Next). However, there was no significant difference in debris extrusion amongst groups prepared with either NiTi rotary or reciprocating file systems.
 Conclusion: The Pro Taper Next resulted in least debris extrusion when compared to Hand k file, reciprocating Wave One and rotary Revo S. However there was not a significant difference between all the NiTi rotary and reciprocating file system.
 Keywords: Apical extrusion debris; Hand k file, instrumentation; ProTaper Next, RevoS and WaveOne.