Evaluation of Apically Extruded Debris and Irrigants during Root Canal Preparation using Different Rotary Instrumentation Systems: An In-vitro Comparative Study

Background: Different instrumentation systems and techniques are used in the instrumentation of the root canal system which can result in debris formation that may be extruded beyond the apical foramen and cause post-operative pain. Aim of the study: Aim of the current study was to compare the amount of apically extruded debris and irrigants during instrumentation using 2 reciprocating single file systems (WaveOne Gold, Reciproc blue) and 2 continuous rotation file systems (ProTaper Gold, 2Shape) and comparing them to the control group (ProTaper Universal). Materials and Methods: Total 50 palatal roots of freshly extracted human maxillary first molars were collected for this study. Teeth were decoronated to a unified length of 15 mm, and then pushed through a pre-perforated rubber cap of pre-weighed glass vial then the root-cap complex was fitted on a glass vial and rubber dam ligated with dental floss was used to cover the glass vial for preventing the coronally extruded debris and irrigants from contaminating the external surface, gauge 25 needle was inserted parallel to the root surface through the rubber dam and cup. Samples were then randomly divided into 5 groups. Results: Data obtained were statistically analyzed using One Way ANOVA and LSD tests. The result showed that all groups resulted in apical extrusion of debris and irrigants, as it showed that the 2Shape Group B, Wave One Gold Group C and Reciproc blue Group D are statistically comparable, while ProTaper Gold Group A and ProTaper Universal Groups E showed statistically significant difference (p<0.05). Conclusions: All of the systems resulted in apical extrusion. There was no influence of kinematic movements on apical extrusion. The 2shape file system produced the least amount of apical extrusion while the ProTaper Universal showed the greatest amount.