Quantitative Evaluation of Apically Extruded Debris of Root Canal Dentin Layer with WaveOne, ProTaper Next, ProTaper Gold Rotary File Systems

Endodontic flare-up or post-operative pain occurs when debris such as necrotic pulp tissue, dentin chips, irrigants, and microorganisms are extruded from the apical foramen intraoperatively into the periradicular tissue during root canal instrumentation. This study compared the amount of apical debris extrusion of the root canal dentin layer after using reciprocating and rotary file systems (WaveOne, ProTaper Next and ProTaper Gold). Sixty extracted human maxillary central incisors with one canal and closed apex were included in the study. Samples were randomly and equally divided into three groups (n = 20) according to the file systems used for preparation of the root canal. Teeth in the WO group were instrumented by WaveOne, while the PTN group were instrumented by ProTaper Next, and teeth samples in the PTG group were cleaned and shaped by ProTaper Gold. The mean apically extruded debris weight in grams was estimated using the modified Myers and Montgomery experimental model. Analysis of variance (ANOVA) test was used for the comparison of debris weight in three groups. Post hoc LSD test was applied for pairwise comparison of debris weight. The alpha value of significance was 0.05. The WO group had significantly lower mean debris weight than the PTN and PTG groups (p = 0.001). Post hoc pairwise comparison revealed that there was a statistically significant difference in mean debris weight between the WO group and PTN group (0.0215 vs. 0.0341, p = 0.001); and the WO group and PTG group (0.0215 vs. 0.0324, p = 0.003). Root canal preparations with different file systems were associated with apical extrusion of the debris from the root canal dentin layer. However, the WaveOne system resulted in a comparatively lower amount of apical debris layer extrusion than the ProTaper Next and ProTaper Gold rotary file systems.