Comparative Evaluation of Apically Extruded Debris Using Different Rotary and Reciprocating File Systems: An In Vitro Study

Abstract

Background: Apical extrusion of debris during root canal instrumentation is an undesirable phenomenon that may lead to postoperative pain, inflammation, and delayed periapical healing. The design, motion, and metallurgy of nickel–titanium file systems influence the amount of debris extruded beyond the apical foramen. Aim: To evaluate and compare the amount of apically extruded debris during root canal instrumentation using ProTaper Universal, ProTaper Next, WaveOne Gold, and XP-endo Shaper file systems. Materials and Methods: Forty extracted human single-rooted mandibular premolars with straight canals were selected and randomly divided into four groups (n = 10). Root canal preparation was performed using ProTaper Universal (Group I), ProTaper Next (Group II), WaveOne Gold (Group III), and XP-endo Shaper (Group IV) according to the manufacturers’ instructions. Apically extruded debris was collected using the Myers and Montgomery model with pre-weighed Eppendorf tubes. The tubes were incubated to allow evaporation of moisture, and the dry weight of the extruded debris was calculated. Statistical analysis was performed using one-way ANOVA followed by Tukey’s post-hoc test. Results: All file systems resulted in some degree of apical debris extrusion. A statistically significant difference was observed among the groups (p < 0.05), with variations in the amount of debris extrusion depending on the file system used. Conclusion: None of the tested instrumentation systems completely prevented apical debris extrusion. However, differences in debris extrusion were influenced by the design and kinematics of the file systems. Clinical Significance: Understanding the debris extrusion potential of different file systems can help clinicians select instrumentation techniques that may reduce postoperative complications and improve patient comfort.

Keywords
Apical debris extrusion, Root canal instrumentation, Rotary files, Reciprocating files