Comparative Evaluation of Apical Debris Extrusion During Root Canal Preparation Using Three Different File Systems: an in Vitro Study

Introduction: One of the most important factors which form the foundation of successful root canal treatment is cleaning and shaping without extruding significant amount of debris in periradicular tissues. Aims: The objective of this study is to evaluate and compare the amount of apically extruded debris during root canal preparation with three different instrumentation systems. Materials and Methods: The mesiobuccal canals of ninety mature, human mandibular molars were randomly divided into three groups (n = 30 teeth/group). Each group was instrumented using one of the three different instrumentation systems: WaveOne Gold (WOG), self-adjusting files (SAFs), and Hyflex EDM (HEDM). The canals were irrigated using bidistilled water. Debris extruded was collected in preweighed Eppendorf tubes, and the extruded irrigant was evaporated. The weight of the dry extruded debris was established by comparing the pre- and post-instrumentation weight of Eppendorf tubes for each group. Statistical Analysis: The debris extrusion was compared and statistically analyzed using the analysis of variance and the post hoc Tukey test. Results: The WOG and HEDM file systems produced significantly more debris compared with SAF system (P < 0.05). Conclusions: All instrumentation systems tested produced apical extrusion of debris. SAFs extruded significantly lesser amount of debris than WOG and HEDM.