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Research Articles
Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study
Emmanuel João Nogueira Leal da Silva, Sara Gomes de Moura, Carolina Oliveira de Lima, Ana Flávia Almeida Barbosa, Waleska Florentino Misael, Mariane Floriano Lopes Santos Lacerda, Luciana Moura Sassone
Restor Dent Endod 2021;46(2):e16.   Published online February 25, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e16
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison.

Materials and Methods

Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level.

Results

No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05).

Conclusions

All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

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Efficacy of reciprocating and rotary retreatment nickel-titanium file systems for removing filling materials with a complementary cleaning method in oval canals
Said Dhaimy, Hyeon-Cheol Kim, Lamyae Bedida, Imane Benkiran
Restor Dent Endod 2021;46(1):e13.   Published online February 3, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e13
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris.

Materials and Methods

Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37°C. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software.

Results

No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05).

Conclusions

Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.

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Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment
Burcu Serefoglu, Gözde Kandemir Demirci, Seniha Miçooğulları Kurt, İlknur Kaşıkçı Bilgi, Mehmet Kemal Çalışkan
Restor Dent Endod 2021;46(1):e5.   Published online December 17, 2020
DOI: https://doi.org/10.5395/rde.2021.46.e5
AbstractAbstract PDFPubReaderePub
Objectives

The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated.

Materials and Methods

Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level.

Results

Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05).

Conclusions

All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.

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Comparison of apical extrusion of intracanal bacteria by various glide-path establishing systems: an in vitro study
Alberto Dagna, Rashid El Abed, Sameeha Hussain, Ibrahim H Abu-Tahun, Livia Visai, Federico Bertoglio, Floriana Bosco, Riccardo Beltrami, Claudio Poggio, Hyeon-Cheol Kim
Restor Dent Endod 2017;42(4):316-323.   Published online October 31, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.316
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems.

Materials and Methods

Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU).

Results

The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria.

Conclusions

All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.

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Original Article
The effect of early coronal flaring about apical extrusion of debris
Min-Kyung Kim, Jeong-Beom Min, Ho-Keel Hwang
J Korean Acad Conserv Dent 2004;29(2):147-152.   Published online March 31, 2004
DOI: https://doi.org/10.5395/JKACD.2004.29.2.147
AbstractAbstract PDFPubReaderePub

The purpose of this study was to investigate the quantity of debris which was extruded apically after canal instrumentation using different types of enlarging instrument in endodontic resin models.

Five groups of 9 endodontic resin models were instrumented using each different technique: hand instrumentation without early coronal flaring, hand instrumentation after early coronal flaring, and three nickel-titanium engine-driven instrumentations (Hero 642, Protaper, K3). Debris extruded from apical foramen during instrumentation was collected on preweighed CBC bottle, desiccated and weighted using electronic balance. The results were analyzed using Kruskal-wallis test and Mann-Whitney U rank sum test at a significance level of 0.05.

The results were as follows:

All of instrumentation techniques produced apically extruded debris.

Group without early coronal flaring extruded significant more debris than groups with early coronal flaring.

There was no significant difference among early coronal flaring groups.

The early coronal flaring is very important to reduce the amount of debris extruded apically.

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