ABSTRACT
Objective @#To compare the removal efficiency and the amounts of apically extruded debris using Twisted File (TF), Twisted File Adaptive (TFA), ProTaper, and ProTaper Next combined with ultrasonic irrigation and to provide an experimental basis for the selection of root canal instrumentation in the clinic.@*Methods@#Forty mandibular premolars were randomly divided into 4 groups (n=10 teeth per group). The canals were cut using a Twisted File, Twisted File Adaptive, ProTaper, or ProTaper Next nickel-titanium instrument. The canals were irrigated with ultrasonic irrigation. The apically extruded debris were collected in preweighted Eppendorf tubes. The amount of dental tissue removed and extruded debris were assessed with an electronic balance.@*Results @#The amount of tooth tissue removed in groups A, B, C and D was 20.5 ± 2.0 mg, 17.8 ± 4.2 mg, 20.8 ± 3.9 mg and 16.5 ± 2.2 mg, respectively. Combined with ultrasonic irrigation, the Twisted File and ProTaper had a better removal efficiency than the ProTaper Next(P < 0.05). There was no significant difference in the amount of extruded debris (χ2=4.057, P=0.255) among four groups.@*Conclusion@#The Twisted File and ProTaper had a better removal efficiency than the ProTaper Next combined with ultrasonic irrigation. There was no significant difference in the amount of extruded debris using four Nickel-titanium instruments combined with ultrasonic irrigation.