ABSTRACT
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal-Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
ABSTRACT
BACKGROUND: Root canal preparation during endodontic treatment may be associated with various complications, including a change in the original pathway of the root canal lumen. The aim of our study was to determine whether files of similar sizes that use various movement kinematics (rotary, reciprocal, adaptive motion) cause root canal transportation, and whether the differences between such systems are statistically significant. METHODS: The degree of root canal transportation (DT) was calculated with the use of computed tomography scans for 3 groups of teeth (for each group: n = 20) in which the root canals were prepared using either rotary (ProTaper Next-PTN), reciprocal (WaveOne Gold-WOG), or adaptive movement (Twisted Files-TF) instruments. RESULTS: For rotary ProTaper Next instruments, the mean value of the DT index was 0.0795 (SD = 0.0179) for 3 mm from the apex, 0.09 (SD = 0.0262) for 6 mm from the apex, and 0.106 (SD = 0.0221) for 9 mm from the apex. For reciprocal WaveOne Gold Primary instruments, the mean value of the DT index was 0.0355 (SD = 0.015) for 3 mm from the apex, 0.061 (SD = 0.02) for 6 mm from the apex, and 0.08 (SD = 0.25) for 9 mm from the apex. For Twisted Files, the mean value of the DT index was 0.05 (SD = 0.03) for 3 mm from the apex, 0.092 (SD = 0.17) for 6 mm from the apex, and 0.08 (SD = 0.02) for 9 mm from the apex. CONCLUSIONS: The use of PTN, WOG, and TF files resulted in root canal transportation to a different degree. The use of rotary PTN files produced the most transported preparation, whereas the use of WOG files produced the conservative root canal preparation that allowed the retention of the original shape of the root canal.
