Elsevier

Journal of Endodontics

Volume 40, Issue 10, October 2014, Pages 1638-1641
Journal of Endodontics

Basic Research
An In Vitro Comparison of Apically Extruded Debris and Instrumentation Times with ProTaper Universal, ProTaper Next, Twisted File Adaptive, and HyFlex Instruments

https://doi.org/10.1016/j.joen.2014.04.004Get rights and content

Abstract

Introduction

The purpose of this study was to compare the in vitro amount of apically extruded debris with new endodontic rotary nickel-titanium instruments.

Methods

Sixty mandibular premolars were instrumented up to size 25 using ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (Dentsply Maillefer), Twisted File Adaptive (SybronEndo, Orange, CA), and HyFlex (Coltene-Whaledent, Allstetten, Switzerland) rotary systems. The apically extruded debris was collected and dried in preweighed Eppendorf tubes. The amount of extruded debris was assessed with an electronic balance. The total time required to complete root canal shaping with the different instruments was also recorded. The significance level was set at P = .05.

Results

The instrumentation time with the ProTaper Universal rotary system was significantly longer than with all the other instruments (P < .05). The Twisted File Adaptive and ProTaper Next systems extruded significantly less debris than the ProTaper Universal and HyFlex systems (P < .05).

Conclusions

The ProTaper Next and Twisted File Adaptive instrumentation systems were associated with less debris extrusion compared with the ProTaper Universal and HyFlex systems.

Section snippets

Materials and Methods

Mandibular premolars were selected from a collection of teeth that had been freshly extracted from patients (aged 40–60 years) for periodontal and prosthodontic reasons. The reasons of the extraction were not unrelated to this study. Specimens were immersed in 0.5% chloramine-T solution (Merck, Darmstadt, Germany) for 48 hours for disinfection. The teeth were stored in 4°C distilled water and used within 2 months. Soft tissue and calculus were removed mechanically from the root surfaces with a

Debris Collection

To evaluate the collection of the apically extruded debris, a similar method as described in previous studies 15, 16 was used. Empty vials without stoppers were weighed with an electronic balance (Sartorius Weighing Technology, Gottingen, Germany) with an accuracy of 10−6 g. After calibrating the scales, each specimen was placed on the scale for 100 seconds, and each value per second was noted automatically using the program included with the electronic balance. Finally, the mean weight of each

Results

The Twisted File Adaptive and ProTaper Next systems extruded significantly less debris than the ProTaper Universal and HyFlex files (P < .001) although no significant differences were obtained between the Twisted File Adaptive and ProTaper Next systems (P > .05). Likewise, there was no significant difference between the ProTaper Universal and HyFlex systems (P > .05) (Table 1).

The mean time for preparation of the root canals with the different instruments is shown in Table 1. The

Discussion

A tendency for increased apical extrusion with an increase in the diameter of the apical patency has been shown (4). Thus, in the present study, if a number 15 K-file extruded beyond the apical foramen, the tooth was excluded from the study. One study evaluating the type of irrigation needle on periapical extrusion indicated that side-vented needles extruded less irrigant compared with regular needles (17). Therefore, we used side-vented needles in all the groups to avoid irrigation extrusion.

Conclusions

Within the limitations of this in vitro study, all the tested systems extruded debris. However, the ProTaper Next and Twisted File Adaptive instrumentation systems were associated with less debris extrusion compared with the ProTaper Universal and HyFlex systems.

Acknowledgments

The authors thank Coltene for providing the HyFlex instruments.

The authors deny any conflicts of interest related to this study.

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