EFFECT OF DIFFERENT SINGLE FILE SYSTEMS ON THE AMOUNT OF APICALLY EXTRUDED DEBRIS IN CURVED ROOT CANALS

Öz

ABSTRACT Introduction:Apical extrusion of necrotic tissues to the periapical area may cause postoperative pain and flare-ups and provoke an acute inflammatory response. The purpose of this study was to evaluate the apical debris extrusion after preparing root canals with different single-file Ni-Ti systems. Methods:A total of 45 extracted mandibular molar teeth were selected and the mesial root canals of the specimens were used for this study. The specimens were randomly divided into three groups (n = 15). Group 1: Glide-path preparation was performed using OneG file and the root canals were instrumented with HyFlex EDM (Colténe/Whaledent). Group 2: The root canals were prepared with OneCurve (Micro-Mega) file after creating a glide-path with OneG. Group 3: OneG was used for glide-path preparation before preparing root canals with WaveOne-Gold primary file (Dentsply Maillefer). The root canals were irrigated with 8 ml NaOCl during the preparation procedure. Apically extruded debris and irrigation solution during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 68 °C for 5 days for the evaporation of irrigation solution. The amount of extruded debris was calculated by subtracting the pre-instrumentation weight from the post-instrumentation weight of the Eppendorf tubes. The obtained data were analyzed using Kruskal-Wallis Test. Results: The amount of extruded debris was not statistically different among the tested groups (P > 0.05). All tested files caused the extrusion of debris. Conclusion: Under the conditions of this in-vitro study, there was no statistically significant difference among the HyFlex EDM, One-Curve and WaveOne-Gold primary files used with different kinematics and had different thermal treatments. All different single Ni-Ti file systems were associated with apical extrusion of debris. Keywords: Apical Debris extrusion, dental instruments, endodontics, HyFlex EDM, OneCurve, root canal preparation, WaveOne-Gold Farklı Tek Eğe Sistemlerinin Eğri Kök Kanallarından Taşan Debris Miktarına etkisi ÖZ Amaç: Nekrotik dokuların periapikal bölgeye taşması post-operatif ağrı ve provoke akut enflamatuar yanıta neden olabilir. Bu çalışmanın amacı kök kanallarının farklı Ni-Ti (Nikel-Titanyum) eğe sistemleri ile şekillendirilmesi sonrasında apikal bölgeye taşan debris miktarını karşılaştırmaktır. Gereç ve Yöntem:Bu çalışma için toplam 45 adet mandibular molar diş seçilmiş ve örneklerin mezial kök kanalları kullanılmıştır. Örnekler rastgele üç gruba ayrılmıştır (n=15). Group 1: Kanal içerisinde OneG eğesi ile rehber yol hazırlandıktan sonra, şekillendirme işlemi HyFlex EDM OneFile ile yapılmıştır. Group 2: OneG eğesi ile rehber yol hazırlandıktan sonra kök kanalları OneCurve eğesi ile genişletilmiştir. Group 3: Kök kanalları OneG eğesi ile rehber yol hazırlandıktan sonra WaveOne-Gold primary eğesi ile şekillendirilmiştir. Şekillendirme sırasında kök kanalları 8ml NaOCl solüsyonu ile yıkanmıştır. Apikalden taşan debris ve irrigasyon solüsyonu ağırlığı önceden ölçülmüş olan Ependorf tüplerinde biriktirilmiştir. Tüpler daha sonra irrigasyon solüsyonunun buharlaşması için inkübatörde 68C°’de 5 gün boyunca bekletilmiştir. Apikalden taşan debris miktarı şekillendirme sonrası tartılan Ependorf tüplerinin ağırlığından şekillendirme öncesi ağırlıkları çıkartılarak hesaplanmıştır. Elde edilen veriler istatistiksel olarak Kruskal-Wallis testi ile değerlendirilmiştir. Bulgular:Deneysel gruplar arasından apikalden taşan debris açısından istatistiksel olarak fark bulunmamıştır (P > 0.05). Bütün gruplarda apikal debris çıkışı gözlenmiştir. Sonuç: Bu in-vitro çalışmanın koşulları altında farklı kinematiğe sahip ve farklı ısıl işlemler uygulanan HyFlex EDM, One-Curve ve WaveOne-Gold primary eğeleri arasında anlamlı bir fark bulunmamıştır. Bütün Ni-Ti eğe sistemleri apikalden debris taşmasına sebep olmuştur. Anahtar Kelimeler: Apikal debris çıkışı, Endodonti, HyFlex EDM, kök kanalını hazırlama, OneCurve, WaveOne-Gold

Anahtar Kelimeler

• Apical Debris extrusion
• dental instruments
• endodontics
• HyFlex EDM
• OneCurve
• root canal preparation
• WaveOne-Gold

EFFECT OF DIFFERENT SINGLE FILE SYSTEMS ON THE AMOUNT OF APICALLY EXTRUDED DEBRIS IN CURVED ROOT CANALS

Öz

ABSTRACT Introduction:Apical extrusion of necrotic tissues to the periapical area may cause postoperative pain and flare-ups and provoke an acute inflammatory response. The purpose of this study was to evaluate the apical debris extrusion after preparing root canals with different single-file Ni-Ti systems. Methods:A total of 45 extracted mandibular molar teeth were selected and the mesial root canals of the specimens were used for this study. The specimens were randomly divided into three groups (n = 15). Group 1: Glide-path preparation was performed using OneG file and the root canals were instrumented with HyFlex EDM (Colténe/Whaledent). Group 2: The root canals were prepared with OneCurve (Micro-Mega) file after creating a glide-path with OneG. Group 3: OneG was used for glide-path preparation before preparing root canals with WaveOne-Gold primary file (Dentsply Maillefer). The root canals were irrigated with 8 ml NaOCl during the preparation procedure. Apically extruded debris and irrigation solution during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 68 °C for 5 days for the evaporation of irrigation solution. The amount of extruded debris was calculated by subtracting the pre-instrumentation weight from the post-instrumentation weight of the Eppendorf tubes. The obtained data were analyzed using Kruskal-Wallis Test. Results: The amount of extruded debris was not statistically different among the tested groups (P > 0.05). All tested files caused the extrusion of debris. Conclusion: Under the conditions of this in-vitro study, there was no statistically significant difference among the HyFlex EDM, One-Curve and WaveOne-Gold primary files used with different kinematics and had different thermal treatments. All different single Ni-Ti file systems were associated with apical extrusion of debris. Keywords: Apical Debris extrusion, dental instruments, endodontics, HyFlex EDM, OneCurve, root canal preparation, WaveOne-Gold,

Anahtar Kelimeler

• Apical Debris extrusion
• dental instruments
• endodontics
• HyFlex EDM
• OneCurve
• root canal preparation
• WaveOne-Gold

Kaynakça

1. References 1. Haridas K, Hariharan M, Singh P, Varughese A, Ravi AB, Varma KR. Effect of Instrumentation Techniques and Kinematics on Apical Extrusion of Debris: An In Vitro Study. J Contemp Dent Pract 2019;20(9):1067-1070.
2. 2. Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endodontic Topics 2005;10(1):30-76.
3. 3. Elashiry MM, Saber SE, Elashry SH. Apical extrusion of debris after canal shaping with three single-file systems. Niger J Clin Pract 2020;23(1):79-83.
4. 4. Burklein S, Schafer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 2012;38(6):850-852.
5. 5. Amaral AP, Limongi P, Fontana CE, Martin AS, Bueno C, Pinheiro SL. Debris Apically Extruded by Two Reciprocating Systems: A Comparative Quantitative Study. Eur J Dent 2019;13(4):625-628.
6. 6. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. J Endod 1985;11(11):472-478.
7. 7. Silva EJ, Teixeira JM, Kudsi N, Sassone LM, Krebs RL, Coutinho-Filho TS. Influence of Apical Preparation Size and Working Length on Debris Extrusion. Braz Dent J 2016;27(1):28-31.
8. 8. De-Deus G, Neves A, Silva EJ, Mendonca TA, Lourenco C, Calixto C, et al. Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig 2015;19(2):357-361.

9. 9. Frota MMA, Bernardes RA, Vivan RR, Vivacqua-Gomes N, Duarte MAH, Vasconcelos BC. Debris extrusion and foraminal deformation produced by reciprocating instruments made of thermally treated NiTi wires. J Appl Oral Sci 2018;26:e20170215.
10. 10. Gunes B, Yesildal Yeter K. Effects of Different Glide Path Files on Apical Debris Extrusion in Curved Root Canals. J Endod 2018;44(7):1191-1194.
11. 11. Razcha C, Zacharopoulos A, Anestis D, Mikrogeorgis G, Zacharakis G, Lyroudia K. Micro-Computed Tomographic Evaluation of Canal Transportation and Centering Ability of 4 Heat-Treated Nickel-Titanium Systems. J Endod 2020;46(5):675-681.
12. 12. Yared G. Canal preparation using only one Ni-Ti rotary instrument: preliminary observations. Int Endod J 2008;41(4):339-344.
13. 13. Elnaghy AM, Elsaka SE. Effect of sodium hypochlorite and saline on cyclic fatigue resistance of WaveOne Gold and Reciproc reciprocating instruments. Int Endod J 2017;50(10):991-998.
14. 14. Webber J. Shaping canals with confidence: WaveOneGold single-file reciprocating system. Roots 2015;1(1):34-40.
15. 15. Pirani C, Iacono F, Generali L, Sassatelli P, Nucci C, Lusvarghi L, et al. HyFlex EDM: superficial features, metallurgical analysis and fatigue resistance of innovative electro discharge machined NiTi rotary instruments. Int Endod J 2016;49(5):483-493.
16. 16. Pedulla E, Lo Savio F, Boninelli S, Plotino G, Grande NM, La Rosa G, et al. Torsional and Cyclic Fatigue Resistance of a New Nickel-Titanium Instrument Manufactured by Electrical Discharge Machining. J Endod 2016;42(1):156-159.
17. 17. Pinheiro SR, Alcalde MP, Vivacqua-Gomes N, Bramante CM, Vivan RR, Duarte MAH, et al. Evaluation of apical transportation and centring ability of five thermally treated NiTi rotary systems. Int Endod J 2018;51(6):705-713.
18. 18. Staffoli S, Grande NM, Plotino G, Ozyurek T, Gundogar M, Fortunato L, et al. Influence of environmental temperature, heat-treatment and design on the cyclic fatigue resistance of three generations of a single-file nickel-titanium rotary instrument. Odontology 2019;107(3):301-307.
19. 19. Elnaghy AM, Elsaka SE. Cyclic Fatigue Resistance of One Curve, 2Shape, ProFile Vortex, Vortex Blue, and RaCe Nickel-Titanium Rotary Instruments in Single and Double Curvature Canals. J Endod 2018;44(11):1725-1730.
20. 20. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971;32(2):271-275.
21. 21. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod 1991;17(6):275-279.
22. 22. Ruiz-Hubard EE, Gutmann JL, Wagner MJ. A quantitative assessment of canal debris forced periapically during root canal instrumentation using two different techniques. J Endod 1987;13(12):554-558.
23. 23. Uslu G, Ozyurek T, Yilmaz K, Gundogar M, Plotino G. Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files. J Endod 2018;44(5):856-859.
24. 24. Tanalp J, Gungor T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J 2014;47(3):211-221.
25. 25. Nevares G, Xavier F, Gominho L, Cavalcanti F, Cassimiro M, Romeiro K, et al. Apical Extrusion of Debris Produced during Continuous Rotating and Reciprocating Motion. ScientificWorldJournal 2015;2015:267264.
26. 26. Toyoglu M, Altunbas D. Influence of Different Kinematics on Apical Extrusion of Irrigant and Debris during Canal Preparation Using K3XF Instruments. J Endod 2017;43(9):1565-1568.
27. 27. Silva EJ, Sa L, Belladonna FG, Neves AA, Accorsi-Mendonca T, Vieira VT, et al. Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod 2014;40(12):2077-2080.
28. 28. Kocak S, Kocak MM, Saglam BC, Turker SA, Sagsen B, Er O. Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems. J Endod 2013;39(10):1278-1280.
29. 29. Kucukyilmaz E, Savas S, Saygili G, Uysal B. Assessment of apically extruded debris and irrigant produced by different nickel-titanium instrument systems. Braz Oral Res 2015;29:1-6.
30. 30. Aktemur Türker S, Uzunoğlu Özyürek E. Apİkalden Taşan Debrİs Mİktari Yönünden Üç Farkli Döner Eğe Sİstemİnİn Karşilaştirilmasi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2015;25(2):185-188.
31. 31. Topcuoglu HS, Duzgun S, Akpek F, Topcuoglu G, Akti A. Influence of a glide path on apical extrusion of debris during canal preparation using single-file systems in curved canals. Int Endod J 2016;49(6):599-603.
32. 32. Farmakis ETR, Sotiropoulos GG, Abramovitz I, Solomonov M. Apical debris extrusion associated with oval shaped canals: a comparative study of WaveOne vs Self-Adjusting File. Clin Oral Invest 2016;20(8):2131-2138.
33. 33. Lu Y, Wang R, Zhang L, Li HL, Zheng QH, Zhou XD, et al. Apically extruded debris and irrigant with two Ni-Ti systems and hand files when removing root fillings: a laboratory study. Int Endod J 2013;46(12):1125-1130.