Comparative analysis of extrusion of debris and irrigants from the apical foramen using hand and rotary systems

Corresponding author: Vaibhav JainReader , Department of Conservative Dentistry and Endodontics, Chhattisgarh Dental College and Research Institute, Chhattisgarh This article may be cited as:Jain V.Comparative analysis of extrusion of debris and irrigants from the apical foramen using hand and rotary systems.Int J Com Health and Med Res 2017;3(2):66-70 Article Received: 11-05-17 Accepted On: 18-05-2017 NTRODUCTION A successful endodontic treatment depends on the effective cleaning and shaping of root canal completely. The aim of combining instrumentation and irrigation is to disinfect the root canal by removing microorganisms, pulp remnants and dentin chips, but debris may extrude through the apex into the periradicular tissues. Extruded debris consists of irrigation solutions, necrotic tissue, microorganisms, pulpal fragments and dentin powder. This is responsible for postoperative inflammation and failure.Vande Visse and Brilliant were the first to quantify the amount of debris extruded apically. In spite of adequate chemomechanical preparation and obturation, endodontic flare up may be caused by extruded material referred as the “worm” of necrotic debris. Alper Kustarci et al reported that mechanical instrumentation with rotary movements significantly reduced the amount of debris extrusion because these techniques tend to pack dentin chips within the grooves of the file and expelled them in a coronal direction from the root canal. Various studies have shown that crown down technique leads to minimum apical extrusion of debris but various instrument designs may affect the extrusion. The aim of present study is to compare the extrusion of debris and irrigants through apical foramen using hand and rotary systems. MATERIALS AND METHODS The present study was conducted in the Department of Conservative Dentistry and Endodontics in the institution. Ethical approval for the study was obtained from the ethical committee of the institute. For the study, authors selected a total of 60 freshly extracted human maxillary canines with complete root formation. Inclusion criteria for selection of extracted teeth: 1. Single canal and apical foramen I Background:The purpose of combining instrumentation and irrigation is to disinfect the root canal by removing microorganisms, pulp remnants and dentin chips, but debris may extrude through the apex into the peri-radicular tissues. The aim of present study was to compare the extrusion of debris and irrigants through apical foramen using hand and rotary systems. Materials and methods: For the study, we selected a total of 60 freshly extracted human maxillary canines with complete root formation. For the study, we grouped the sample equally into 4 groups for instrumentation with different techniques; Group 1Instrumentation of the teeth sample was carried out with step-back technique; Group 2-The teeth in this group were instrumented with a Hand Protaper; Group 3The teeth were instrumented with K-3 Rotary Ni-Ti Technique; Group 4the instrumentation of teeth in this group was carried out with a Rotary Protaper. Results: More debris and irrigant was extruded from the apex with hand instrumentation techniques (Step-back and Hand Protaper techniques) as compared to engine driven K-3 and Rotary Protaper systems. The extrusion of debris and irrigant was observed to be highest with step-back technique. The authors observed statistically significant difference between the step-back technique and other hand and rotary Ni-Ti instrumentation techniques. Conclusion: The extrusion of debris and irrigants from apical area is present in all the techniques but is greatest in hand K-files instrumentation with step-back technique.