EVALUATION OF APICAL DEBRIS EXTRUSION OF TWO FULL-ROTATING INSTRUMENTS, HYFLEX EDM AND RACE EVO, VERSUS TWO RECIPROCATING INSTRUMENTS, RECIPROC BLUE AND R-MOTION: AN IN-VITRO STUDY.

Abstract

Complete cleaning and shaping of the root canal space is a mandatory stage for the success of root canal treatment. Extrusion of different materials apically during this step such as dentine debris, pulp tissue remnants, necrotic fragments, microorganisms and irrigants may occur. These extruded materials lead to periapical irritation, pain and/or swelling. To evaluate the apical debris extrusion of Race EVO and Hyflex EDM which are full-rotating instruments, versus R-motion and Reciproc Blue as reciprocating instruments. Forty extracted human mandibular premolar teeth were selected with single canals not affected by fluorosis, resorption, or fracture. Teeth were then randomly divided into four groups (n=10) according to the instrumentation files: R-motion (FKG), Reciproc blue (VDW), Race EVO (FKG) and Hyflex EDM (Colten). Extruded debris were collected and weighed using an analytical balance. All data collected from the study were statistically analyzed using the statistical package for social science (SPSS). The mean of apical debris using Race EVO and Hyflex EDM were higher than those produced with R-motion and Reciproc blue. A significant difference was observed between the four experimental groups. Race EVO and Hyflex EDM showed comparable results. No significant difference was observed for R-motion with the other experimental groups. Reciproc Blue generated significant less apical debris than Hyflex EDM and Race EVO. Reciprocating files seem to produce less apical debris extrusion than full rotation files. Reciproc Blue generated significant less apical debris than Hyflex EDM and Race EVO. R-motion showed less debris apical debris extrusion, however without significant difference. Further studies are required to find the best technique and instrument that result in minimal apical debris extrusion, thus reducing the possibility of periapical tissue irritation.