Impact of Various File Systems on Apical Debris Extrusion in Single Canal Teeth: An in Vitro Study
DOI:
https://doi.org/10.15218/edj.2025.22Keywords:
Debris extrusion, ProTaper Next, RACE EVO, MtwoAbstract
Background and Objectives: This study aims to analyze and correlate the quantity of debris extruded from apical foramen amid root canal instrumentation applying Mtwo, ProTaper Next, and Race Evo file systems.
Materials and Method: A collection of sixty single-rooted, single-canal premolars were selected. The roots were divided randomly into three different groups (n = 20 each) based on the type of instrumentation system used: Group 1 – “ProTaper Next,” Group 2 – “RACE EVO,” and Group 3 – “Mtwo.” The debris extruded during instrumentation was collected, dried in pre-weighed vials, and measured using an electronic balance.
Results: There was a highly significant difference in apically extruded debris among the three file systems. Mtwo had the lowest debris extrusion (0.00054 ± 0.00018), while Protaper Next had the highest mean debris extrusion (0.00101 ± 0.00020), followed by RACE EVO (0.00077 ± 0.00024).
Conclusion: Mtwo with continuous rotation exhibited the most advantageous performance of the evaluated systems due to its S-shaped cross-section and effective debris removal capabilities.
References
Tanalp, J., & Güngör, T. (2014). Apical extrusion of debris: A literature review of an inherent occurrence during root canal treatment. International Endodontic Journal, 47(3), 211-221.
Kocak, M. M., Çiçek, E., Kocak, S., Sağlam, B. C., & Türker, S. A. (2013). Apical extrusion of debris using reciprocating and conventional rotary instrumentation systems. Brazilian Oral Research, 27(5), 382-387.
Haapasalo, M., & Shen, Y. (2013). Evolution of nickel–titanium instruments: From past to future. Endodontic Topics, 29(1), 3-17.
Bürklein S, Schäfer E. (2012). Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod, 38(6):850–852. https://doi.org/10.1016/j.joen.2012.01.005
Elnaghy, A. M., & Elsaka, S. E. (2014). Evaluation of the mechanical properties of ProTaper Next nickel-titanium rotary files. International Endodontic Journal, 47(10), 1034-1039.
Zupanc, J., Vahdat-Pajouh, N., & Schäfer, E. (2018). New thermomechanically treated NiTi alloys – a review. International Endodontic Journal, 51(10), 1088-1103.
Myers, G. L., & Montgomery, S. (1991). A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. Journal of Endodontics, 17(6), 275-279.
Santa-Rosa, C. C., Resende, P. D., Peixoto, I. F. da C., Buono, V. T. L., Viana, A. C. D., & Bahia, M. G. de A. (2018). Evaluating the cutting efficiency of NiTiinstruments with reciprocating motions TT-Avaliação da eficiência de corte de instrumentos NiTi com movimento reciprocante. Arq. Odontol, 54, 1–8.
Koch K, B. D. (2002). Real world endo: design features of rotary files and how they affect clinical performance. Oral Health, 92(February), 39–49.
Hussein HA, Al-Zaka IM. (2018). Evaluation of apical debris extrusion during root canal instrumentation using three rotary systems. Int J Dent Res, 6(3): 108–112.
Veltri M, Mollo A, Mantovani L, Grandini S, Balleri P, Ferrari M. (2005). A comparative study of nickel–titanium rotary instruments for root canal preparation. J Endod, 31(11): 817–821.
Ghivari SB, Kubasad GC, Chandak MG, Akarte NR. (2011). Apical extrusion of debris and irrigant using hand and rotary systems with different irrigation needles. J Conserv Dent, 14(2): 187–190. https://doi.org/10.4103/0972-0707.82639
Bürklein, S., Schäfer, E., Flüch, S., & Schmidt, C. (2012). Comparison of various rotary nickel-titanium systems with respect to apically extruded debris. Journal of Endodontics, 38(10), 1279-1282.
Caviedes-Bucheli J, Munoz HR, Azuero-Holguin MM, Ulate E. (2016). The influence of two reciprocating single-file and two rotary-file systems on the apical extrusion of debris and its biological relationship with symptomatic apical periodontitis: A systematic review and meta-analysis. Int Endod J, 49(3): 255–270. https://doi.org/10.1111/iej.12436
Kharouf N, Pedullà E, Nehme W, et al. Apically extruded debris in curved root canals using a new reciprocating single-file shaping system. J Endod. 2022;48(1):117-122. doi:10.1016/j.joen.2021.10.002
Caviedes-Bucheli J, Castellanos F, Vasquez N, Ulate E, Munoz HR. The influence of two reciprocating single-file and two rotary-file systems on the apical extrusion of debris and its biological relationship with symptomatic apical periodontitis. A systematic review and meta-analysis. International Endodontic Journal, 49, 255–270, 2016.
Al Omari, T., El-Farraj, H., Arıcan, B. and Atav Ateş, A. (2022), Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. Aust Endod J, 48: 245-250. https://doi.org/10.1111/aej.12540.
Caviedes-Bucheli J, Castellanos F, Vasquez N, Ulate E, Munoz HR. (2010). Histological changes in periradicular tissues after root canal instrumentation with nickel-titanium rotary instruments in teeth with apical periodontitis. Int Endod J, 43(5): 447–453.
Silveira CMM, Pimpão MV, Fernandes LA, Westphalen VPD, Cavenago BC, Carneiro E. Influence of Different Irrigation Solutions and Instrumentation Techniques on the Amount of Apically Extruded Debris. Eur Endod J. 2019;4(3):122-126. Published 2019 Nov 19. doi:10.14744/eej.2019.57966.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ribwar Aman Ferman, Diyar Khalid Bakr (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Erbil Dental Journal is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
