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      A Comparative Evaluation of the Apically Extruded Debris from Root Canals Prepared by R-Motion NiTi File System

      research-article
      ,
      International Journal of Dentistry
      Hindawi

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          Abstract

          Background

          Apically extruded debris (AED) is an inherent concern during root canal treatment for both endodontists and general practitioners. The present study investigates the AED of the novel R-Motion single-file reciprocating system compared to standard single reciprocating and multifile rotary systems.

          Materials and Methods

          Fifty-six moderately curved palatal roots of upper maxillary first molars were selected for the present study. The samples were then divided randomly into four groups ( n = 14)— Group I: R-motion (RM), Group II: WaveOne Gold (WOG), Group III: ProTaper Next (PTN), and Group IV: HyFlex EDM (HFEDM). The researcher has modified Myers and Montgomery's method to simulate human body temperature. Vials were used to collect debris and weighted using a 0.00001 sensitive balance before and after instrumentation. The instrumentation of all experimented groups was done at 37°C, terminated at master apical file #25. An auto syringe with a side vented needle was used to deliver 8 ml of deionized water for irrigation of each sample during preparation. Vials were stored in a dry sealed desiccator which contained CaSO 4 crystals, for 24 hr before weighing. The weight of the collected debris was obtained by subtracting the preinstrumentation weight from the postinstrumentation weight for each vial. The Kruskal–Wallis and Mann–Whitney U tests were performed to analyse the statistical difference in the amount of debris between the tested groups at a 0.05 significance level.

          Results

          The RM system produced less debris extrusion than all tested groups, with a significant difference between the former and the WOG and the PTN systems. However, WOG, PTN, and HFEDM showed no statistically significant difference in the amount of AED.

          Conclusion

          All tested groups produced apical debris in different amounts. The RM produced substantially less AED than WOG and PTN. Meanwhile, WOG, PTN, and HFEDM caused a comparable amount of AED.

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          Most cited references41

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          A comparison of canal preparations in straight and curved root canals

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            Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems.

            The purpose of this in vitro study was to assess the amount of apically extruded debris using rotary and reciprocating nickel-titanium instrumentation systems. Eighty human mandibular central incisors were randomly assigned to 4 groups (n = 20 teeth per group). The root canals were instrumented according to the manufacturers' instructions using the 2 reciprocating single-file systems Reciproc (VDW, Munich, Germany) and WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) and the 2 full-sequence rotary Mtwo (VDW, Munich, Germany) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) instruments. Bidistilled water was used as irrigant. The apically extruded debris was collected in preweighted glass vials using the Myers and Montgomery method. After drying, the mean weight of debris was assessed with a microbalance and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. The time required to prepare the canals with the different instruments was also recorded. The reciprocating files produced significantly more debris compared with both rotary systems (P .05), the reciprocating single-file system Reciproc produced significantly more debris compared with all other instruments (P < .05). Instrumentation was significantly faster using Reciproc than with all other instrument (P < .05). Under the condition of this study, all systems caused apical debris extrusion. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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              Microbial causes of endodontic flare-ups.

              J Siqueira (2003)
              Inter-appointment flare-up is characterized by the development of pain, swelling or both, following endodontic intervention. The causative factors of flare-ups encompass mechanical, chemical and/or microbial injury to the pulp or periradicular tissues. Of these factors, microorganisms are arguably the major causative agents of flare-ups. Even though the host is usually unable to eliminate the root canal infection, mobilization and further concentration of defence components at the periradicular tissues impede spreading of infection, and a balance between microbial aggression and host defences is commonly achieved. There are some situations during endodontic therapy in which such a balance may be disrupted in favour of microbial aggression, and an acute periradicular inflammation can ensue. Situations include apical extrusion of infected debris, changes in the root canal microbiota and/or in environmental conditions caused by incomplete chemo-mechanical preparation, secondary intraradicular infections and perhaps the increase in the oxidation-reduction potential within the root canal favouring the overgrowth of the facultative bacteria. Based on these situations, preventive measures against infective flare-ups are proposed, including selection of instrumentation techniques that extrude lesser amounts of debris apically; completion of the chemo-mechanical procedures in a single visit; use of an antimicrobial intracanal medicament between appointments in the treatment of infected cases; not leaving teeth open for drainage and maintenance of the aseptic chain throughout endodontic treatment. Knowledge about the microbial causes of flare-ups and adoption of appropriate preventive measures can significantly reduce the incidence of this highly distressing and undesirable clinical phenomenon.
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                Author and article information

                Contributors
                Journal
                Int J Dent
                Int J Dent
                ijd
                International Journal of Dentistry
                Hindawi
                1687-8728
                1687-8736
                2023
                26 April 2023
                : 2023
                : 5731248
                Affiliations
                Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad 10001, Iraq
                Author notes

                Academic Editor: Luca Testarelli

                Author information
                https://orcid.org/0000-0002-9214-9755
                https://orcid.org/0000-0002-4611-3794
                Article
                10.1155/2023/5731248
                10156454
                37152476
                7d7e5171-b6a5-4cf2-b39d-e7990d26d0b7
                Copyright © 2023 Farah B. Al-Saffar and Hikmet A. Al-Gharrawi.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 January 2023
                : 7 February 2023
                : 7 April 2023
                Funding
                Funded by: Mustansiriyah University
                Categories
                Research Article

                Dentistry
                Dentistry

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