European Journal of Molecular & Clinical Medicine

Abstract

Background: Apical extrusion of debris, irrigating solution and microorganism are always being concern for operator as these may cause flare-ups during root canal therapy. These noxious insults can also cause cell-mediated or humoral immunological phenomenon causing severe distress to the patient. Aim of this ex vivo study was to evaluate the effect of different types of instrumentation in combination with different irrigation methods on apical expulsion of debris and irrigating solution.
Material and Methods: Four hundred and ten extracted human permanent teeth were selected for the study. Ten teeth were kept as control group which were neither instrumented nor irrigated. Manual file (MF), protaper universal rotary (PTU), waveOne reciprocating(WO) and flexiCON rotary systems (FC) were used for instrumentation of the canals using two different irrigation techniques: conventional needle irrigation and endoVac irrigation. A single experienced operator carried out all the endodontic procedures. Four hundred teeth were equally divided in four groups (n = 100), in which instrumentation was performed using a MF (group 1), PTU (group 2), WO (group 3) and FC (group 4). In each group, 50 samples were irrigated with conventional needle irrigation, and 50 samples were irrigated with the endoVac irrigation method. During instrumentation, apically extruded debris and irrigating solution were collected in preweighed Eppendorf tube. Weight of expelled debris and volume of expelled irrigating 
solution were quantitatively measured individually. The data collected were statistically analysed.
Results: The group 1 showed highest extrusion of debris and irrigating solution while group 4 showed lowest. The order of sequence for debris expulsion from minimum to maximum is FlexiCON < waveOne < protaper < manual instrumentation. The order of sequence from minimum to maximum is FlexiCON < protaper < waveOne < manual instrumentation.
Conclusion: FlexiCON rotary instrumentation with the endoVac irrigation system produced significantly less debris and irrigating solution than the other techniques.
Clinical significance: This report highlights on how the apical extrusion of debris and irrigating solution can be minimised with altered instrumentation and irrigation technique for effective endodontic therapy