Influence of operator experience on apical debris extrusion after endodontic instrumentation with different single-file systems
Accepted: 26 November 2021
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Aim: This study evaluated whether operator experience interferes with the amount of apically extruded debris and actual instrumentation time.
Methodology: Seventy-five mesial roots of extracted mandibular first molars were randomly allocated to 6 groups (n=15 each) according to operator experience and instrumentation system used (HyFlex EDM, WaveOne Gold, or Reciproc Blue). Each root was secured in a preweighed Eppendorf tube for collection of debris extruded during instrumentation. Actual instrumentation time and the total amount of extruded debris were recorded. The Shapiro-Wilk test was used to assess data distribution normality, followed by descriptive analysis and the Kruskal-Wallis test with Dunn’s post hoc test. Spearman’s correlation analysis was done too.
Results: There was no significant difference in the amount of apically extruded debris between experienced and inexperienced operators or between the instrumentation systems used. Regarding instrumentation time, a significant difference was observed: HyFlex EDM-inexperienced > WaveOne Gold-experienced. No correlation between extruded debris, instrumentation time, and operator’s experience was found.
Conclusions: All instrumentation systems produced extrusion, with no difference between them or between operator’s experience. Instrumentation time differed only between 2 groups.
Labbaf H, Moghadam KN, Shahab S, et al. An in vitro comparison of apically extruded debris using reciproc, protaper universal, neolix and hyflex in curved canals. Iran Endod J. 2017;12:307-311.
Mendonça de Moura JD, Bueno CE da S, Fontana CE, et al. Extrusion of Debris from Curved Root Canals Instrumented up to Different Working Lengths Using Different Reciprocating Systems. J Endod. 2019;45:930-934.
Ahn SY, Kim HC, Kim E. Kinematic effects of nickel-titanium instruments with reciprocating or continuous rotation motion: A systematic review of in vitro studies. J Endod. 2016;42:1009-1017.
Arruda-Vasconcelos R, Barbosa-Ribeiro M, Louzada LM, et al. Apically extruded debris using passive ul trasonic irrigation associated with different root canal irrigants. Braz Dent J. 2019;30:363-367.
Coltene. HyFlex EDM. Available at: https://www.coltene.com/fileadmin/Data/EN/Products/Endodontics/Root_Canal_Shaping/HyFlex_EDM/31328A_HyFlexEDM_Brochure_US.pdf. Accessed October 13, 2020.
Sobotkiewicz T, Huang X, Haapasalo M, et al. Effect of canal curvature location on the cyclic fatigue resistance of reciprocating files. Clin Oral Investig 2020. Jun 2.
Dentsply Tulsa Dental Specialties. Wave One Gold. Available at: https://www.dentsplysirona.com/content/dam/dentsply/pim/en_GB/Endodontics/Obturation/Paper_Points/WaveOne_Gold_Absorbent_Points/WaveOne%20GOLD%20Brochure%202015.pdf. Accessed October 13, 2020.
VDW. Reciproc Blue. Available at: https://www.vdw-dental.com/fileadmin/Dokumente/Sortiment/Aufbereitung/Reziproke-Aufbereitung/RECIPROC-blue/VDW-Dental-RECIPROCblue-User-Brochure-EN.pdf. Accessed October 13, 2020.
Plotino G, Nagendrababu V, Bukiet F, et al. Influence of Negotiation, Glide Path, and Preflaring Procedures on Root Canal Shaping—Terminology, Basic Concepts, and a Systematic Review. J Endod. 2020; 46:707-729.
Tavares LG, Lima SMF, Lima MG, et al. Undergraduate dentistry students’ perception of difficulties regarding endodontic treatment. Aust Endod J. 2019;45:98-105.
Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32:271-275.
Uslu G, Özyürek T, Yılmaz K, et al. Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files. J Endod. 2018;44:856-859.
Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991;17:275-279.
Silva EJ, Carapia MF, Lopes RM, et al. Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems. Int Endod J. 2016;49:700-705.
Boijink D, Costa DD, Hoppe CB, et al. Apically Extruded Debris in Curved Root Canals Using the WaveOne Gold Reciprocating and Twisted File Adaptive Systems. J Endod. 2018;44:1289-1292.
Troiano G, Dioguardi M, Cocco A, et al. Influence of Operator’s Experience on the Shaping Ability of Protaper Universal and Waveone Systems: A Comparative Study on Simulated Root Canals. Open Dent J. 2016;10:546-552.
Muñoz E, Forner L, Garcet S, et al. Canal shaping with a reciprocating system is easy to learn. Int Endod J. 2019;52:1244-1249.
Muñoz E, Forner L, Llena C. Influence of operator’s experience on root canal shaping ability with a rotary nickel-titanium single-file reciprocating motion system. J Endod. 2014;40:547-550.
Bueno MR, Estrela C, Azevedo BC, et al. Root Canal Shape of Human Permanent Teeth Determined by a New Cone-Beam Computed Tomography Software. J Endod 2020. Jun 8. Doi:10.1016/j.joen.2020.05.014
Keles A, Keskin C. Deviations of Mesial Root Canals of Mandibular First Molar Teeth at the Apical Third: A Micro–computed Tomographic Study. J Endod. 2018;44:1030-1032.
Silveira C, Pimpão MV, Fernandes LA, et al. Influence of different irrigation solutions and instrumentation techniques on the amount of apically extruded debris. Eur Endod J. 2019;4:122-126.
Borges ÁH, Pereira TM, Porto AN, et al. The influence of cervical preflaring on the amount of apically extruded debris after root canal preparation using different instrumentation systems. J Endod. 2016;42:465-469.
Delvarani A, Akhlaghi NM, Aminirad R, et al. In vitro comparison of apical debris extrusion using rotary and reciprocating systems in severely curved root canals. Iran Endod J. 2017;12:4-37.
De-Deus G, Neves A, Silva EJ, et al. Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig. 2015;19:357-361.
Wong AWY, Zhang S, Li SKY, et al. Incidence of post-obturation pain after single-visit versus multiple-visit non-surgical endodontic treatments. BMC Oral Health. 2015;15:1-11.
Ng YL, Glennon JP, Setchell DJ, et al. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int Endod J. 2004;37:381-391.
Haug SR, Solfjeld AF, Ranheim LE, et al. Impact of Case Difficulty on Endodontic Mishaps in an Undergraduate Student Clinic. J Endod. 2018;44:1088-1095.
Siqueira Jos F. Standing on our standards: Time for reflection. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;110:545–7.
Supporting AgenciesAmazon Foundation for Studies and Research Support (FAPESPA)
Copyright (c) 2022 Carlos Eduardo Fontana, Carlos Eduardo da Silveira Bueno, João Daniel Mendonça de Moura, Gávila da Rocha Bastida Pinheiro, Victor Camelotti Trevensoli, Rina Andrea Pelegrine, Daniel Guimarães Pedro Rocha, Alexandre Sigrist De Martin, Sérgio Luiz Pinheiro
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Giornale Italiano di Endodonzia has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.