Comparative Evaluation of Periapical Expulsion Using Manual, Rotary, and Reciprocating Instrumentation With EndoVac...

Area of Science:

• Endodontics
• Biomaterials Science
• Dental Instrumentation

Background:

• Nickel-titanium (Ni-Ti) rotary systems are widely used in endodontic treatment.
• Optimizing irrigation and instrumentation techniques is crucial for effective root canal cleaning and disinfection.
• The extrusion of debris and microorganisms beyond the apical foramen is a concern in endodontic procedures.

Purpose of the Study:

• To evaluate the efficacy of the heat-treated FlexiCON Ni-Ti rotary system.
• To compare FlexiCON with hand files, ProTaper Universal, and WaveOne systems.
• To assess the impact of the EndoVac irrigation system on debris and microbial extrusion.

Main Methods:

• A total of 210 single-rooted human anterior teeth were divided into four groups (n=50 each) and a control group (n=10).
• Instrumentation was performed using step-back (hand file), ProTaper Universal, WaveOne, and FlexiCON rotary systems.
• All groups utilized the EndoVac irrigation system for canal irrigation.

Main Results:

• The FlexiCON rotary system group exhibited the least extrusion of debris, irrigating solution, and Enterococcus faecalis (14 CFUs).
• The step-back hand file group showed the highest extrusion (39 CFUs).
• The control group demonstrated no extrusion of debris, irrigant, or microorganisms.

Conclusions:

• FlexiCON Ni-Ti rotary instrumentation, combined with EndoVac irrigation, significantly reduced the extrusion of debris, irrigating solution, and bacteria.
• This system demonstrated superior performance in minimizing apical extrusion compared to ProTaper Universal, WaveOne, and hand files.
• The findings suggest FlexiCON offers an advantageous approach for root canal preparation with enhanced safety regarding apical extrusion.