Comparative Evaluation of Apical Debris Extrusion Upon Use of Rotary Files and Hand Files for Root Canal Instrumentation in Primary Teeth

Abstract

Introduction: Endodontic flare-up is a common complication characterised by pain, swelling or both that occurs within a few hours or days after endodontic procedure and one of the major reasons is the apical extrusion of dental filings, pulp tissue fragments, necrotic tissue, micro-organisms and irrigant during chemo-mechanical preparation of the root canals. Thus, it is important to limit the amount of the debris extruded through the apical foramen into the peri-radicular region for a successful root canal treatment. Aim: To quantify and compare the amount of debris extruded apically during root canal preparation using conventional hand files, K3 and Kedo-S Rotary files in primary teeth. Materials and Methods: Thirty six extracted human primary canines were selected and randomly assigned to one of the three groups of twelve teeth each. Myers and Montgomery experimental model was used for instrumentation and debris collection. The teeth were then instrumented with the following file systems: Group 1: Hand files; Group 2: K3 files; Group 3: Kedo-S files. The apical debris which got extruded during instrumentation was collected in Eppendorf tubes which were pre-weighed. The tubes were then placed in an Incubator at 70° Celsius for five days and weighed again to determine the post-instrumentation weight. The weight of the dry debris collected was measured by subtracting the pre-weight of the Eppendorf tubes from the post-instrumentation weight for all the three groups. The data were analysed using one-way ANOVA and Tukey’s post-hoc tests. Results: A statistically significant difference was observed between hand files and Kedo-S (p<0.05) and between hand files and K3 files (p<0.05). However, there was no statistically significant difference between K3 and Kedo-S files (p=0.069). Conclusion: Apical debris extrusion was found to be less with Kedo-S files compared to hand files.

Keywords

• apical debris
• deciduous teeth
• instrumentation