Evaluating the apically extruded debris and irrigants in different nickel–titanium instrumentation and irrigation techniques

Purpose: This study aims to evaluate the amount of debris and irrigant extruded apically following the use of the ProFile.04/.06 with Orifice Shapers and HERO 642 rotary instrumentation systems and manual preparation using the modified step-down technique, in combination with irrigation by an anesthetic needle, perforated needle, or passive ultrasonic irrigation (PUI).
Methods: One hundred and eighty teeth with single canals and similar morphologies were included in this study. The teeth were then divided into nine groups. In each group, instrumentation and irrigation were performed using different methods. The extruded material was collected in preweighed vials and the amount of extruded debris was calculated. The data were analyzed using Kruskal–Wallis one-way analysis of variance and Dunn’s test.
Results: The amount of debris extruded apically was determined to be significantly higher with the step-down technique (p< 0.001) and ProFile system (p< 0.05) compared to the HERO 642 system. While the amount of irrigant extruded apically by perforated needle was higher than that by PUI (p< 0.01), compared to both methods, the anesthetic needle caused significant irrigant extrusion apically (p< 0.001). While a negative correlation was determined between the extruded irrigant and working length (p< 0.01), the irrigant was positively correlated with both minor (p< 0.01) and major foramen areas (p< 0.05) (n = 180).
Conclusion: HERO 642 and PUI yielded better results in terms of the parameters tested.