A comparison of apical extrusion of debris during root canal preparation using K-File, Neoendo Flex File, WaveOne Gold File and Self Adjusting File- An in vitro study

Background: Root canal treatment involves chemo mechaninal preparation, despite taking all precautions: dentinal chips, pulpal fragments, necrotic debris, irrigant solutions and microorganisms are inevitably pushed out from the root canal into periapical tissues during canal preparation. Aim: To evaluate and compare the amount of apically extruded debris caused by four file systems namely Hand K file, Neoendo Flex File, Self-Adjusting File (SAF) and WaveOne Gold File Methodology: A total of 120 extracted intact human mandibular premolar teeth Extracted for orthodontic or periodontic purpose were collected. The experimental model was created and root canal treatment was done suing four file. The debris that adhered to the root surface was collected by washing the apical part with 1 mL distilled water in the tube after removing it from the assembly. The debris in each tube was calculated by subtracting the Pre weight from the Post weight of the tube i.e by subtracting the weight of the empty tube from the weight of the tube containing dried debris. One-way ANOVA with Welch correction was applied. Results: Statistical significant differences were seen between the amount of apically extruded debris (F = 34.228, P <0.001) between the four groups. The post hoc analysis showed that highest amount of apically extruded debris was observed in Hand K File group, followed by Neoendo Flex File then WaveOne Gold File and the lowest in Self-Adjusting Files (SAF) group. Conclusion: In the present study least extrusion was seen with single file system (Self Adjusting File and WaveOne Gold) and greater extrusion with multiple file system (Neoendo Flex File and Hand K file).