Assessment of Extruded Debris in Primary Molars Comparing Manual and Reciprocating Instrumentation

Isabela Ribeiro Madalena, Sofia Vasconcelos Carneiro, Suzimara dos Reis Géa Osório, Rozimeri dos Santos Basso da Silva, Thais Gimenez, Sérgio Luis Pinheiro, José Carlos Pettorossi Imparato


Objective: To compare the amount of extruded debris in primary molars after manual instrumentation or WaveOne system. Material and Methods: Twenty-five primary molar roots with mild and moderate root angulation (between 10 to 20º), having at least two thirds of root length, no pathological reabsorption (internal or external) or furcation perforation, were selected for this study. Roots were standardized at 6 mm in length, inserted and stabilized in individual acrylic resin blocks with random distribution into two groups: G1 (n=12): Instrumentation with crown-down manual technique; and G2 (n=13): instrumentation with WaveOne system. Blocks with roots were weighed before and after instrumentation, allowing the calculation of extruded debris using both mechanical preparations. Data analysis was performed by Bioestat 4.0 statistical software using Mann Whitney test. Results: The mean weight of extruded debris in manual instrumentation and WaveOne system have no significant difference (p=0.8704). Conclusion: Manual crown-down instrumentation or WaveOne system does not influence the amount of extruded debris after mechanical preparation, suggesting that both techniques were effective in canals clean causing similar extrused debris, however more studies with largest sample should be done to better validate this evidence.


Tooth, Deciduous; Endodontics; Instrumentation.

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Fumes AC, Sousa-Neto MD, Leoni GB, Versiani MA, da Silva LA, da Silva RA, Consolaro A. Root canal morphology of primary molars: A micro-computed tomography study. Eur Arch Paediatr Dent 2014; 15(5):317-26. doi: 10.1007/s40368-014-0117-0.

Madhusudhana K, Mathew VB, Reddy NM. Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems: An in vitro study. Contemp Clin Dent 2010; 1(4):234-6. doi: 10.4103/0976-237X.76390.

Luisi SB, Zotti AC, Piffer CS, Vansin ACM, Ligabue RA. Apical extrusion of debris after hand, engine-driven reciprocating and continuous preparation. Rev Odonto Ciência 2010; 25(3):288-91.

Nayak G, Singh I, Shetty S, Dahiya S. Evaluation of apical extrusion of debris and irrigant using two new reciprocating and one continuous rotation single file systems. J Dent 2014; 11(3):302-9.

Plotino G, Grande NM, Testarelli L, Gambarini G. Cyclic fatigue of Reciproc and WaveOne reciprocating instruments. Int Endod J 2012; 45(7):614-8. doi: 10.1111/j.1365-2591.2012.02015.

Berutti E, Chiandussi G, Paolino DS, Scotti N, Cantatore G, Castellucci A, et al. Effect of canal length and curvature on working length alteration with WaveOne reciprocating files. J Endod 2011; 37(12):1687-90. doi: 10.1016/j.joen.2011.09.014.

Amaral PG, dos Santos RL, Salazar-Silva JR, Batista AUD, Bonan PRF. Prevalence of dentinal defects after root canal preparations in molars with reciproc and WaveOne Systems. Braz Res Pediatr Dent Integr Clin 2016; 16(1):159-65. doi: 10.4034/PBOCI.2016.161.17.

Katge F, Patil D, Poojari M, Pimpale J, Shitoot A, Rusawat B. Comparison of instrumentation time and cleaning efficacy of manual instrumentation, rotary systems and reciprocating systems in primary teeth: An in vitro study. J Indian Soc Pedod Prev Dent 2014; 32(4):311-6. doi: 10.4103/0970-4388.140957.

Pinheiro SL, Silva JN, Gonçalves RO, Villalpando KT. Manual and rotator instrumentation ability to reduce enterococcus fecalis associated with photodynamic therapy in deciduous molars. Braz Dent J 2014; 25(6):502-7. doi: 10.1590/0103-6440201302414.

Pinheiro SL, Ota CM, Romitti FMG, Barret FGA, Pato TS, Imparato JCP. Morphological assessment and cleaning capacity of a reciprocating system in root canals of deciduous teeth. Braz Res Pediatr Dent Integr Clin 2016; 16(1):299-305. doi: 10.4034/PBOCI.2016.161.31.

Schneider SW. A comparison of canal preparations in straight and curved root. Oral Surg Oral Med Oral Pathol 1971; 32(2):271-5.

Bernardes RA, Duarte MA, Vasconcelos BC, Moraes IG, Bernardineli N, Garcia RB, et al. Evaluation of precision of length determination with 3 electronic apex locators: Root ZX, Elements Diagnostic Unit and Apex Locator, and RomiAPEX D-30. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(4):e91-94. doi: 10.1016/j.tripleo.2007.05.016.

Cerqueira LG, Gomes CC, Penina P, Prado MA, Freitas LF, Camões, ICG, Fidel R. Hand and rotary root canal preparation techniques comparison of the shaping. UFES Rev Odontol 2007; 9(1):13-19.

Siqueira Jr JF. Microbial causes of endodontic flare-ups. Int Endod J 2003; 36(7):453-63.

Reddy SA, Hicks ML. Apical extrusion of debris using two hand and two rotary instrumentation techniques. J Endod 1998; 24(3):180-3. doi: 10.1016/S0099-2399(98)80179-9.

Gambarini G, Sudani DAL, Di Carlo S, Pompa G, Pacifici A, Pacifici L, et al. Incidence and intensivity of postoperative pain and periapical inflammation after endodontic treatment with two different instrumentation techniques. Eur J Inflammation 2012; 10(1):99-103. doi: 10.1177/1721727X1201000111.

Jaramillo DE, Aguilar E, Leon M, Aprecio R. Comparison of the extrusion of dentin debris using a new instrumentation concept. Oral Health 2015; 28(32):1-7.

Alves VO, Bueno CES, Cunha RS, Pinheiro SL, Fontana CE, Martin AS. Comparison among Manual Instruments and pathfile and Mtwo rotary instruments to create a glide path in the root canal preparation of curved canals. J Endod 2012; 38 (1):117-20. doi: 10.1016/j.joen.2011.10.001.

Martin H, Cunningham WT. The effect of endosonic and hand manipulation on the amount of root canal material extruded. Oral Surg Oral Med Oral Pathol 1982; 53(6):611-3.

Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filling and canal master techniques. J Endod 1991; 17(6):275-9. doi: 10.1016/S0099-2399(06)81866-2.

Beeson TJ, Hartwell GR, Thornton JD, Gunsolley JC. Comparison of debris extruded apically in straight canals: Conventional filing versus profile. J Endod 1998; 24(1):18-22. doi: 10.1016/S0099-2399(98)80206-9.

Kim HC, Kwak S, Cheung GS, Ko DH, Chung S, Lee W. Cyclic fatigue and torsional resistance of two new nickel-titanium instruments used in reciprocation motion: Reciproc versus WaveOne. J Endod 2012; 38(4):541- 4. doi: 10.1016/j.joen.2011.11.014.

Goering AC, Michelich RJ, Schultz HH. Instrumentation of root canals in molar using the step-down technique. J Endod 1982; 8(12):550-4. doi: 10.1016/S0099-2399(82)80015-0.