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. 2017 Jan-Feb;20(1):30-36.
doi: 10.4103/0972-0707.209066.

Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis

J Sylvia Western  1 , Daniel Devaprakash Dicksit  1
Affiliations

Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis

J Sylvia Western et al. J Conserv Dent. 2017 Jan-Feb.

Abstract

Background: All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing.

Objectives: Of this meta-analysis was to collect and analyze in vitro studies quantifying apically extruded debris while using Hand ProTaper (manual), ProTaper Universal (rotary), Wave One (reciprocating), and self-adjusting file (SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically.

Methodology: An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms "Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems." A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris.

Results: Statistically significant difference was seen in the following comparisons: SAF < Wave One, SAF < Rotary ProTaper.

Conclusions: Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.

Keywords: Apical extrusion; Hand ProTaper; Rotary ProTaper; Wave One; debris extruded; endodontic instrumentation; meta-analysis; self-adjusting file.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A flow chart showing the whole process of study selection
Figure 2
Figure 2
Basic characteristics of included studies with statistical analysis and forest plots
See this image and copyright information in PMC

References

    1. Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. J Endod. 1985;11:472–8. - PubMed
    1. McKendry DJ. Comparison of balanced forces, endosonic, and step-back filing instrumentation techniques: Quantification of extruded apical debris. J Endod. 1990;16:24–7. - PubMed
    1. Siqueira JF., Jr Microbial causes of endodontic flare-ups. Int Endod J. 2003;36:453–63. - PubMed
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. Open Med. 2009;3:e123–30. - PMC - PubMed
    1. Türker SA, Uzunoglu E, Aslan MH. Evaluation of apically extruded bacteria associated with different nickel-titanium systems. J Endod. 2015;41:953–5. - PubMed