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Comparative Study
. 2024 Dec;37(3):254-261.
doi: 10.54589/aol.37/3/254.

Apical extrusion following different glide path instrumentation in curved canals of mandibular molars

Marlene P Torres  1 , Ana Gs Limoeiro  2 , Wayne M Nascimento  1 , Virgílio Mb Braga  1 , Ana Raquel Ls Miranda  3 , Thais Mc Coutinho  4 , Marilia Fv Marceliano-Alves  4   5   6 , Marcos Frozoni  1
Affiliations
Comparative Study

Apical extrusion following different glide path instrumentation in curved canals of mandibular molars

Marlene P Torres et al. Acta Odontol Latinoam. 2024 Dec.

Abstract
in English, Portuguese

Endodontic failures are usually the result of technical errors compromising the proper endodontic procedures required to control and prevent periradicular infections. Among these errors, the extrusion of materials through the apical foramen has been associated with periapical inflammation, postoperative pain, tissue necrosis, delayed periapical healing and long-term failure.

Aim: To compare the debris extruded through the apical foramen when different glide path files are used prior to endodontic instrumentation with the WaveOne Gold Primary file.

Materials and method: Twenty-four mesial roots of extracted human mandibular first molars were divided into three groups (n=8): C-Pilot hand file (CPH) #15/.02; R-Pilot (RPL); WaveOne Gold Glider (WGG). The roots were placed in Eppendorf tubes containing 1.5% agar gel and weighed before and after instrumentation to calculate the weight of debris and irrigant solution extruded. Apical extrusion of debris was compared using one-way analysis of variance. The Games-Howell test was used for multiple comparisons due to heteroscedasticity, with a significance level of 5%.

Results: Debris extrusion was significantly lower with the WaveOne Gold Glider file than with the R-Pilot file, which in turn produced less extrusion than the C-Pilot file.

Conclusion: All glide path files caused apical extrusion, with the WaveOne Gold Glider causing the least.

O fracasso do tratamento geralmente é resultado de erros técnicos que comprometem os procedimentos endodônticos adequados necessários para controlar e prevenir infecções perirradiculares. Entre esses erros, a extrusão de material obturador através do forame tem sido associada à inflamação periapical, dor pós-operatória, necrose tecidual, atraso na cicatrização periapical e falhas a longo prazo.

Objetivo: Comparar os detritos extruídos através do forame apical quando diferentes instrumentos para exploração do canal radicular são usados antes da instrumentação com o instrumento WaveOne Gold Primary.

Material e métodos: Vinte e quatro raízes mesiais de primeiros molares inferiores humanos extraídos foram divididas em três grupos (n=8): Lima manual C-Pilot (CPH) #15/.02; R-Pilot (RPL); WaveOne Gold Glider (WGG). As raízes foram colocadas em tubos Eppendorf contendo gel de ágar a 1,5% e pesadas antes e depois da instrumentação para calcular o peso dos detritos e da solução irrigante extruídos. A extrusão apical de detritos foi comparada usando análise de variância unidirecional. O teste de Games-Howell foi usado para múltiplas comparações devido à heterocedasticidade, com um nível de significância de 5%.

Resultados: A extrusão de detritos foi significativamente menor com o instrumento WaveOne Gold Glider do que com o R-Pilot, que por sua vez produziu menos extrusão do que o C-Pilot.

Conclusao: Todos os instrumentos de caminho glide path causaram extrusão apical, sendo o WaveOne Gold Glider o que causou a menor extrusão.

Keywords: apical extrusion; automated instruments; debris; glide path.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflicts of interest regarding the research, authorship, and/or publication of this article.

Figures

Fig 1
Fig 1. Representative CT images of the Vertucci´s type IV mandibular molars used in the present study.
Fig 2
Fig 2. Representative images of the extruded dentinal debris weighing procedure. A) Shaping and irrigating procedures. B) Washing any remaining debris that might have adhered to the root apex. C) Debris weighing procedure.
Fig 3
Fig 3. Schematic figure showing the technical sequence of weighing the extruded dentinal debris.
See this image and copyright information in PMC

References

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