title: Apical extrusion of debris and irrigants using two hand and three engine-driven instrumentation techniques.
abstract: OBJECTIVE
  To evaluate the weight of debris and irrigant volume extruded apically from extracted teeth in vitro after endodontic instrumentation using the balanced force technique, a hybrid hand instrumentation technique, and three engine-driven techniques utilizing nickel-titanium instruments (ProFile .04, Quantec 2000 and Pow-R).
  
  
  METHODS
  Five groups of 20 extracted human teeth with single canals were instrumented using one or other of five techniques: balanced force, hybrid, Quantec 2000, ProFile .04, or Pow-R. Debris extruded from the apical foramen during instrumentation were collected into preweighed 1.5 mL tubes. Following instrumentation, the volume of extruded irrigant fluid was determined by visual comparison to control centrifuge tubes filled with 0.25 mL increments of distilled water. The weight of dry extruded dentine debris was also established.
  
  
  RESULTS
  Overall, the engine-driven techniques extruded less debris than the manual ones. However, there was no statistical difference between the balanced force technique and the engine-driven methods. The volume of irrigant extruded through the apex was directly associated with the weight of extruded debris, except within the ProFile group. The hybrid technique was associated with the greatest extrusion of both debris and irrigant.
  
  
  CONCLUSIONS
  Overall, the engine-driven nickel-titanium systems were associated with less apical extrusion.
authors.affiliation: Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, Brazil. cferraz@fop.unicamp.br
authors.forename: C C
authors.initials: CC
authors.lastname: Ferraz
authors.forename: N V
authors.initials: NV
authors.lastname: Gomes
authors.forename: B P
authors.initials: BP
authors.lastname: Gomes
authors.forename: A A
authors.initials: AA
authors.lastname: Zaia
authors.forename: F B
authors.initials: FB
authors.lastname: Teixeira
authors.forename: F J
authors.initials: FJ
authors.lastname: Souza-Filho
mesh_terms: D003755:Dental High-Speed Technique; D003762:Dental Instruments; D003804:Dentin; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D007180:Incisor; D009532:Nickel; D012388:Root Canal Irrigants; D018915:Root Canal Preparation / Q000295:instrumentation* / Q000379:methods*; D016369:Smear Layer; D014025:Titanium; D019227:Tooth Apex
chemical_list: D012388:Root Canal Irrigants; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium