Apical extrusion using various hand and rotary systems

Success of endodontic treatment depends upon adequate cleaning and shaping of root canals. Over past 40 years, a number of studies have confirmed that despite strict length control of endodontic instruments during root canal preparation dentinal filings, pulp tissue fragments, necrotic tissue, micro-organisms and intracanal irrigants may be extruded from apical foramen which cause inter-appointment flare-ups. Proper measures should be employed for reducing apical extrusion of infected debris by practicing crown-down instrumentation techniques, using instruments in rotational motion rather than filing motion, using copious and frequent irrigation. In present study, a total number of 160 extracted human permanent mandibular premolar teeth were selected for measuring the extrusion of debris, irrigant and bacteria through apical foramen. Two rotary and hand instrumentation techniques were studied for apical extrusion of debris, irrigant and bacteria. Based on the results obtained the following conclusions were drawn from the present study. Hand instrumentation techniques extruded larger amount of debris, irrigant and bacteria than the engine driven techniques.