Apical Extrusion of Debris and Irrigant Using XP-Endo Finisher, EndoActivator, Passive Ultrasonic Irrigation or Syringe Irrigation

Objective: Extrusion of irrigant and debris into the periapical tissues is a potential risk for flare-ups during root canal treatment. The aim of this study was to evaluate the apically extruded debris and sodium hypochlorite during XP-Endo Finisher (XP-Endo) file use and compare with final irrigation techniques. The tested null hypothesis in this study was that there was no difference among the irrigation techniques. Materials­and­Methods:­An agar gel model was prepared for 80 extracted single rooted human mandibular premolar teeth, which were prepared up to the apical size of #40. The samples were divided into four groups according to the final irrigation regime: conventional syringe irrigation, XP-Endo, passive ultrasonic irrigation (PUI), and EndoActivator (EA). The test apparatus was weighed before and after the experiment, and the amount of apically extruded debris and irrigant was calculated. Results: There was minimal irrigant and debris extrusion in all groups. No significant difference among the tested groups was detected (p>0.05). Conclusion: Using the PUI, XP-Endo file, or EA according to the manufacturers’ instruction does not increase the extrusion risk.

Amaç: Kanal tedavisi esnasında irrigantların ve debrisin periapikal dokulara taşması akut alevlenme açısından potansiyel bir risk teşkil etmektedir. Bu çalışmanın amacı XP-Endo Finisher (XP-Endo) kullanımı esnasında apikalden taşan debrisi ve sodyum hipokloriti değerlendirmek ve final irrigasyon teknikleri ile karşılaştırmaktır. Çalışmanın sıfır hipotezi, test edilen sistemler arasında fark olmadığıdır. Gereç ve Yöntemler: Bir agar jel model, apikal boyutları 40 numaraya kadar prepare edilmiş 80 adet çekilmiş tek köklü insan mandibular premolar dişi kullanılarak hazırlandı. Örnekler final irrigasyon protokolüne göre dört gruba ayrıldı: Geleneksel iğne irrigasyonu, XP-Endo, EndoActivator (EA) ve pasif ultrasonik irrigasyon (PUI). Test düzeneği deneyden önce ve sonra tartıldı ve apikalden taşan debris ve irrigant hesaplandı.Bulgular: Her grupta minimal irrigant ve debris ekstrüzyonu saptandı. Test edilen gruplar arasında anlamlı fark bulunamadı (p>0,05). Sonuç: PUI, XP-Endo ve EA üretici firma talimatlarına uyarak kullanıldığında apikal ekstrüzyon riskini artırmamaktadır.

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