Apical Debris Extrusion Associated with Oval Shaped Canals: A Comparative Study of WaveOne vs Self-Adjusting File

E.T. Farmakis, G.G. Sotiropoulos, I. Abramovitz, M. Solomonov

Clinical Oral Investigations. 2016 Nov;20(8):2131-2138


OBJECTIVES: The aim was to evaluate ex vivo apical debris extrusion associated with WaveOne and Self-Adjusting File instruments when used in oval canals.

METHODS: Twenty-four extracted human mandibular premolars with oval-shaped canals were assigned in two equal groups. Following coronal cavity preparation, a glide path was created. Group A was subjected to canal preparation using a WaveOne primary file, which was used along with syringe and needle irrigation and 10 mL of 2.4 % NaOCl solution, followed by flushing with 10 mL of 17 % EDTA solution, activation with EndoActivator for 1 min and final flushing with 10 mL of 2.4 % NaOCl solution, and activation for 30 s. Group B, the SAF system was used with continuous simultaneous irrigation, provided by the system's pump. The irrigant was supplied at 5 mL/min, alternating every minute between 2.4 % NaOCl solution and 17 % EDTA solution, over a total of 4 min followed by final flushing with 10 mL of 2.4 % NaOCl solution. Extruded apical debris from each root canal was collected into a preweighed glass vial and dried. The mean weight of the debris from each group was assessed and analyzed statistically. Both systems resulted in apical debris extrusion.

RESULTS: The WaveOne system was associated with a statistically significant greater mean mass of apically extruded debris (2.18 ± 0.44 mg) than the SAF system (0.49 ± 0.33 mg, permutation-based Wilcoxon test, p < 0.001).

CONCLUSION: Both WaveOne and the SAF systems were associated with apical debris extrusion. The amount of debris extruded by the WaveOne system was 4.4 times greater than that extruded by the SAF system.

CLINICAL RELEVANCE: The results of the present ex vivo comparative study cannot be directly applied to the clinical situation. Difference between both groups remains completely unclear; maybe the amount of extrusion is harmless in both groups or similarly deleterious for the periradicular tissues in both groups or may be dose-related to the amount of the extruded material.


The full article is available on ResearchGate

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