The Influence of ProTaper and WaveOne on Apically Extruded Debris: A Systematic Review and Meta-analysis

Overview

Journal J Conserv Dent

Specialty Dentistry

Date 2018 Oct 9

PMID 30294105

Citations 5

Authors

Chen Zhang

Jun Liu

Lingshuang Liu

Affiliations

Soon will be listed here.

Abstract

Background: Apically extruded debris produced during root canal preparation can induce postoperative inflammation and subsequent failure of root canal treatment. Therefore, debris production must be reduced to improve the outcome of root canal treatment.

Aim: This study aimed to provide a theoretical basis for the improvement of root canal treatment by comparing the difference in the amount of apically extruded debris produced during the root canal preparation of extracted human teeth with ProTaper Universal (PTU), ProTaper Next (PTN), and WaveOne (WO).

Materials And Methods: On March 30, 2017, three researchers searched five electronic databases (PubMed/Medline, Cochrane, Science Direct Online, Embase, and Web of Science) with no time limitations. Only articles written in English were retrieved, and 150 articles were obtained. Then, the three researchers independently selected articles in accordance with previously established inclusion and exclusion criteria, and inconsistent results were discussed. Data were analyzed through meta-analysis for standardized mean difference (SMD).

Results: Eight studies met the inclusion criteria and were subjected to qualitative analysis. Four articles showed that PTU produced higher amounts of apical debris than WO; two articles showed that PTU produced lower amounts of apical debris than WO; and three articles showed that PTN produced lower amounts of apical debris than WO. Moreover, one article demonstrated that PTU produced higher amounts of apical debris than PTN. A meta-analysis showed that PTU and WO did not produce significantly different amounts of apically extruded debris: SMD = -0.26, = 0.50 ( > 0.05). PTU produced lower amounts of apically extruded debris than WO: SMD = -4.98, = 2.79 ( < 0.05). However, results were significantly heterogeneous among all the included studies ( = 97%). No significant difference was found between PTU and WO in the amounts of apically extruded debris: SMD = 0.47, = 1.06 ( > 0.05).

Conclusion: Currently available evidence shows that PTN can produce lower amounts of apical debris than WO ( < 0.05). Moreover, the amounts of apically extruded debris produced by PTU and WO are not significantly different ( > 0.05). Nevertheless, given the limited number of studies reviewed, a definitive conclusion cannot be reached.

Citing Articles

The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study.

Mali S, Patil A, Sharma D, Jaiswal H, A Saoji H, Sinha A Cureus. 2024; 16(2):e54310.

PMID: 38496119 PMC: 10944652. DOI: 10.7759/cureus.54310.

Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study.

da Silva E, de Moura S, Lima C, Barbosa A, Misael W, Lacerda M Restor Dent Endod. 2021; 46(2):e16.

PMID: 34123752 PMC: 8170380. DOI: 10.5395/rde.2021.46.e16.

Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer.

Bel Haj Salah K, Jaafoura S, Tlili M, Ben Ameur M, Sahtout S Int J Dent. 2021; 2021:8816628.

PMID: 33815503 PMC: 7994073. DOI: 10.1155/2021/8816628.

Apically Extruded Debris following Programmed Over Instrumentation of Curved Canals with Three Nickel Titanium Rotary Instruments.

Yammine S, Jabbour E Eur J Dent. 2020; 15(1):20-26.

PMID: 32864731 PMC: 7902109. DOI: 10.1055/s-0040-1714175.

Apical extrusion of debris following the use of single-file rotary/reciprocating systems, combined with syringe or ultrasonically-facilitated canal irrigation.

Gummadi A, Panchajanya S, Ashwathnarayana S, Santhosh L, Jaykumar T, Shetty A J Conserv Dent. 2019; 22(4):351-355.

PMID: 31802818 PMC: 6873604. DOI: 10.4103/JCD.JCD_14_19.

References

Fairbourn D, McWalter G, Montgomery S . The effect of four preparation techniques on the amount of apically extruded debris. J Endod. 1987; 13(3):102-8. DOI: 10.1016/S0099-2399(87)80174-7. View

Wu M, Dummer P, Wesselink P . Consequences of and strategies to deal with residual post-treatment root canal infection. Int Endod J. 2006; 39(5):343-56. DOI: 10.1111/j.1365-2591.2006.01092.x. View

Uzun I, Guler B, Ozyurek T, Tunc T . Apical extrusion of debris using reciprocating files and rotary instrumentation systems. Niger J Clin Pract. 2016; 19(1):71-5. DOI: 10.4103/1119-3077.173715. View

Pawar A, Pawar M, Metzger Z, Kokate S . The self-adjusting file instrumentation results in less debris extrusion apically when compared to WaveOne and ProTaper NEXT. J Conserv Dent. 2015; 18(2):89-93. PMC: 4379665. DOI: 10.4103/0972-0707.153057. View

Myers G, Montgomery S . A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod. 1991; 17(6):275-9. DOI: 10.1016/S0099-2399(06)81866-2. View

Karatas E, Ersoy I, Gunduz H, Uygun A, Kol E, Cakici F . Influence of Instruments Used in Root Canal Preparation on Amount of Apically Extruded Debris. Artif Organs. 2016; 40(8):774-7. DOI: 10.1111/aor.12675. View

De-Deus G, Neves A, Silva E, Mendonca T, Lourenco C, Calixto C . Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig. 2014; 19(2):357-61. DOI: 10.1007/s00784-014-1267-5. View

Altunbas D, Kutuk B, Toyoglu M, Kutlu G, Kustarci A, Er K . Reciproc versus Twisted file for root canal filling removal: assessment of apically extruded debris. J Istanb Univ Fac Dent. 2017; 50(2):31-37. PMC: 5573529. DOI: 10.17096/jiufd.96734. View

Torabinejad M, Walton R . Managing endodontic emergencies. J Am Dent Assoc. 1991; 122(5):99, 101, 103. DOI: 10.1016/s0002-8177(91)25025-4. View

10.

Ozsu D, Karatas E, Arslan H, Topcu M . Quantitative evaluation of apically extruded debris during root canal instrumentation with ProTaper Universal, ProTaper Next, WaveOne, and self-adjusting file systems. Eur J Dent. 2014; 8(4):504-508. PMC: 4253107. DOI: 10.4103/1305-7456.143633. View

11.

Faggion Jr C . Guidelines for reporting pre-clinical in vitro studies on dental materials. J Evid Based Dent Pract. 2012; 12(4):182-9. DOI: 10.1016/j.jebdp.2012.10.001. View

12.

Burklein S, Schafer E . Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod. 2012; 38(6):850-2. DOI: 10.1016/j.joen.2012.02.017. View

13.

Ng Y, Mann V, Rahbaran S, Lewsey J, Gulabivala K . Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int Endod J. 2007; 40(12):921-39. DOI: 10.1111/j.1365-2591.2007.01322.x. View

14.

Kocak S, Kocak M, Saglam B, Turker S, Sagsen B, Er O . Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems. J Endod. 2013; 39(10):1278-80. DOI: 10.1016/j.joen.2013.06.013. View

15.

Silva E, Carapia M, Lopes R, Belladonna F, Senna P, Souza E . Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems. Int Endod J. 2015; 49(7):700-5. DOI: 10.1111/iej.12503. View

16.

Swartz D, Skidmore A, Griffin Jr J . Twenty years of endodontic success and failure. J Endod. 1983; 9(5):198-202. DOI: 10.1016/S0099-2399(83)80092-2. View

17.

Lu Y, Chen M, Qiao F, Wu L . Comparison of apical and coronal extrusions using reciprocating and rotary instrumentation systems. BMC Oral Health. 2015; 15:92. PMC: 4527245. DOI: 10.1186/s12903-015-0081-z. View

18.

FIELD J, Gutmann J, Solomon E, Rakusin H . A clinical radiographic retrospective assessment of the success rate of single-visit root canal treatment. Int Endod J. 2004; 37(1):70-82. DOI: 10.1111/j.1365-2591.2004.00765.x. View

19.

Capar I, Kaval M, Ertas H, Sen B . Comparison of the cyclic fatigue resistance of 5 different rotary pathfinding instruments made of conventional nickel-titanium wire, M-wire, and controlled memory wire. J Endod. 2014; 41(4):535-8. DOI: 10.1016/j.joen.2014.11.008. View

20.

Kucukyilmaz E, Savas S, Saygili G, Uysal B . Evaluation of Apically Extruded Debris and Irrigant Produced by Different Nickel-Titanium Instrument Systems in Primary Teeth. J Contemp Dent Pract. 2016; 16(11):864-8. DOI: 10.5005/jp-journals-10024-1772. View