Comparative Evaluation Of Apical Debris Extrusion During Root Canal Preparation Using Four Different Single-File Systems: An In-Vitro Study

Abstract

Background: Effective cleaning and shaping of the root canal system are essential for successful endodontic therapy. However, extrusion of debris beyond the apical foramen during biomechanical preparation may result in postoperative pain, inflammation, and delayed healing. Contemporary nickel–titanium (NiTi) single-file systems have simplified instrumentation and claim to minimize apical extrusion through improved design and metallurgy.

Aim: To evaluate and compare the amount of apically extruded debris produced by four single-file systems—WaveOne Gold (WOG), Hyflex EDM (HEDM), One Curve (OC), and XP-Endo Shaper (XPS).

Materials and Methods: Sixty extracted human mandibular premolars were randomly divided into four groups (n = 15) and instrumented with one of the above systems. The Myers and Montgomery apparatus was used for debris collection. Tubes were incubated at 70 °C for 5 days and weighed on a digital analytical balance. Data were analyzed using one-way ANOVA and Tukey’s post hoc test (α = 0.05).

Results: All groups showed measurable apical extrusion. Mean extrusion (g): OC 0.0382 > HEDM 0.0370 > WOG 0.0286 > XPS 0.0214. ANOVA showed a significant difference (p = 0.001).

Conclusion: Apical extrusion of debris is unavoidable, but the XP-Endo Shaper produced the least extrusion, followed by WOG, HEDM, and OC. File design, taper, alloy, and motion kinematics play critical roles in reducing apical extrusion.