APICALLY EXTRUDED DEBRIS ASSOCIATED WITH TRUNATOMY, 2SHAPE, GENIUS AND EDGEENDO X7 FILE SYSTEMS: AN IN VITRO STUDY
Keywords:
EdgeEndoX7, Genius file, Trunatomy file, 2Shape file, apical debris extrusion, Reciprocation.
Abstract
Aims: The amount of apical debris extrusion after using rotary endodontic files was compared in this study.
(TruNatomy , 2Shape, Genius and EdgeEndo X7) .
Method: Forty extracted human mandibular first premolars with single canal were included. Samples were randomly divided into four groups (n = 10) according to file used for preparation of the root canal. Groups (I): the root canals were prepared using Trunatomy (II): 2Shape, (III): Genius and (IV): EdgeEndo.
The mean apically extruded debris weight in grams was estimated using the modified Myers and Montgomery experimental model. Analysis of variance (ANOVA) was used for the comparison of debris weight in the four groups. The value of significance was 0.05.
Results: Least apical debris extrusion value was produced by Genius files (0.04 ±0.01) followed by EdgeEndo (0.05±0.02) and Trunatomy (0.06±0.01), while the highest apical debris extrusion was produced by 2shape file (0.07 ±0.02). There was lower apical debris extrusion in reciprocation movement compared to continuous rotation (P=0.0001).
Conclusion: All single file systems used in this study resulted in extrusion of debris apically. Although, Genius and EdgeEndoX7 system contributed in less extrusion of debris than the other systems. Reciprocation movement extruded less debris apically compered to continues rotation
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References
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Endodontic Journal. May 1;9(2):71.
Alcalde, M.P. Duarte. M.A.H. Bramante, C.M. Vasconselos, B.C. Tanomaru‑Filho,M.
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thermally treated reciprocating nickel‑titanium instruments. Clin Oral Investig ;22:1865‑71.
Bortoluzzi, E.A., Carlon, D., Meghil, M.M., El-Awady, A.R., Niu, L., Bergeron, B.E., et al. (2015).
Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals. J Dent., 43,597–604.
Bürklein, S. and Schäfer, E. (2015). Minimally invasive endodontics. Quintessence Int., 46:119–24.
Cirakoglu, N.Y and Ozbay, Y. (2021). Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. Journal of dental research dental clinics dental prospects, 15(1), 30-34.
De-Deus, G. Neves, E. Silva, E.J. Mendonça, T.A. Lourenço, C. Calixto, C. et al. (2015). Apically
extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig.;19:357–61.
De‑Deus, G. Silva, E.J. Vieira, V.T. Belladonna, F.G. Elias, C.N. Plotino, G. et al. (2017). Blue
thermomechanical treatment optimizes fatigue resistance and flexibility of the reciproc files. J Endod ;43:462‑6.
Dentsply Sirona.(2021). TruNatomy Brochure. https://www.dentsplysirona.com/en/
explore/endodontics/trunatomy.html. Accessed April.
Elashiry, M. Saber, S. Elashry, S. (2020). Apical extrusion of debris after canal shaping with three single-
file systems. Niger J Clin Pract, 23: 79.
Gambrini, G. Galli, M. Seracchiani, M. Di Nardo, D. Versiani, M.A. Piasecki, L. et al. (2019). In vivo
evaluation of operative torque generated by two nickel-titanium rotary instruments during root canal preparation. Eur J Dent.;13(4):556-62.
Ghoneim, W.M. and Shaheen, N.A. (2018). Apically extruded debris associated with different
instrumentation systems and irrigation needles. Tanta dental journal, 19(3).
Gummadi, A. Panchajany, S. Ashwathnarayana, S. Santhosh, L. Jaykumar, T. and Shetty, A. (2019).
Apical extrusion of debris following the use of single-file rotary/reciprocating systems, combined with syringe or ultrasonically-facilitated canal irrigation. 22(4): 351–355.
Gündoğar, M. and Sezgin, G.P. (2018). Cyclic Fatigue Resistance of Genius, RC Gold and Revo-S
Nickel-titanium Instruments, 4(4): 342-345.
Gunes, B. Yeter, K.Y. (2018). Effects of different glide path files on apical debris extrusion in curved
root canals. J Endod, 44: 1191–4.
Koçak, M.M., Çiçek, E., Koçak, S., Sağlam, B.C., Furuncuoğlu, F. (2016). Comparison of ProTaper Next
and HyFlex instruments on apical debris extrusion in curved canals. Int Endod J., 49(10):996-1000.
Labbaf, H., Nazari Moghadam, K., Shahab, S., Mohammadi Bassir, M., Fahimi, M.A. (2017). An In vitro
Comparison of Apically Extruded Debris Using Reciproc, ProTaper Universal, Neolix and Hyflex in Curved Canals. Iran Endod J.,12(3),307-311.
Lu, Y. Wang, R. Zhang, L. Li, H.L. Zheng, Q.H. Zhou, X.D. et al. (2013). Apically extruded debris and irrigant with two Ni-Ti systems and hand files when removing root fillings: a laboratory
study. Int Endod J.;46(12):1125–30.
Mohammadi, Z. Shalavi, S. Yaripour, S. Kinoshita, J.I. Manabe, A. Kobayashi, M. Giardino, L. Palazzi,
F. Sharifi, F. Jafarzadeh, H. (2019). Smear layer removing ability of root canal irrigation solutions: a review. Journal of Contemporary Dental Practice.;20(3):395-402.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod 2021; 47: 976–81.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod. ;47:976–81.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod. ;47:976–81.
Ozlek, E. Neelakantan, P. Khan, K. Cheung, G.S. Rossi‐ Fedele, G. (2020). Debris extrusion during root
canal preparation with nickel‐titanium instruments using liquid and gel formulations of sodium hypochlorite in vitro. Aust Endod J (in press).
Özyürek, T. Gündoğar, M. Uslu, G. Yılmaz, K. Staffoli, S. Nm, G. Plotino, G. Polimeni, A. (2018).
Cyclic fatigue resistances of Hyflex EDM, WaveOne gold, Reciproc blue and 2shape NiTi rotary files in different artificial canals. Odontology 2018;106:408-413.
Parirokh, M. Jalali, S. Haghdoost, A.A. Abbott, P.V. (2012). Comparison of the effect of various irrigants
on apically extruded debris after root canal preparation. J Endod; 38: 196–9.
Pasqualini, D. Mollo, L. Scotti, N. et al. (2012). Postoperative pain after manual and mechanical glide
path: a randomized clinical trial. J Endod; 38: 32–6.
Pintor, A.V. Dos Santos, M.R. Ferreira, D.M. Barcelos, R. Primo, L.G. Maia, L.C. (2016). Does smear
layer removal influence root canal therapy outcome? A systematic review. Journal of Clinical
Pediatric Dentistry.;40(1):1-7.
Predin Djuric, N. Van Der Vyver, P. Vorster, M. Vally, Z.I. (2021). Comparison of apical debris
extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and
reciprocating systems. Aust Endod J.;47:394–400
Predin, Djuric, N., Van Der Vyver, P. Vorster, M. Vally, Z.I. (2021). Comparison of apical debris
extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and reciprocating systems. Aust Endod J.;47:394–400.
Riyahi, M.A. Bashiri, A. Alshahrani, K. Alshahrani, S. Alamri, H.M. Sudani, D.A. (2020). Cyclic Fatigue
comparison of TruNatomy, Twisted File, and ProTaper Next Rotary Systems. Int J Dent.:3190938.
Roshdy, N.N. and Hassan, R. (2022). Quantitative evaluation of apically extruded debris using
TRUShape, TruNatomy, and WaveOne Gold in curved canals. BDJ Open, 8: 13.
Silva, E.J. Sa, L. Belladonna, F.G. Neves, A.A. Accorsi-Mendonca, T. Vieira, V.T., et al. (2014).
Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod. ,40:2077–80.
Al omari, T. El farraj, H. Arican, B. Atav Ates, Ayfer. (2021). Apical debris extrusion of full-sequenced
rotary systems in narrow ribbon-shaped canals. Australian endodontic journal.
Tanalp, J. and Gungor, T. (2014). Apical extrusion of debris: a literature review of an inherent occurrence
during root canal treatment. Int Endod J.,47:211–21.
Tanalp, J. and Gungor, T. (2014). Apical extrusion of debris: a literature review of an inherent occurrence
during root canal treatment. Int Endod J, 47, 211–21.
Ünal, B. and Zan, R. (2022). Comparative Evaluation of the Effect of Different Rotary Instrument
Systems on the Amount of Apically Extruded Debris. Cumhuriyet Dental Journal, 25(2): 172-
178.
Uslu, G. Gundogar, M. Özyurek, T. et al (2020). Cyclic fatigue resistance of reduced-taper nickel
titanium (NiTi) instruments in doubled-curved (S-shaped) canals at body temperature. J Dent Res Dent Clin Dent Prospects;14(2):111. DOI: 10.34172/joddd.2020.024.
Üstün, Y. Çanakçi, B.C. Dinçer, A.N. Er, O. Düzgün, S. (2015). Evaluation of apically extruded debris
associated with several Ni–Ti systems. Int Endod J.;48:701–4.
Uzunoglu, E. Turker, S.A.(2016). Impact of different file systems on the amount of apically extruded
debris during endodontic retreatment. Eur J Dent, 10, 210‑4.
Van der Vyver, P. Vorster, M.J. and Peters, O. A. (2019). “Minimallyinvasive endodontics using a new
single-file rotary system,”International Dentistry–African Edition, vol. 9, no. 4, pp. 6–20.
Van der Vyver, P.J., Vorster, M., Peters, O.A. (2019). Minimally invasive endodontics using a new
single-file rotary system. Int Dent Afr Ed. ,9,6–20.
Virdee, S.S. Seymour, D.W. Farnell, D. Bhamra, G. Bhakta, S. (2018). Efficacy of irrigant activation
techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. International endodontic journal. Jun;51(6):605-21.
Wahed, A. (2021). COMPARATIVE ASSESSMENT OF APICALLY EXTRUDED DEBRIS USING
PROTAPER NEXT, HYFLEX CM AND EDGEFILE X7 NICKEL TITANIUM INSTRUMENTS (AN IN VITRO STUDY). Egyptian Dental Journal. 67, 3751:3757.
Zinge, P.R and Patil, J. (2017). Comparative evaluation of effect of rotary and reciprocating single-file
systems on pericervical dentin: A cone-beam computed tomography study. Journal of Conservative dentistry, 20(6), 424–428
Endodontic Journal. May 1;9(2):71.
Alcalde, M.P. Duarte. M.A.H. Bramante, C.M. Vasconselos, B.C. Tanomaru‑Filho,M.
Guerreiro‑Tanomaru, J.M. et al. (2018). Cyclic fatigue and torsional strength of three different
thermally treated reciprocating nickel‑titanium instruments. Clin Oral Investig ;22:1865‑71.
Bortoluzzi, E.A., Carlon, D., Meghil, M.M., El-Awady, A.R., Niu, L., Bergeron, B.E., et al. (2015).
Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals. J Dent., 43,597–604.
Bürklein, S. and Schäfer, E. (2015). Minimally invasive endodontics. Quintessence Int., 46:119–24.
Cirakoglu, N.Y and Ozbay, Y. (2021). Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. Journal of dental research dental clinics dental prospects, 15(1), 30-34.
De-Deus, G. Neves, E. Silva, E.J. Mendonça, T.A. Lourenço, C. Calixto, C. et al. (2015). Apically
extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Investig.;19:357–61.
De‑Deus, G. Silva, E.J. Vieira, V.T. Belladonna, F.G. Elias, C.N. Plotino, G. et al. (2017). Blue
thermomechanical treatment optimizes fatigue resistance and flexibility of the reciproc files. J Endod ;43:462‑6.
Dentsply Sirona.(2021). TruNatomy Brochure. https://www.dentsplysirona.com/en/
explore/endodontics/trunatomy.html. Accessed April.
Elashiry, M. Saber, S. Elashry, S. (2020). Apical extrusion of debris after canal shaping with three single-
file systems. Niger J Clin Pract, 23: 79.
Gambrini, G. Galli, M. Seracchiani, M. Di Nardo, D. Versiani, M.A. Piasecki, L. et al. (2019). In vivo
evaluation of operative torque generated by two nickel-titanium rotary instruments during root canal preparation. Eur J Dent.;13(4):556-62.
Ghoneim, W.M. and Shaheen, N.A. (2018). Apically extruded debris associated with different
instrumentation systems and irrigation needles. Tanta dental journal, 19(3).
Gummadi, A. Panchajany, S. Ashwathnarayana, S. Santhosh, L. Jaykumar, T. and Shetty, A. (2019).
Apical extrusion of debris following the use of single-file rotary/reciprocating systems, combined with syringe or ultrasonically-facilitated canal irrigation. 22(4): 351–355.
Gündoğar, M. and Sezgin, G.P. (2018). Cyclic Fatigue Resistance of Genius, RC Gold and Revo-S
Nickel-titanium Instruments, 4(4): 342-345.
Gunes, B. Yeter, K.Y. (2018). Effects of different glide path files on apical debris extrusion in curved
root canals. J Endod, 44: 1191–4.
Koçak, M.M., Çiçek, E., Koçak, S., Sağlam, B.C., Furuncuoğlu, F. (2016). Comparison of ProTaper Next
and HyFlex instruments on apical debris extrusion in curved canals. Int Endod J., 49(10):996-1000.
Labbaf, H., Nazari Moghadam, K., Shahab, S., Mohammadi Bassir, M., Fahimi, M.A. (2017). An In vitro
Comparison of Apically Extruded Debris Using Reciproc, ProTaper Universal, Neolix and Hyflex in Curved Canals. Iran Endod J.,12(3),307-311.
Lu, Y. Wang, R. Zhang, L. Li, H.L. Zheng, Q.H. Zhou, X.D. et al. (2013). Apically extruded debris and irrigant with two Ni-Ti systems and hand files when removing root fillings: a laboratory
study. Int Endod J.;46(12):1125–30.
Mohammadi, Z. Shalavi, S. Yaripour, S. Kinoshita, J.I. Manabe, A. Kobayashi, M. Giardino, L. Palazzi,
F. Sharifi, F. Jafarzadeh, H. (2019). Smear layer removing ability of root canal irrigation solutions: a review. Journal of Contemporary Dental Practice.;20(3):395-402.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod 2021; 47: 976–81.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod. ;47:976–81.
Mustafa, R. Al Omari, T. Al-Nasrawi, S. Al Fodeh, R. Dkmak, A. Haider, J. (2021). Evaluating in vitro
performance of novel nickel-titanium rotary system (TruNatomy) based on debris extrusion and preparation time from severely curved canals. J Endod. ;47:976–81.
Ozlek, E. Neelakantan, P. Khan, K. Cheung, G.S. Rossi‐ Fedele, G. (2020). Debris extrusion during root
canal preparation with nickel‐titanium instruments using liquid and gel formulations of sodium hypochlorite in vitro. Aust Endod J (in press).
Özyürek, T. Gündoğar, M. Uslu, G. Yılmaz, K. Staffoli, S. Nm, G. Plotino, G. Polimeni, A. (2018).
Cyclic fatigue resistances of Hyflex EDM, WaveOne gold, Reciproc blue and 2shape NiTi rotary files in different artificial canals. Odontology 2018;106:408-413.
Parirokh, M. Jalali, S. Haghdoost, A.A. Abbott, P.V. (2012). Comparison of the effect of various irrigants
on apically extruded debris after root canal preparation. J Endod; 38: 196–9.
Pasqualini, D. Mollo, L. Scotti, N. et al. (2012). Postoperative pain after manual and mechanical glide
path: a randomized clinical trial. J Endod; 38: 32–6.
Pintor, A.V. Dos Santos, M.R. Ferreira, D.M. Barcelos, R. Primo, L.G. Maia, L.C. (2016). Does smear
layer removal influence root canal therapy outcome? A systematic review. Journal of Clinical
Pediatric Dentistry.;40(1):1-7.
Predin Djuric, N. Van Der Vyver, P. Vorster, M. Vally, Z.I. (2021). Comparison of apical debris
extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and
reciprocating systems. Aust Endod J.;47:394–400
Predin, Djuric, N., Van Der Vyver, P. Vorster, M. Vally, Z.I. (2021). Comparison of apical debris
extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and reciprocating systems. Aust Endod J.;47:394–400.
Riyahi, M.A. Bashiri, A. Alshahrani, K. Alshahrani, S. Alamri, H.M. Sudani, D.A. (2020). Cyclic Fatigue
comparison of TruNatomy, Twisted File, and ProTaper Next Rotary Systems. Int J Dent.:3190938.
Roshdy, N.N. and Hassan, R. (2022). Quantitative evaluation of apically extruded debris using
TRUShape, TruNatomy, and WaveOne Gold in curved canals. BDJ Open, 8: 13.
Silva, E.J. Sa, L. Belladonna, F.G. Neves, A.A. Accorsi-Mendonca, T. Vieira, V.T., et al. (2014).
Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod. ,40:2077–80.
Al omari, T. El farraj, H. Arican, B. Atav Ates, Ayfer. (2021). Apical debris extrusion of full-sequenced
rotary systems in narrow ribbon-shaped canals. Australian endodontic journal.
Tanalp, J. and Gungor, T. (2014). Apical extrusion of debris: a literature review of an inherent occurrence
during root canal treatment. Int Endod J.,47:211–21.
Tanalp, J. and Gungor, T. (2014). Apical extrusion of debris: a literature review of an inherent occurrence
during root canal treatment. Int Endod J, 47, 211–21.
Ünal, B. and Zan, R. (2022). Comparative Evaluation of the Effect of Different Rotary Instrument
Systems on the Amount of Apically Extruded Debris. Cumhuriyet Dental Journal, 25(2): 172-
178.
Uslu, G. Gundogar, M. Özyurek, T. et al (2020). Cyclic fatigue resistance of reduced-taper nickel
titanium (NiTi) instruments in doubled-curved (S-shaped) canals at body temperature. J Dent Res Dent Clin Dent Prospects;14(2):111. DOI: 10.34172/joddd.2020.024.
Üstün, Y. Çanakçi, B.C. Dinçer, A.N. Er, O. Düzgün, S. (2015). Evaluation of apically extruded debris
associated with several Ni–Ti systems. Int Endod J.;48:701–4.
Uzunoglu, E. Turker, S.A.(2016). Impact of different file systems on the amount of apically extruded
debris during endodontic retreatment. Eur J Dent, 10, 210‑4.
Van der Vyver, P. Vorster, M.J. and Peters, O. A. (2019). “Minimallyinvasive endodontics using a new
single-file rotary system,”International Dentistry–African Edition, vol. 9, no. 4, pp. 6–20.
Van der Vyver, P.J., Vorster, M., Peters, O.A. (2019). Minimally invasive endodontics using a new
single-file rotary system. Int Dent Afr Ed. ,9,6–20.
Virdee, S.S. Seymour, D.W. Farnell, D. Bhamra, G. Bhakta, S. (2018). Efficacy of irrigant activation
techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. International endodontic journal. Jun;51(6):605-21.
Wahed, A. (2021). COMPARATIVE ASSESSMENT OF APICALLY EXTRUDED DEBRIS USING
PROTAPER NEXT, HYFLEX CM AND EDGEFILE X7 NICKEL TITANIUM INSTRUMENTS (AN IN VITRO STUDY). Egyptian Dental Journal. 67, 3751:3757.
Zinge, P.R and Patil, J. (2017). Comparative evaluation of effect of rotary and reciprocating single-file
systems on pericervical dentin: A cone-beam computed tomography study. Journal of Conservative dentistry, 20(6), 424–428
Published
2022-12-06
How to Cite
JAMIL , V. S., & IBRAHEEM, A. R. (2022). APICALLY EXTRUDED DEBRIS ASSOCIATED WITH TRUNATOMY, 2SHAPE, GENIUS AND EDGEENDO X7 FILE SYSTEMS: AN IN VITRO STUDY . Journal of Duhok University, 25(2), 312-320. https://doi.org/10.26682/sjuod.2022.25.2.29
Section
Pure and Engineering Sciences
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