Main Article Content
Apical Extrusion, Intracanal, Biofilm, Root Canal, Rotary Instrumentation, In Vitro Study
Background- Endodontic instrumentation carries the risk of extrusion of debris and bacteria. The instrumentation technique used and the type of instrumentation influences this risk of extrusion.
Aim- The purpose of this study was to evaluate and compare the apical extrusion of intracanal biofilm after root canal preparation using Hyflex CM, K3XF and Heroshaper.
Objective- 1)To evaluate the amount of bacteria extruded apically after root canal preparation using Hyflex CM.
2)To evaluate the amount of bacteria extruded apically after root canal preparation using K3XF.
3)To evaluate the amount of bacteria extruded apically after root canal preparation using Heroshaper.
4)To compare the amount of bacteria extruded apically after root canal preparation using Hyflex CM, K3XF, Heroshaper.
Methodology- Sixty five extracted single-rooted human mandibular premolar teeth were used. Endodontic access cavities were prepared and root canals were then contaminated with a suspension of Enterococcus faecalis and dried. Re-inoculation process was done upto 30 days.The contaminated roots were divided into five groups. Group 1=Hyflex CM,Group 2=K3xf,Group 3=Heroshaper,Group 4= Negative Control Group,Group 5= Positive Control Group.Before instrumentation positive control group was checked by SEM.Group 1,2 and 3 were instrumented upto #25,4%.Bacteria extruded from the apical foramen during instrumentation were collected into vials.Samples were incubated in brain heart incubation agar at 370 C for 24 hr.The resulting bacterial titre ,in colony-forming units(CFU) per ml was determined. The data obtained were analysed using the Analysis of variance (ANOVA) Test and post hoc analysis.
Results- Heroshaper extruded least amount of bacteria followed by K3XF files. Maximum extrusion of E. faecalis was seen in hyflex CM group.
Conclusion- All the rotary instruments extruded bacteria apically after root canal preparation.
2. Er K, Sümer Z, Akpınar KE. Apical extrusion of intracanal bacteria following use of two engine‐driven instrumentation techniques. International endodontic journal. 2005 Dec;38(12):871-6.
3. Mohammadi Z, Palazzi F, Giardino L, Shalavi S. Microbial biofilms in endodontic infections: an update review. Biomedical journal. 2013;36(2):59-70.
4. Narayanan LL, Vaishnavi C. Endodontic microbiology. Journal of conservative dentistry: JCD. 2010 Oct;13(4):233.
5. Jhajharia K, Parolia A, Shetty KV, Mehta LK. Biofilm in endodontics: a review. Journal of International Society of Preventive & Community Dentistry. 2015 Jan;5(1):1.
6. Usha HL. Biofilm in endodontics: New understanding to an old problem. International Journal of Contemporary Dentistry. 2010 Dec 28;1(3).
7. Garlapati R, Venigalla BS, Patil JD, Raju RV, Rammohan C. Quantitative evaluation of apical extrusion of intracanal bacteria using K3, Mtwo, RaCe and protaper rotary systems: An in vitro study. Journal of conservative dentistry: JCD. 2013 Jul;16(4):300.
8. Siqueira Jr JF, Rôças IN. Bacterial pathogenesis and mediators in apical periodontitis. Brazilian dental journal. 2007;18(4):267-80.
9. Dr. AmanAbrol , Dr. Arvinderpal Singh , Dr. Charanjeet Singh , Dr. Anuj Sharma , Dr. PriyaPundir.A comparison of apical bacterial extrusion in manual, mtwo and v taper rotary instrumentation techniques- an in -vitro study.International Journal of Current Research.2018 July 1;10(7):71898-71901.
10. Siqueira Jr JF. Microbial causes of endodontic flare‐ups. International Endodontic Journal. 2003 Jul;36(7):453-63.
11. ZahedMohammadi DMD MS. In vitro evaluation of apical extrusion of bacteria following use of new rotary instrumentation system. New York State Dental Journal. 2009 Apr 1;75(3):28.
12. Neelakantan P, Romero M, Vera J, Daood U, Khan A, Yan A, Cheung G. Biofilms in endodontics—current status and future directions. International journal of molecular sciences. 2017 Aug;18(8):1748.
13. Kalra P, Rao A, Suman E, Shenoy R, Suprabha BS. Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria-An in vitro randomized trial. Journal of clinical and experimental dentistry. 2017 Feb;9(2):e254.
14. Al-Mizraqchi AS, Al-Hashimi WN, Shalan LA. Comparative study of apical extrusion of intracanal bacteria using different instruments and techniques (In vitro study). Journal of baghdad college of dentistry. 2009;21(2):23-7.
15. Uslu G, Özyürek T, Yılmaz K. Comparison of alterations in the surface topographies of HyFlex CM and HyFlex EDM nickel-titanium files after root canal preparation: a three-dimensional optical profilometry study. Journal of endodontics. 2018 Jan 1;44(1):115-9.
16. Kumar GP, Godavarthy DS, Yarlagadda M, Beesetty N, Killi N. Apical Extrusion of Debris in Mesiobuccal Root of Maxillary Molars with Five Rotary File Systems. Journal Of Clinical And Diagnostic Research. 2018 May 1;12(5):Zc5-9.
17. Tanalp J, Kaptan F, Sert S, Kayahan B, Bayirl G. Quantitative evaluation of the amount of apically extruded debris using 3 different rotary instrumentation systems.OOOOE. 2006 Feb 1;101(2):250-7.
18. N Upendranatha Reddy,M. Chandrashekhar , M. Gopikrishna Reddy , S Naga Lakshmi Reddy , A Praveen Kumar Reddy , Y Pavan Kumar. An in vitro Comparison of Apically Extruded Debris with the use of Full Sequence M-two and Heroshaper Ni-Ti File systems. International journal of Contemporary Medical Research.2017; Feb 4(2):309-11.
19. Jindal R, Singh S, Gupta S, Jindal P. Comparative evaluation of apical extrusion of debris and irrigant with three rotary instruments using crown down technique–An in vitro study. Journal of oral biology and craniofacial research. 2012 May 1;2(2):105-9.
20. Taneja S, Kumari M, Barua M, Dudeja C, Malik M. Apical extrusion of Enterococcus faecalis using three different rotary instrumentation techniques: An in vitro study. Indian Journal of Dental Research. 2015 Jan 1;26(1):67.
21. Gavini G, Santos MD, Caldeira CL, Machado ME, Freire LG, Iglecias EF, Peters OA, Candeiro GT. Nickel–titanium instruments in endodontics: a concise review of the state of the art. Brazilian oral research. 2018;32.
22. Zan R, Tunç T, Hubbezoglu I, Sumera Z. Apical extrusion of intracanal biofilm using ProTaper Gold, WaveOne Gold, Twisted File Adaptive, OneShape new generation and K3XF. EurEndod J. 2016 Sep 13;1:3.
23. Zan R, Topcuoglu HS, Tunc T, Ozer SG, Hubbezoglu I, Kutlu G. Apical extrusion of intracanal biofilm after root canal preparation using Revo-S, Twisted File Adaptive, One Shape New Generation, ProTaper Next, and K3XF instrumentation systems. Turkish Endodontic Journal (TEJ). 2016;1(2):73-9.
24. Ghogre P, Chourasia HR, Agarwal M, Singh MP, Gurav S, Ghogre R. Quantitative evaluation of apical extrusion of intracanal bacteria using rotary ProTaper, K3XF, twisted and hand K-file system: An ex vivo study. Indian Journal of Dental Research. 2015 Jul 1;26(4):406.
25. Garlapati R, Venigalla BS, Patil JD, Raju RV, Rammohan C. Quantitative evaluation of apical extrusion of intracanal bacteria using K3, Mtwo, RaCe and protaper rotary systems: An in vitro study. Journal of conservative dentistry: JCD. 2013 Jul;16(4):300.