Apical extrusion of debris when using OneCurve, ProTaper Next and TruNatomy in curved canals.

BACKGROUND: The extrusion of apical debris is related to various factors, and may be affected by variations in technique or instrumentation system. Although the extrusion cannot be completely prevented, it is crucial to minimize the amount of extruded material. OBJECTIVES: The present study aimed to compare apical debris extrusion by the novel TruNatomy (TRN), OneCurve (OC) and ProTaper Next (PTN) instruments in curved root canals. MATERIAL AND METHODS: A total of 60 multi-rooted human mandibular molar teeth with moderate and severe curvature were selected and randomly divided into 3 groups. The root canals were prepared with the OC, TRN and PTN files. For collecting the debris extruded through the apical foramen, Eppendorf tubes were used. After the vaporizing period, the tubes were re-weighed, and the amount of the extruded debris was calculated by subtracting the initial weight from the final weight. Statistical analysis was performed with the Shapiro-Wilk and Kruskal-Wallis tests. The statistical significance level was set at p < 0.05. RESULTS: The least amount of debris was extruded with TRN and the greatest with PTN, but the difference between the groups was not significant (p = 0.257). CONCLUSIONS: All instrumentation systems were associated with debris extrusion. The tested file systems presented similar results in terms of apical debris extrusion in curved canals. The novel TRN system demonstrated promising results, comparable to OC and PTN.

Efficacy of various activation techniques on tubule penetration of resin-based and bioceramic root canal sealers: An in vitro confocal microscopy study.

To compare the penetration of Ah Plus and MTA Fillapex after irrigation activation with sonic, passive ultrasonic, SWEEPS and XP-Endo Finisher using confocal microscopy. Instrumented root canals of 160 mandibular premolar teeth were allocated randomly to four groups (n = 40/group) and eight subgroups according to the activation techniques and canal sealers (n = 20/subgroup). After the obturation, three sections at 1-2, 5-6 and 9-10 mm levels from the apex were examined. Penetration area and maximum penetration depth values were represented as mean and standard deviation, and results below 0.05 were considered statistically significant. For penetration area and maximum penetration depth, the statistical difference was found in terms of material, device and region (Maximum penetration depth: p = 0.006, p < 0.001, p < 0.001; Penetration area: p = 0.004, p < 0.001, p < 0.001). SWEEPS was found to be relatively higher than other groups. Sealers presented similar results when evaluated independently of the region. The use of SWEEPS for irrigation activation is promising in terms of tubule penetration.

Dentinal tubule penetration of gutta-percha with syringe-mix resin sealer using different obturation techniques: A confocal laser scanning microscopy study.

This study aimed to evaluate dentinal tubule penetration of the root canal filling material using various techniques such as cold lateral compaction, new generation thermoplastic core carrier and continuous-wave obturation. The root canals of premolar teeth were instrumented, and the teeth were allocated randomly to three groups (n = 15/group). After the obturation with three different techniques, three sections of 2-mm thickness at 2, 5 and 8-mm from the apex were examined under a confocal laser scanning microscope. The data were analysed of variance with a significance level of P < 0.05. There was no significant difference between techniques when parameters were evaluated in total (penetration depth P = 0.418, penetration area P = 0.701). The mean value of the cold lateral compaction group for maximum penetration depth was obtained higher than continuous wave (P = 0.004), whilst there was no significant difference between the thermoplastic core carrier and the other groups.

A comparative investigation between ProTaper Next, Hyflex CM, 2Shape, and TF-Adaptive file systems concerning cyclic fatigue resistance.

Background. This study aimed to compare the cyclic fatigue resistance of ProTaper Next, Hyflex CM, 2Shape, and TF-Adaptive nickel-titanium endodontic file systems with various alloy properties and production methods and investigate the fractured cross-sectional surface of files due to cyclic fatigue by scanning electron microscopy (SEM). Methods. A total of 120 instruments were used (n=30). For standardization, #25/.06 apical diameter and taper angle were selected for each file system. The experiment of files was subjected to a static cyclic fatigue model. The time for files' failure was recorded with a digital chronometer and multiplied by the rotation speed to calculate the number of cycles. Kolmogorov-Smirnov, one-way ANOVA, and post hoc Bonferroni analysis were used for statistical analysis. Statistical significance was set at P < 0.05. Results. The number of cycles for the failure of files was compared between the groups, and significant differences were found (P < 0.05). The number of cycles for instrument failure was recorded from the highest to the lowest as follows: Hyflex CM, TF-Adaptive, ProTaper Next, and 2Shape. Conclusion. The files were fractured at different average numbers of cycles in an artificial canal in all the groups. The Hyflex CM demonstrated better cyclic fatigue resistance than TF Adaptive, ProTaper Next, and 2Shape file systems. Factors such as production patterns, alloy properties, and the phase in which the files were produced might affect the lifespan of file systems.

Effects of repeated sterilization cycles on the surface alterations of ProTaper Next, TF Adaptive, HyFlex CM, and 2Shape instruments.

Background. This study aimed to evaluate the effects of repeated sterilization cycles on the surface alterations of various nickel-titanium instruments, including ProTaper Next (PTN), TF Adaptive (TFA), HyFlex CM (HCM), and 2Shape (2S). Methods. Twenty-four new NiTi files of four different alloys were selected. The instruments in each group were divided into two equal groups, as follows: control and sterilization. The first group was chosen as the control without applying any sterilization procedure, while in group 2, five cycles of sterilization procedures were applied. The surface topographies were evaluated using scanning electron microscope (SEM) and atomic force microscope (AFM). The root mean square (RMS) and maximum height (MH) values and three-dimensional images were recorded. The data were analyzed with the Shapiro-Wilk test, one-way ANOVA, and post hoc Tukey tests. The statistical significance level was set at P ≤ 0.05. Results. Before the experiment, HCM demonstrated the highest RMS value, and 2S showed the lowest. After the procedures, the RMS and MH values deteriorated on the surface of PTX, TFA, and 2S (P < 0.001). The HCM was not affected by sterilization processes (P > 0.05). Conclusion. The initial irregularity on the surface did not affect the rate of alteration. The HCM files demonstrated superior surface properties after several cycles of sterilization. The PTN, TFA, and 2S presented similar surface responses after five cycles of autoclave sterilization.

Evaluation of Apically Extruded Debris Using Continuous Rotation, Reciprocation, or Adaptive Motion.

The aim of this study was to compare the amount of apically extruded debris during root canal instrumentation using ProTaper Next (PTN), Twisted File (TF) Adaptive, and Reciproc instruments. Forty-five extracted human maxillary canines were selected and randomly assigned into 3 groups. The root canals were prepared using PTN instruments with continuous rotation (n=15), TF Adaptive instruments with adaptive motion (n=15), Reciproc instruments with reciprocating motion (n=15). During the preparations, canals were irrigated using distilled water and material extruded apically was collected in pre-weighed Eppendorf tubes. After a 5-day drying period in an incubator, the tubes were weighed and the dry weight of the extruded debris was calculated. Data distributions were assessed via the Shapiro-Wilk test, and groups were compared via the Kruskal-Wallis test. The greatest amount of debris extruded by TF Adaptive and the least by PTN, but the difference was insignificant between groups (p=0.259). All instrumentation systems were associated with debris extrusion.

Effect of Mineral Trioxide Aggregate Apical Plug Thickness on Fracture Resistance of Immature Teeth.

INTRODUCTION: The aim of this study was to compare the fracture resistance of simulated immature teeth after using different thicknesses of mineral trioxide aggregate (MTA) apical plugs. METHODS: Fifty-two human maxillary anterior teeth were used. Five teeth were the positive control group; they were prepared using Peeso reamers to simulate immature teeth without any access cavity preparation. Access cavities of the 47 teeth were prepared, and the canals were instrumented with Peeso reamers. Five teeth served as the negative control; they were filled with calcium hydroxide. Forty-two teeth were divided into 3 groups; in groups 1, 2, and 3, MTA was placed into canals as a 3-mm and a 6-mm apical plug and a thorough canal length, respectively. The rest of the canals in groups 1 and 2 were filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). After the storage period, the roots were covered with a polyether impression material and were embedded into self-curing resin blocks. Each specimen was then subjected to fracture testing using a universal testing machine. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test for multiple comparisons. RESULTS: The negative group showed the lowest fracture resistance compared with the other groups. The 3-mm apical plug group showed the highest fracture resistance (P < .05). No significant differences were found between the 3-mm and 6-mm apical plug groups (P > .05). CONCLUSIONS: MTA should be used as an apical plug instead of root canal filling material to increase the fracture resistance of immature teeth.

Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study.

OBJECTIVES: The aim of this clinical study was to evaluate the influence of the instrumentation techniques on the incidence and intensity of postoperative pain in single-visit root canal treatment. MATERIAL AND METHODS: Ninety patients with single root/canal and non-vital pulps were included. The patients were assigned into 3 groups according to root canal instrumentation technique used; modified step-back, reciprocal, and rotational techniques. Root canal treatment was carried out in a single visit and the severity of postoperative pain was assessed via 4-point pain intensity scale. All the participants were called through the phone at 12, 24 and 48 h to obtain the pain scores. Data were analyzed through the Kruskal-Wallis test. RESULTS: There was significant difference between all groups (p<0.05). The modified step-back technique produced postoperative pain significantly lower than the rotational (p=0.018) and reciprocal (p=0.020) techniques. No difference was found between the reciprocal and rotational techniques (p=0.868). Postoperative pain in the first 12 h period (p=0.763) and in the 24 h period (p=0.147) was not significantly different between the groups. However, the difference in the 48 h period was statistically different between the groups (p=0.040). CONCLUSION: All instrumentation techniques caused postoperative pain. The modified step-back technique produced less pain compared to the rotational and reciprocal techniques.

Comparison of the amount of apical debris extrusion associated with different retreatment systems and supplementary file application during retreatment process.

BACKGROUND: The type of instrument affects the amount of debris extruded. The aim of this study was to compare the effect of retreatment systems and supplementary file application on the amount of apical debris extrusion. MATERIALS AND METHODS: Forty-eight extracted mandibular premolars with a single canal and similar length were selected. The root canals were prepared with the ProTaper Universal system with a torque-controlled engine. The root canals were dried and were obturated using Gutta-percha and sealer. The specimens were randomly divided into four equal groups according to the retreatment procedures (Group 1, Mtwo retreatment files; Group 2, Mtwo retreatment files + Mtwo rotary file #30 supplementary file; Group 3, ProTaper Universal retreatment (PTUR) files; and Group 4, PTUR files + ProTaper F3 supplementary file). The extruded debris during instrumentation were collected into preweighed Eppendorf tubes. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. Three consecutive weights were obtained for each tube. RESULTS: No statistically significant difference was found in the amount of apically extruded debris between Groups 1 and 3 (P = 0.590). A significant difference was observed between Groups 1 and 2 (P < 0.05), and between Groups 3 and 4 (P < 0.05). CONCLUSIONS: The use of supplementary file significantly increased the amount of apically extruded debris.

Evaluation of the dentinal wall adaptation ability of MTA Fillapex using stereo electron microscope.

BACKGROUND: An ideal root canal obturation requires a complete dentinal wall adaptation of sealer and Gutta-percha combinations without any gap formations. AIMS: The aim of the study was to evaluate the dentinal wall adaptation ability of MTA Fillapex root canal sealer using stereo electron microscope (SEM). METHODS: Twenty-four, single-rooted, human maxillary incisor teeth were used. All canals were prepared with a rotary nickel-titanium (Ni-Ti) instrument to a size F3 file. Teeth divided into two equal groups and one of the experimental groups was filled with AH Plus, and the other group was filled with MTA Fillapex using Gutta-percha single cone as a core material. The roots were prepared for SEM evaluation, and serial scanning electron photomicrographs were taken at ×50, ×100, ×500, and ×1000 magnifications. The gaps between the root canal sealer and canal walls were detected and measured in coronal, middle, and apical thirds. For each section, the highest value among the detected gap formations was recorded. STATISTICAL ANALYSIS: Mann-Whitney U-test, Freidman, and Wilcoxon tests were used. RESULTS: The statistical analysis showed no significant difference between two sealers in terms of gap formation (P > 0.05). CONCLUSIONS: MTA Fillapex has a similar dentinal wall adaptation ability as AH Plus does.

Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material.

AIM: The aim of this study was to compare the efficacy of hand file, nickel titanium rotary instrument, and two reciprocating instruments for removing gutta-percha and sealer from the root canals. MATERIALS AND METHODS: Eighty-eight mandibular premolar teeth were used. The root canals were shaped and filled with gutta-percha and a resin-based sealer. The specimens were divided into four groups according to the technique by which the root filling material was removed: Group 1 - Wave One; Group 2 - Reciproc; Group 3 - ProTaper; and Group 4 - Gates-Glidden burs and stainless steel hand file. Then teeth were split longitudinally and photographed. The images were transferred to a computer. The ratio of remaining filling material to the root canal periphery was calculated with the aid of ImageJ software. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney tests. RESULTS: A significant difference was found among all groups (P < 0.001). The WaveOne group demonstrated significantly less remaining filling material. The greatest amount of filling material was found in specimens where gutta-percha was removed with Gates-Glidden burs and stainless steel hand file. CONCLUSION: The reciprocating files were found to be significantly more effective in removing the filling material from the canal walls compared to the rotational file and hand file.

Influence of diode laser application on the efficiency of QMiX and EDTA solutions in removing smear layer.

OBJECTIVE: The aim of this study was to compare the efficacy of QMiX and ethylenediaminetetraacetic acid (EDTA) solutions with diode laser treatment in smear layer removal. BACKGROUND DATA: Removing the smear layer from the apical thirds of root canals is difficult, regardless of the solution used. Researchers have been improved some irrigation agitation methods to overcome this challenge, and agitation of irrigants with laser devices has become popular. METHODS: Seventy-five extracted mandibular premolars were used. After root canals were, prepared the specimens were divided into five groups (n = 15): Group 1, no irrigation; Group 2, 17% EDTA; Group 3, QMiX solution; Group 4, 17% EDTA with diode laser; and Group 5, QMiX with diode laser. The roots were split longitudinally and prepared for scanning electron microscopic (SEM) investigation. The smear layer was evaluated under × 500, × 1000, and × 2000 magnifications. RESULTS: The amount of smear layer was found significantly high in the control group (p < 0.001). In the EDTA group, the amount of smear layer was significantly high at the apical thirds, and the differences among the three regions were statistically significant (p < 0.001). In the QMiX group, no difference was found between the coronal and middle thirds; however, the amount of smear layer was significantly high at the apical thirds (p < 0.001). In the EDTA plus laser and the QMiX plus laser groups, the smear layer was found significantly high at the apical thirds (p < 0.001). However, no differences were found between the coronal and middle thirds in either group. CONCLUSIONS: None of the solutions completely removed the smear layer, especially at the apical thirds. Diode laser treatment with solutions decreased the amount of smear layer, without significance.

Comparison of Nd:YAG and diode laser irradiation during intracoronal bleaching with sodium perborate: color and Raman spectroscopy analysis.

OBJECTIVE: The aim of this study was to evaluate the color and enamel structure changes after intracoronal bleaching with sodium perborate under neodymium:yttrium-aluminum-garnet (Nd:YAG) and diode laser irradiation. BACKGROUND DATA: Although some studies investigated the efficacy of laser irradiation during intracoronal bleaching, no study has been conducted to investigate the changes in both color and enamel structure during intracoronal bleaching with laser irradiation. METHODS: Thirty-six extracted mandibular incisors were used. The root canals were prepared and filled with AH Plus and gutta-percha. Baseline color values and Raman spectra were obtained from all samples. The samples were randomly divided into three groups as follows: group 1, intracoronal bleaching with sodium perborate plus NdYAG laser irradiation; group 2, intracoronal bleaching with sodium perborate plus diode laser irradiation; and group 3, intracoronal bleaching with sodium perborate without any laser irradiation. Following the bleaching procedures, the final baseline color values and Raman spectra were obtained. The baseline and final values were statistically analyzed. Statistical analyses were performed with SPSS 18.0 software using Anova and the Kruskal-Wallis test. RESULTS: There was a significant difference between the Nd:YAG laser and control groups (p<0.05). There was no significant difference between the diode laser group and the control group, or the diode laser group and the Nd:YAG laser group. There was no significant difference among all groups in terms of Raman relative intensity (RRI) and fluorescence intensity (FI) percentage values (p>0.05). CONCLUSIONS: Laser application, especially Nd:YAG laser irradiation, was able to increase the efficacy of intracoronal bleaching with sodium perborate. Laser irradiation significantly increased the bleaching efficacy without any changes in the enamel surface structure.

Evaluation of microcrack formation in root canals after instrumentation with different NiTi rotary file systems: a scanning electron microscopy study.

The aim of this study was to evaluate the dentinal microcrack formation of ProTaper Universal, ProTaper Next, and WaveOne. Sixty extracted mandibular molars were selected. The mesial roots were resected and randomly divided into four groups (n = 15). The canals were prepared with hand files (group 1), ProTaper Universal (group 2), ProTaper Next (group 3), and WaveOne (group 4) instrument systems. The roots were separated horizontally at 3, 6, and 9 mm from the apex. Digital images were captured at ×40 magnification using scanning electron microscopy to detect microcrack formation. Statistical analysis was performed by Pearson Chi-square test. The prevalence of microcracks in group 2, group 3, and group 4 were significantly higher when compared to group 1 (p < 0.001). Group 2, group 3, and group 4 demonstrated similar prevalence of microcracks without significant difference (p > 0.05) in all sections. All instruments caused microcracks except for hand file. The highest percentage of microcrack was recorded in 3 mm section for all groups.

The effect of glide path on the surface quality of new and used rotary and reciprocating single files: OneShape versus WaveOne.

The aim of this study was to evaluate the effect of glide path preparation on the surface topography changes of WaveOne and OneShape single files using atomic force microscopy analysis. Two commercially available brands of single file systems were analyzed, including 15 specimens/brand as following: Group I; WaveOne 0.08/25 (Dentsply Maillefer, Ballaigues, Switzerland) and Group II; OneShape 0.06/25 (Micro Mega, Besançon, France). In each group, 3 new files were subjected to AFM analysis as received from manufacturer, and 12 files were analyzed after preparation of root canals. A total of 20 human maxillary molar teeth were selected. In each group, 12 files were divided into 4 subgroups according to instruments that were used in one or three root canals with or without a previous glide path (n = 3). After preparation the surface analysis of single files was performed on 11 different points located along a 3-mm section starting at the tip of each file using AFM. Root mean square (RMS) values were recorded to investigate the surface features of endodontic files. The differences between RMS values were tested by one-way ANOVA. There was no statistically significant difference between the groups (p > 0.05). Creation of a glide path did not affect the surface topography of single file systems.

Efficacy of three irrigation agitation techniques on bacterial elimination: a microbiologic and microscopic evaluation.

The aim of this study was to compare in vitro reduction of Enterococcus faecalis by using three agitation methods. Fifty-five mandibular premolar teeth were used. The root canals were prepared by using ProTaper instruments to size F4. Fresh bacterial suspensions were inoculated into each canal and the teeth were incubated at 37°C under aerobic conditions for 3 weeks. The specimens in negative control group were not contaminated and the teeth in positive control receive no further instrumentation or irrigation after contamination. The contaminated teeth were divided into three experimental groups and two control groups. The experimental groups were as follows according to agitation of NaOCl irrigation solution; group 1, the brush-covered NaviTip FX needle; group 2, EndoVac apical negative pressure irrigation system; and group 3, self-adjusting file (SAF). Following the final irrigation, samples obtained with sterile #40 H-file from teeth and the file used were placed into sterile microcentrifuge tubes. After the incubation period, bacterial colony numbers were noted as CFU/ml. Three teeths were randomly selected from each group for scanning electron microscope evaluation. The three groups were compared with the Kruskal-Wallis test. Comparisons between three groups were made with the Mann-Whitney U-test with Bonferroni correction. SAF was significantly effective in elimination of E. faecalis when compared to EndoVac (p < 0.05). There was no difference between NaviTip FX needle and other two methods (p > 0.05). In conclusion, agitation of NaOCl with SAF for 2 min may be an effective alternative approach.

Clinical comparison between the bleaching efficacy of light-emitting diode and diode laser with sodium perborate.

The aim of this clinical study was to test the efficacy of a light-emitting diode (LED) light and a diode laser, when bleaching with sodium perborate. Thirty volunteers were selected to participate in the study. The patients were randomly divided into two groups. The initial colour of each tooth to be bleached was quantified with a spectrophotometer. In group A, sodium perborate and distilled water were mixed and placed into the pulp chamber, and the LED light was source applied. In group B, the same mixture was used, and the 810 nm diode laser was applied. The final colour of each tooth was quantified with the same spectrophotometer. Initial and final spectrophotometer values were recorded. Mann-Whitney U-test and Wicoxon tests were used to test differences between both groups. Both devices successfully whitened the teeth. No statistical difference was found between the efficacy of the LED light and the diode laser.

Efficacy of different solvents in removing gutta-percha from curved root canals: a micro-computed tomography study.

The aim of this study was to compare the root filling material that remained after retreatment of curved root canals with chloroform and Endosolv R as solvents. The evaluation employed micro-computed tomography (CT) imaging. Thirty-six extracted molar teeth with curved roots were selected. After preparation with ProTaper rotary instruments, the canals were filled with gutta-percha and AH26 sealer. The teeth were randomly divided into three groups according to solvent used (n = 12) as follows: group 1: chloroform; group 2: Endosolv R; group 3: no solvent (negative control). ProTaper Universal Retreatment files were used to remove each root canal filling and then the self-adjusting file was applied for two minutes. Preoperative and postoperative micro-CT images were used to assess the percentage of residual filling material. The mean percentage of residual filling material was quantified. There were no statistically significant differences between the groups in terms of percentage volume of residual root canal filling.

Comparison of calcium hydroxide removal by self-adjusting file, EndoVac, and CanalBrush agitation techniques: An in vitro study.

OBJECTIVES: This study comparatively evaluated the efficacy of self-adjusting file (SAF), Endovac, and CanalBrush irrigant agitation protocols in removing calcium hydroxide (Ca(OH)2) from the root canals. MATERIALS AND METHODS: Sixty extracted human mandibular canine teeth were instrumented with ProTaper rotary instruments to size #40 and dressed with Ca(OH)2. The roots were randomly assigned to four groups according to irrigant agitation protocol used (n = 15). In Group 1: Conventional syringe irrigation (no activation, control); Group 2: Rotary brush agitation (CanalBrush); Group 3: Apical negative pressure irrigation (EndoVac system); and Group 4: Sonic agitation (SAF) were used. Scanning electron microscopic (SEM) evaluation was done for assessment of Ca(OH)2 removal in the coronal and apical thirds. Statistical analysis was performed by Wilcoxon and Kruskal-Wallis tests. RESULTS: There were statistically significant differences among the groups (P = 0.218). A statistically significant difference was seen between the test groups in Ca(OH)2 removal from the apical third of the canal (P < 0.05). In the coronal third, there was no difference between the groups (P > 0.05). The most efficient Ca(OH)2 removal in apical third was recorded in Group 3 (EndoVac) and Group 4 (SAF) (P < 0.05). In Group 4 (sonic agitation), there was no significantly difference between Ca(OH)2 removal in coronal and apical thirds. CONCLUSIONS: SAF and EndoVac showed significantly better performance than CanalBrush and conventional syringe irrigation in removing Ca(OH)2 from apical third of the root canals.

Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems.

INTRODUCTION: The purpose of this study was to evaluate the weight of debris extruded apically from teeth using different in vitro preparation techniques. METHODS: Sixty-eight extracted human mandibular premolars with single canals and similar lengths were instrumented using ProTaper F2 (25, .08; Dentsply Maillefer, Ballaigues, Switzerland), the Self-Adjusting File (1.5-mm diameter; Re-Dent Nova, Ra'anana, Israel), Revo-S SU (25, .06; MicroMega, Besancon, France), or Reciproc (R25; VDW GmbH, Munich Germany). Debris extruded during instrumentation were collected into preweighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70°C for 5 days. The Eppendorf tubes were weighed to obtain the final weight of the Eppendorf tubes when the extruded debris were included. Three consecutive weights were obtained for each tube. RESULTS: There were no statistically significant differences among the groups (P = .218). The ProTaper group produced the highest mean extrusion value. The Reciproc produced less debris compared with all the other instruments (P > .05). CONCLUSIONS: All instrumentation techniques were associated with extruded debris.