Citation Information :
Sivakumar JS, Vaiyapuri R, Loganathan B, Mathimaraiselvan C, Sivakumar A, Prasad AS. Comparative Evaluation of the Amount of Apical Extrusion of Bacteria from the Root Canal System Using Different Instrumentation Techniques: An In Vitro Study. J Oper Dent Endod 2019; 4 (2):88-91.
Aim: To evaluate the amount of apical extrusion of bacteria from the root canal system following the use of different instrumentation techniques.
Materials and methods: A total of 45 single-rooted mandibular premolar teeth were used. Access opening was done and root canals were then contaminated with a suspension of Enterococcus faecalis and then dried. The contaminated roots were divided into three experimental groups of 15 teeth each. GI: Hand instrumentation. The root canals were instrumented using the K-file in the step-back technique. GII: The root canals were instrumented using the Protaper Gold File system. GIII: The root canals were instrumented using the Mtwo File system. Bacteria extruded from the apical foramen during the instrumentation were collected in the vials. The resultant microbiological samples were removed from the vials and then incubated in culture media for 24 hours. The number of colony-forming units (CFU) was determined for each sample. The data obtained were analyzed using the Kruskal–Wallis one-way analysis of variance and Mann–Whitney U-tests, with α = 0.05 as the level for statistical significance.
Results: There was a significant difference between the rotary instrumentation technique and the hand instrumentation technique (p < 0.05). The hand instrumentation technique was associated with the greatest apical extrusion of bacteria.
Conclusion: All instrumentation techniques extruded intracanal bacteria apically. No significant difference was found in the number of CFU among the rotary instrumentation groups; the hand instrumentation technique extruded significantly more bacteria.
Siqueira JF. Microbial cause of endodontic flare-ups. Int Endod J 2003;36(7):453–463. DOI: 10.1046/j.1365-2591.2003.00671.x.
Morse DR. Asymptomatic teeth with associated pulp and associated periapical radiolucencies: relation of endodontic flare-ups to endodontic instrumentation, antibiotic usage and stress in three separate practices at three different time periods. 1-5. Int J Psychosomat 1986;33(1):335–387.
Torabinejad M, Kettering JD, McGraw JC, et al. Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps. J Endod 1988;14(5):261–266. DOI: 10.1016/S0099-2399(88)80181-X.
Kuştarci A, Akpinar KE, Sümer Z, et al. Apical extrusion of intracanal bacteria following use of various instrumentation techniques. Int Endodon J 2008;41(12):1066–1071. DOI: 10.1111/j.1365-2591.2008.01470.x.
Bartles HA, Noidarf IJ. A study of some associated factors associated with endodontic flare-ups. Oral Surg, Oral Med, Oral Pathol 1968;25(2):255–261. DOI: 10.1016/0030-4220(68)90287-9.
Er K, Sümer Z, Akpinar KE. Apical extrusion of intracanal bacteria following use of two engine-driven instrumentation techniques. Int Endod J 2005;38(12):871–876. DOI: 10.1111/j.1365-2591.2005.01029.x.
Dahlen G, Haapasalo M. Microbiology of apical periodontitis. In: Orstavik D, Pitt Ford TR. Essential Endodontology: Prevention and Treatment of Apical Periodontitis. 1st ed., Oxford, UK: Blackwell Sciences Ltd; 1998. pp. 106–125.
Portenier I, Waltimo TMT, Haapasalo M. Enterococcus faecalis – the root canal survivor and ‘star’ in post-treatment disease. Endodon Top 2003;6(1):135–159. DOI: 10.1111/j.1601-1546.2003.00040.x.
Seltzer S, Soltanoff W, Sinai I, et al. Biologic aspects of endodontics, 3. Periapical tissue reactions to root canal instrumentation. Oral Surg, Oral Med Oral Pathol 1968;26(4):534–546. DOI: 10.1016/0030-4220(68)90334-4.
Torneck CD, Smith JS, Grindall P. Biologic effect of endodontic procedures on developing incisor teeth. 3. Effect of debridement and disinfection procedures in the treatment of experimentally induced pulp and periapical disease. Oral Surg, Oral Med, Oral Pathol 1973;;35(4):532–540. DOI: 10.1016/0030-4220(73)90011-x.
Ruiz-Hubard EE, Gutmann JL, Wagner MJ. A quantitative assessment of canal debris forced periapically during root canal instrumentation using two different techniques. J Endodont 1987;13(12):554–558. DOI: 10.1016/S0099-2399(87)80004-3.
Kayaoglu G, Ørstavik D. Virulence factors of enterococcus faecalis: relationship to endodontic disease. Crit Rev Oral Biol Med 2004;15(5):308–320. DOI: 10.1177/154411130401500506.
Harish Kumar Shetty SK, Ravi Varma K, Prathap MS. Apical extrusion of bacteria from the root canal system following instrumentation-an ex vivo evaluation. Endodontol 2017. 46–54.