Evaluation of apical extrusion of debris, irrigant solution and bacteria after canal instrumentation using iRace, waveone and Protaper NEXT: An in vitro study

Aim: Extrusion of debris during endodontic preparation carries the risk of flare-ups. Purpose of this study was to evaluate and compare the three different rotary systems (ProTaper Next, WaveOne and iRace) for the amount of debris, irrigant, and bacteria they extruded apically. Materials and methods: Present study is an in vitro, experimental single-blinded randomized study. Thirty extracted premolars were used for the study. Biomechanical preparations of the specimens were done using either ProTaper Next, WaveOne or iRace file systems. The apically extruded irrigant was collected and measured using the Myers and Montgomery model. Statistical analysis was done using Mann–Whitney and Kruskal–Wallis test. The level of significance was set at <0.05. Results: Study revealed that WaveOne extruded least bacteria and debris and Protaper Next the highest which was statistically significant. WaveOne group and Protaper Next had more number of irrigant extrusion than iRace. The difference between WaveOne and iRace was statistically significant. A significant difference was noted in the amount of debris, bacteria, and irrigant between WaveOne and iRace. A significant difference was also noted in the amount of debris, irrigant, and bacteria extruded between Protaper Next and iRace. Conclusion: Significant amount of debris and bacterial extrusion was seen in ProTaper Next followed by iRace and WaveOne, whereas apical extrusion of irrigant solution, was greater with WaveOne than ProTaper Next and iRace. Clinical significance: WaveOne causes the least extrusion of debris and bacteria and this outcome would help in the selection of the system while choosing the rotary system for endodontic treatment.