Comparative analysis of debris extrusion and instrumentation time among various endodontic file systems: an in vitro study

Aim: Debris extrusion during endodontic procedures, characterized by the unintended displacement of root canal debris, poses significant clinical challenges, potentially leading to postoperative pain and infection. In this study, we aimed to evaluate the differences in debris extrusion and instrumentation time among various endodontic file systems. Methodology: 120 mandibular first molars were included in the study, with 15 specimens in each group: Protaper Next, HyFlex CM, HyFlex EDM, WaveOne Gold, Reciproc Blue, Trunatomy, PTUltimate, and Rmotion. Both debris extrusion and instrumentation time for these systems were assessed. Descriptive analyses were performed, and statistical comparisons were made using the Kruskal-Wallis test (p<0.05). Results: Protaper Next and HyFlex CM exhibited significantly higher mean debris extrusion compared to other systems. On the other hand, the remaining systems, showed lower mean debris extrusion. HyFlex CM was the most time-consuming, while WaveOne Gold, R-Motion, and Reciproc Blue were among the quickest. HyFlex EDM demonstrated a balanced performance, being efficient in both debris extrusion and time. Conclusions: The findings suggest that while some systems significantly minimize debris extrusion and reduce instrumentation time, the choice of an endodontic file system should be guided by specific clinical conditions and operator preference based on our comparative analysis.