Apical extrusion following different glide path instrumentation in curved canals of mandibular molars.

Endodontic failures are usually the result of technical errors compromising the proper endodontic procedures required to control and prevent periradicular infections. Among these errors, the extrusion of materials through the apical foramen has been associated with periapical inflammation, postoperative pain, tissue necrosis, delayed periapical healing and long-term failure.

Aim: To compare the debris extruded through the apical foramen when different glide path files are used prior to endodontic instrumentation with the WaveOne Gold Primary file.

Materials and method: Twenty-four mesial roots of extracted human mandibular first molars were divided into three groups (n=8): C-Pilot hand file (CPH) #15/.02; R-Pilot (RPL); WaveOne Gold Glider (WGG). The roots were placed in Eppendorf tubes containing 1.5% agar gel and weighed before and after instrumentation to calculate the weight of debris and irrigant solution extruded. Apical extrusion of debris was compared using one-way analysis of variance. The Games-Howell test was used for multiple comparisons due to heteroscedasticity, with a significance level of 5%.

Results: Debris extrusion was significantly lower with the WaveOne Gold Glider file than with the R-Pilot file, which in turn produced less extrusion than the C-Pilot file.

Conclusion: All glide path files caused apical extrusion, with the WaveOne Gold Glider causing the least.