An In Vitro Comparison of Apically Extruded Debris and Instrumentation Times with ProTaper Universal, ProTaper Next, Twisted File Adaptive, and HyFlex Instruments

Introduction: The purpose of this study was to compare the in vitro amount of apically extruded debris with new endodontic rotary nickel-titanium instruments. Methods: Sixty mandibular premolars were instrumented up to size 25 using ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (Dentsply Maillefer), Twisted File Adaptive (SybronEndo, Orange, CA), and HyFlex (Coltene-Whaledent, Allstetten, Switzerland) rotary systems. The apically extruded debris was collected and dried in pre-weighed Eppendorf tubes. The amount of extruded debris was assessed with an electronic balance. The total. time required to complete root canal shaping with the different instruments was also recorded. The significance level was set at P = .05. Results: The instrumentation time with the ProTaper Universal rotary system was significantly longer than with all the other instruments (P <.05). The Twisted File Adaptive and ProTaper Next systems extruded significantly less debris than the ProTaper Universal and HyFlex systems (P < .05). Conclusions: The ProTaper Next and Twisted File Adaptive instrumentation systems were associated with less debris extrusion compared with the ProTaper Universal and HyFlex systems.