The effect of the use of irrigation activationmethods with different file systems on theamount of apical debris extrusion

Aim: Our study aimed to compare the debris extrusion caused by Passive Ultrasonic Irrigation, Sonic Activation and Conventional Irrigation methods when used with different rotary and reciprocating file systems in irrigation activation. Materials and Methods: A total of 135 human mandibular premolar teeth were used in the study. The samples were divided into nine groups (n=15) by combining three irrigation activation methods and three file systems. After the experimental setups were prepared and the canal shaping of the teeth was completed using XP-endo Rise Shaper, ProTaper Ultimate, and WaveOne Gold files, irrigation activation was performed in each group. Distilled water was used as the irrigation solution. Eppendorf tubes containing distilled water and debris were kept in an incubator set at 37°C for 14 days. The tubes with remaining dry debris were weighed three times on a precision scale and the average of the weights was recorded. The previously recorded average weights of the empty tubes were subtracted from the final average weights of the tubes to obtain the apically extruded debris weights. Results: Passive Ultrasonic Irrigation caused the most debris extrusion among the irrigation activation methods (P=0.003). All file systems caused apical debris extrusion, but no significant differences were found among them (P>0.05). Among the combinations of file systems and irrigation activation methods, using the WaveOne Gold file and Sonic Activation together resulted in significantly less debris extrusion (P=0.009). Conclusions: Passive Ultrasonic Irrigation caused more apical debris extrusion than Sonic Activation and Conventional Irrigation. The combined use of WaveOne Gold with Sonic Activation in root canal treatments may help reduce postoperative pain and acute flare-ups.