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Ab s t r Ac t Aim: To evaluate the amount of apical extrusion of bacteria from the root canal system following the use of different instrumentation techniques. Materials and methods: A total of 45 single-rooted mandibular premolar teeth were used. Access opening was done and root canals were then contaminated with a suspension of Enterococcus faecalis and then dried. The contaminated roots were divided into three experimental groups of 15 teeth each. GI: Hand instrumentation. The root canals were instrumented using the K-file in the step-back technique. GII: The root canals were instrumented using the Protaper Gold File system. GIII: The root canals were instrumented using the Mtwo File system. Bacteria extruded from the apical foramen during the instrumentation were collected in the vials. The resultant microbiological samples were removed from the vials and then incubated in culture media for 24 hours. The number of colony-forming units (CFU) was determined for each sample. The data obtained were analyzed using the Kruskal–Wallis one-way analysis of variance and Mann–Whitney U-tests, with α = 0.05 as the level for statistical significance. Results: There was a significant difference between the rotary instrumentation technique and the hand instrumentation technique (p < 0.05). The hand instrumentation technique was associated with the greatest apical extrusion of bacteria. Conclusion: All instrumentation techniques extruded intracanal bacteria apically. No significant difference was found in the number of CFU among the rotary instrumentation groups; the hand instrumentation technique extruded significantly more bacteria.

journal of operative dentistry and endodontics

Comparative Evaluation of the Amount of Apical Extrusion of Bacteria from the Root Canal System Using Different Instrumentation Techniques: An In Vitro Study