The goals of endodontic instrumentation include thorough debridement and disinfection of the root canal system, in addition to creating a suitable shape to achieve a complete 3D obturation. In an effort to obtain these goals, debris such as dentinal shavings, necrotic pulp tissue, bacteria and their byproducts or irrigants may be extruded into the periradicular tissue. The extruded material has been referred to as a ‘worm’ of necrotic debris and has been cited as a major cause of mid-treatment flare-ups. Studies have shown that almost all instrumentation techniques produce apical debris to some extent. Vande Visse and Brilliant were the first to quantify the amount of debris extruded apically. They concluded that instrumentation without irrigation did not produce any significant collectable debris. A common finding of the studies examining the amount of apically extruded debris was that the instrumentation techniques using a push-pull motion tend to produce more apical debris than instrumentation techniques using a rotational motion. This has led to the hypothesis that instrument systems utilizing a rotary motion will produce lesser debris. As these instruments can vary among themselves in their design and use, differences may also exist between them with regard to apically extruded debris. The ProTaper hand, ProTaper rotary and ProFile are three contemporary instrumentation systems preferred for their shaping and time-saving ability.
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