COMPARATIVE EVALUATION OF APICALLY EXTRUDED DEBRIS AMONG TRUNATOMY, PROTAPER GOLD, AND GENENDO ROTARY NICKEL-TITANIUM FILE SYSTEMS: AN IN VITRO STUDY

Abstract

Background: Debris pushed beyond the apical terminus during canal shaping has long been implicated in postoperative discomfort, interappointment flare-ups, and delayed periradicular healing. Contemporary nickel-titanium (NiTi) rotary systems differ in taper, cross-sectional geometry, and kinematics — variables that can influence how much material is forced past the apex. Aim: To compare, in vitro, the quantity of apically extruded debris generated by TruNatomy, ProTaper Gold, and GenEndo rotary NiTi systems while shaping mandibular premolars, using the Myers and Montgomery apparatus. Materials and Methods: Thirty extracted single-rooted mandibular premolars of comparable canal anatomy were randomly divided into three equal groups (n = 10) and instrumented with TruNatomy, ProTaper Gold, or GenEndo within a Myers and Montgomery double-chamber setup. Debris forced past the apex was captured in pre-weighed Eppendorf tubes, desiccated, and re-weighed on an electronic analytical balance, with the weight gain representing extruded debris per specimen. Normality was checked with the Kolmogorov-Smirnov and Shapiro-Wilk tests; intergroup differences were analyzed by one-way analysis of variance (ANOVA), with pairwise comparisons via Tukey's Honestly Significant Difference (HSD) test, using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Results: Debris weights were normally distributed in all groups (p > 0.05). TruNatomy produced the smallest mean debris weight (1.13 ± 0.022 g), followed by GenEndo (1.24 ± 0.019 g) and ProTaper Gold (1.39 ± 0.022 g). One-way ANOVA showed a highly significant intergroup difference (F = 376.73, p < 0.001), and Tukey's HSD confirmed that every pairwise comparison reached significance (p < 0.001). Conclusion: Within the limits of this in vitro model, TruNatomy extruded significantly less apical debris than either GenEndo or ProTaper Gold, while ProTaper Gold extruded the most. File-design variables — particularly taper and cross sectional geometry — appear to be meaningful contributors to the tendency for apical extrusion.