Comparative in vitro study of apically extruded material after four different root canal Instrumentation techniques.
Forty newly extracted human upper central incisors were submitted to root canal instrumentation 1 mm from the apex using four different techniques: standard, step-preparation, crown-down, and ultrasound, with distilled and deionized water as the irrigating solution. The extrusion product was collected into a collecting device constructed for this purpose. Extrusion was calculated by the determination of the mass of extruded material. The step-preparation technique caused a larger amount of extrusion than the standard technique, which in turn caused greater extrusion than the crown-down and ultrasound techniques. All techniques used caused extrusion of material beyond the apical foramen.