Retreatment efficacy of hand versus automated instrumentation in oval‐shaped root canals: an ex vivo study (original) (raw)
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Retreatment Efficacy of Hand vs Rotary Instrumentation in Oval-shaped Root Canals: An In Vitro Study
World Journal of Dentistry
Complete removal of obturating material exposes the necrotic tissue remnant that may be accountable for the posttreatment disease. Removal of GP and root canal sealers would assist in maximizing the ability to disinfect the root canal system. Gutta-percha in conjunction with different sealers is the most commonly used obturation material. Different techniques have been used to remove GP from the root canal which includes use of K-type or H-files along with solvents such as, chloroform, IntroductIon One of the primary goals of endodontic treatment is the elimination of microorganisms from the root canal. However, root canal treatment may fail even when the treatment is carried out with the highest standard and the most meticulous treatment procedure. In most cases, the endodontic failure results from persistent or secondary intraradicular infection. 1,2 Initial root canal treatment failure rate is about 14-16%. 3 Previously treated teeth with persistent periapical infection might be retained with nonsurgical Retreatment or endodontic surgery, assuming the tooth is restorable, periodontally sound, and the patient desires to retain the tooth. An epidemiological study was done by Kvist and Reit to know the success of nonsurgical Retreatment and surgical Retreatment. There was no statistically significant difference between the success rate of surgical and nonsurgical Retreatment; the most commonly selected treatment for failed endodontic cases is nonsurgical Retreatment as surgical Retreatment resulted in more postoperative discomfort, trauma to the normal oral tissues, and postsurgical complications. 3 A nonsurgical Retreatment showed a higher success rate of 83.0% compared with 71.8% for endodontic surgery. An endodontic surgery offers more favorable initial success, but nonsurgical Retreatment offers a more favorable long-term outcome. 4 Nonsurgical endodontic Retreatment aims to eliminate previous obturating material which is followed by complete mechanical as well as chemical disinfection and in the end a three-dimensional obturation of the root canal complex. 5
IP Innovative Publication Pvt. Ltd., 2017
Nonsurgical endodontic retreatment consists of cleaning, shaping, and three dimensional filling of previously obturated root canals. It is the treatment of choice for the management of endodontic failures when access to the root canals is feasible. To successfully accomplish retreatment, all the obstructions preventing a direct access to the root canals need to be removed. For this study 60 freshly extracted human mandibular premolars with single canals were collected. These 60 teeth were endodontically treated and then again divided into 2 groups consisting of 30 samples each for retreatment. Of the two groups on one group retreatment was performed with RC solvent and other group without RC solvent. Efficacy of two nickel titanium instruments over H files with and without use of RC solvent in removal of gutta-percha in root canal retreatment was evaluated in this study. The amount of remaining gutta-percha was evaluated using image analysis software.
The Journal of Contemporary Dental Practice
Aim: The aim of the present study was to evaluate the efficacy of different instrumentation for removal of gutta-percha and sealers in endodontic retreatment. Materials and methods: A total of single-rooted mandibular premolars were collected. Access opening was performed in all specimens. The working length was determined by reducing 1 mm from the length of instruments that were seen reaching the apex. All the canals were dried with paper points. Lateral condensation technique was used to obturate the canals with gutta-percha and zinc oxide eugenol was used as a sealer. The specimens were randomly segregated into three experimental groups. Group I: ultrasonic retreatment tip, group II: R-Endo retreatment files, group III: Mtwo retreatment files. Roots were grooved into two halves with a diamond disc in a longitudinal, buccolingual direction. A stereomicroscope with ×40 magnification was used to image the quantity of gutta-percha and sealer on canal walls. Results: With ultrasonic retreatment tip, least amount (1.96 ± 0.32) of gutta-percha and sealer remained, followed by Mtwo retreatment files (2.84 ± 0.24) and R-Endo retreatment files (3.18 ± 0.63). A statistically significant inter-group difference among different instrumentation groups was demonstrated by ANCOVA analysis. Conclusion: In the present study, ultrasonic retreatment tip file systems was found to be more effective in the removal of root canal filling material, followed subsequently by Mtwo retreatment file system and R-Endo retreatment file system. Clinical significance: Thorough removal of filling material from the root canals is essential during root canal retreatment for probable cleaning and shaping of canal morphology. Thus, clinicians should be aware of the suitable and better instrumentation system that provides a clean and sterile root canal system without any debris.
Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment
Journal of …, 2006
The purpose of this study was to evaluate the efficiency of FlexMaster, ProTaper, and RaCe rotary instruments compared with Hedström files for removal of guttapercha during retreatment. Sixty mandibular premolars with one single straight canal were instrumented with K-type files and filled using cold lateral compaction and sealer. The teeth were randomly divided into four groups of 15 specimens each. After repreparation with Gates Glidden burs and the test instruments the specimens were cleared. The area of remaining gutta-percha/sealer on the root canal wall was measured from two directions. The RaCe group showed significantly less residual obturation material than FlexMaster and Hedström group (p Ͻ 0.05; closed test procedure). There was no difference between ProTaper and all other instruments (p Ͼ 0.05). ProTaper and RaCe instruments required significantly less time for retreatment than FlexMaster and Hedström files (p Ͻ 0.05). One RaCe file, two ProTaper, and two FlexMaster instruments separated. RaCe cleaned obturated canals more effectively than hand files and FlexMaster files. (J Endod 2006;32:469 -472)
Journal of Endodontics, 2008
The aim of this study was to measure the remaining filling volume of different obturation materials from root-filled extracted teeth by using 2 removal techniques. Eighty single-rooted teeth were collected and decoronated, and the root canal was prepared by using the ProTaper nickel-titanium rotary files. The teeth were randomly allocated into 4 groups, and each group was obturated by using a different material. Group 1 was filled with gutta-percha and TubliSeal sealer, group 2 was filled with EndoRez points and EndoRez sealer, group 3 was filled with RealSeal points and RealSeal sealer, and Group 4 was filled with a gutta-percha point and GuttaFlow sealer. Teeth were scanned with a micro-computed tomography scan, and then root fillings were removed by using ProTaper retreatment files or hand K-files. Teeth were scanned again, and volume measurements were carried out with micro-computed tomography software. Statistical analysis showed significant differences between the 2 removal techniques for gutta-percha and for both techniques between gutta-percha and the other groups. T h e present study showed that all tested filling materials were not completely removed during retreatment by using hand or rotary files. Gutta-percha was more efficiently removed by using hand K-files. (J Endod 2008;34:1370 -1373
Journal of clinical and experimental dentistry, 2016
Complete removal of old filling material during root canal retreatment is fundamental for predictable cleaning and shaping of canal anatomy. Most of the retreatment methods tested in earlier studies have shown inability to achieve complete removal of root canal filling. Therefore the aim of this investigation was to assess the efficacy of three different rotary nickel titanium retreatment systems and Hedstrom files in removing filling material from root canals. Sixty extracted mandibular premolars were decoronated to leave 15 mm root. Specimen were hand instrumented and obturated using gutta percha and AH plus root canal sealer. After storage period of two weeks, roots were retreated with three (Protaper retreatment files, Mtwo retreatment files, NRT GPR) rotary retreatment instrument systems and Hedstroem files. Subsequently, samples were sectioned longitudinally and examined under stereomicroscope. Digital images were recorded and evaluated using Digital Image Analysing Software. ...
The Journal of Contemporary Dental Practice
Aim: One of the common dental procedures employed these days in patients with irreversible pulpitis is root canal therapy. In retreatment cases, it is necessary for complete removal of obturate gutta-percha (GP) from obturate root canal system. Various methods and techniques are available these days for this purpose. This study was aimed to assess the efficacy of D-RaCe files, ProTaper retreatment files, Mtwo retreatment files, and manual Hedstrom files (H-files) in removing filling materials from the root canals of the endodontically treated teeth. Materials and methods: The present study included comparative evaluation of efficacy of nickel-titanium (NiTi) retreatment instruments and H-files in removing GP and sealer from root canals. All the samples were randomly and broadly divided into four study groups based on the instrumentation technique for removing the root canal fillings. Evaluation of the results was done based on operating time and remaining root canal filling material. Stereomicroscopic evaluation of the samples was done at 8× magnification. Results: All the results were assessed and analyzed by Statistical Package for the Social Sciences (SPSS) software. Least quantity of filling material was left by ProTaper retreatment files. When put together in decreasing order, the efficacy of different study groups, in terms of mean time taken for retreatment, was found to be as follows: D-RaCe > ProTaper Retreatment > Mtwo Retreatment > H-file. Conclusion: No single technique can completely remove obturating fillings from the root canals of endodontically treated
Aim: To compare the effectiveness of conventional and rotary NiTi files for Gutta-Percha (GP) removal in straight roots during retreatment root canal treatment (RCT), using manual Hedstrom files and ProTaper Universal System, respectively. Methods: It was an in-vitro experimental study using non-probability consecutive sampling. Sixty extracted single rooted maxillary and mandibular permanent teeth with straight canals were selected for this study. Following preparation, the root canals were filled with GP along with a sealer and kept for two weeks in a moist environment at room temperature. Thirty teeth were randomly allocated to the study and control groups each. GP removal was accomplished with Hedstrom files and Pro Taper retreatment files in group 1 and group 2, respectively. Digital radiographs were obtained using Kodak RVG digital radiography system software version VER.6.10.8.3-A and analyzed for the difference of opacities indicating residual GP. AutoCAD 2006 software was u...