Removal of the Previous Root Canal Filling Material for Retreatment: Implications and Techniques (original) (raw)
Related papers
Journal of Endodontics, 2008
The aim of this study was to compare the effectiveness of the Mtwo R (Sweden & Martina, Padova, Italy), ProTaper retreatment files (Dentsply-Maillefer, Ballaigues, Switzerland), and a Hedström manual technique in the removal of three different filling materials (gutta-percha, Resilon [Resilon Research LLC, Madison, CT], and EndoRez [Ultradent Products Inc, South Jordan, UT]) during retreatment. Ninety single-rooted straight premolars were instrumented and randomly divided into 9 groups of 10 teeth each (n ϭ 10) with regards to filling material and instrument used. For all roots, the following data were recorded: procedural errors, time of retreatment, apically extruded material, canal wall cleanliness through optical stereomicroscopy (OSM), and scanning electron microscopy (SEM). A linear regression analysis and three logistic regression analyses were performed to assess the level of significance set at p ϭ 0.05. The results indicated that the overall regression models were statistically significant. The Mtwo R, ProTaper retreatment files, and Resilon filling material had a positive impact in reducing the time for retreatment. Both ProTaper retreatment files and Mtwo R showed a greater extrusion of debris. For both OSM and SEM logistic regression models, the root canal apical third had the greatest impact on the score values. EndoRez filling material resulted in cleaner root canal walls using OSM analysis, whereas Resilon filling material and both enginedriven NiTi rotary techniques resulted in less clean root canal walls according to SEM analysis. In conclusion, all instruments left remnants of filling material and debris on the root canal walls irrespective of the root filling material used. Both the engine-driven NiTi rotary systems proved to be safe and fast devices for the removal of endodontic filling material. (J Endod 2008;34:466 -469)
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020
Introduction: Endodontic treatment failures are caused by persistent or secondary intraradicular infection due to inefficient treatment or re-infection of the obturated root canal system because of coronal or apical leakage. Complete removal of Gutta-Percha (GP) from the root canal system is essential during retreatment procedures in order to re-establish healthy periapical tissues. Many techniques and materials have been advocated in root canal-treated teeth to remove the obturating materials. However, residues of the filling materials have been observed on the canal walls in all the techniques. Therefore, this study was designed to explore the application of passive ultrasonic activation in the removal of gutta-percha and epoxy resin based root canal sealer during endodontic retreatment by rotary and hand instruments. Aim: To evaluate the efficacy between passive ultrasonic activation assisted hand vs. rotary retreatment files in the removal of gutta-percha and sealer during endodontic retreatment. Materials and Methods: The current study was an experimental in vitro study where all the procedures were carried out in extracted human teeth from October 2018 till February 2019. Forty extracted human single rooted teeth were selected. The root canals were prepared using ProTaper Next rotary files and obturated by a hybrid warm gutta-percha technique. They were divided into four groups of ten specimens each based on the retreatment procedures: Group 1: H-files, Group 2: H-files and passive ultrasonic activation of xylene, Group 3: ProTaper Universal retreatment files and Group 4: ProTaper Universal retreatment files and passive ultrasonic activation of xylene. The specimens were sectioned buccolingually after retreatment procedure and viewed under stereomicroscope for evaluating the percentage of remaining gutta-percha. Data obtained was subjected to Normality tests. Further statistical analysis was done using one-way ANOVA followed by Tukey Kramer Test for pairwise comparisons. Results: Irrespective of the technique, all the specimens showed residual filling materials on the canal walls. ProTaper Universal retreatment files with or without ultrasonic activation of solvent showed significantly (p<0.05) less filling material remnants when compared to H-files with/without ultrasonic activation of solvent. Conclusion: Rotary instrumentation supplemented with passive ultrasonic activation was found to be more efficient in removing root canal filling materials.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Maximum removal of gutta percha and sealer followed by reinstrumentation is very crucial for successful re-treatment. As the bacteria or fungi surviving and thriving under the gutta percha and sealer have to be removed [1-3]. Gutta percha can be removed using K or H files along with chemical solvents. Alternatively, it can also be removed from the coronal portion using gates glidden drills or heated pluggers followed by the use of ultrasonics, lasers or Ni Ti rotary files for the remaining part of the canal [4,5]. Pro-Taper instruments (Dentsply-Maillefer Ballaigues, Switzerland) have a convex triangular cross-sectional design with different shafts. A new NiTi rotary system, ProTaper Universal Tulsa (Dentsply Tulsa, Tulsa,) is introduced. This new system is integrated with 3 ProTaper retreatment files, D1, D2, D3. The 3 ProTaper Universal System retreatment files (PTUS) are designed to facilitate the removal of filling material. Each file has different lengths, tapers, and apical tip diameters. Mtwo Retreatment Files consist of two instruments of 21mm length with active cutting tip: R1 (size 15, 0.05 taper) and R2 (size 25, 0.05 taper). They have S-shaped cross-section but a shorter pitch length to enhance the advancement of the file into the filling material. They are used at a speed of 250-350rpm and a torque of 120gcm. These instruments are characterized by two cutting edges, which cut dentine effectively [6]. Thus, the purpose of this in vitro study was to evaluate and compare the efficacy of two rotary retreatment file systems: ProTaper universal retreatment files, mtwo retreatment files and hand files (Hedstrom Files) in the removal of root canal filling material during root canal retreatment and the influence of the type of sealers zinc oxide eugenol and AH plus on the presence of debris of filling material in re-instrumented canals in single rooted mandibular premolars.
Efficacy of 3 techniques in removing root canal filling material
Journal (Canadian Dental Association), 2008
Retreatment of a root canal in the case of infection requires complete removal of previous filling material. This study evaluated the efficacy of 3 techniques in removing laterally compacted Resilon/Epiphany and gutta-percha/AH Plus from straight and curved canals during retreatment. Extracted human teeth (90 maxillary anterior teeth with single,straight root canals and 90 mandibular molars with mesial canal root curvatures of 20 degrees to 35 degrees ) were divided into 6 groups each consisting of 15 straight and 15 curved root canals. Three groups were obturated using gutta-percha/AH Plus and 3 were obturated with Resilon/Epiphany. After 3 weeks storage at 37 degrees C and 100% humidity, all root canal fillings were removed using a Gates Glidden drill, a Gates Glidden drill plus chloroform or a System B device. For all removal techniques, specimens obturated with gutta-percha/AH Plus showed significantly more remnants of obturation material than specimens filled with Resilon/Epiph...
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.
Efficacy of different techniques used for root canal retreatment
Future Dental Journal, 2018
This study compared the efficacy of gutta percha and sealer removal during retreatment using Protaper universal retreatment rotary files, D-Race rotary files and hand files with Gates Glidden. Methods: Thirty six extracted single rooted teeth were selected for the current study. The canals were prepared using a modified crown-down technique then filled using the lateral compaction technique. Specimens were randomly divided into 3 equal groups each consisted of twelve specimens. Group one used manual files, group 2 used D-Race system while group 3 used Protaper retreatment system. Samples were split longitudinally and examined under the stereomicroscope. Results: No significant differences among the Protaper and the D-RaCe groups in the mean values of root canal filling remnants, whereas the hand files and Gates Glidden group differed significantly. Conclusion: D-Race and Protaper retreatment files removed gutta percha and sealer more efficiently than hand files and Gates Glidden.
International Endodontic Journal, 2020
Aim To compare the retreatment ability of several rotary and reciprocating file systems in curved root canals of extracted teeth and to evaluate the influence of additional apical enlargement performed after a basic retreatment on the amount of remaining filling material. Methodology A total of 65 round curved root canals were used. The root canals were prepared with the ProTaper Next rotary system to size 25, .06 taper and filled with an epoxy-resin based sealer and guttapercha using continuous wave vertical compaction and warm injection back-filling. The canals were randomly divided into four groups according to the retreatment system used: Group I. ProTaper Universal Retreatment system + ProTaper Gold (PTG) instrumentation system up to PTG F2; Group II. Reciproc Blue (RB) system up to the instrument RB25; Group III. Reciproc system up to the instrument R25; Group IV. Wave One Gold (WOG) system up to the instrument WOG25. After the basic retreatment, additional apical enlargement was performed in each group with a one size larger instrument: in groups I, II and III up to apical size 40, and in group IV up to 35. The final irrigation protocol included: 15% ethylenediaminotetraacetic acid followed by NaOCl irrigation. The volume of filling material was measured using an industrial micro-CT four times: after root canal filling (Volume I), after basic retreatment with files tip size 25 (Volume II), after additional root canal enlargement with larger instrument (Volume III), and after the final irrigation protocol (Volume IV). Results There were no significant differences among the systems tested in the amount of the remaining filling material, or the reduction rates after each phase of the retreatment procedures (p > 0.05). Intragroup analysis indicated that the use of a larger final instrument removed significantly more filling material in all groups (p < 0.001). Conclusion The four tested instrumentation systems were equally effective in removing filling materials from curved root canals in extracted teeth. Additional apical enlargement with larger files improved the removal of filling remnants after basic retreatment.
Revista de Odontologia da UNESP, 2016
Introduction The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. Objective To evaluate the efficacy of passive ultrasonic irrigation (PUI) in the removal of residual root filling material after removing the bulk of the root filling with nickel-titanium rotary instruments. Material and method Eighteen mesial isthmus-containing roots of human mandibular molars were prepared and filled. The root canal filling was removed with the ProTaper Retreatment system and K-files. The specimens were randomized into 2 groups (n = 9), both irrigated with 2.5% NaOCl and 17% EDTA. In the conventional group, an irrigation syringe was used. In the PUI group, the PUI technique was used. The roots were sectioned longitudinally and evaluated under stereomicroscopy. Student’s t test was used to compare groups and the general linear model was used to compare the apical, cervical, a...
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
Objective. The aim of this study was to compare Profile .04 taper series 29 instruments and hand files for gutta-percha removal. Study design. Twenty maxillary central incisors with a single straight canal were instrumented and filled. The teeth were divided into 2 groups of 10 specimens each, according to gutta-percha removal techniques: Group 1-Profile series 29 and Group 2-hand files and solvent. The amount of time for gutta-percha removal and the number of fractured instruments were evaluated. Radiographs were taken and the teeth were grooved longitudinally and split. The area of residual debris was measured using computer software. Results. The time for filling material removal was significantly shorter when Profile series 29 was used (P ϭ .00). Regarding cleanliness, there were no statistical differences in the teeth halves evaluations (P Ͼ .05). Hand instruments cleaned the canals significantly better than Profiles, in the radiographic analysis considering the whole canal. Overall, the radiographic analysis showed a smaller percentage of residual debris than the teeth halves analysis. Conclusion. The Profile series 29 instruments proved to be faster than hand instruments in removing root filling materials; however, hand instruments yielded better root canal cleanliness. Some residual debris was not visualized by radiographs.
Abstract The aim of this in vitro study was to evaluate the efficacy of passive ultrasonic irrigation used as adjunct during endodontic retreatment and its effect on the removal of obturation material from canal walls. Thirty-six extracted human single-rooted teeth were instrumented and obturated with gutta-percha and zinc oxide-eugenol- based sealer using the lateral condensation technique. Teeth were stored at 37ºC in a humid environment for four weeks. The removal of root canal filling was performed using ProTaper™ universal retreatment rotary files without solvent. Teeth were then divided into three groups of 12 specimens each based on the irrigation technique: group 1) syringe irrigation technique with 5.25% NaOCl solution applied as a final irrigation; group 2) passive ultrasonic irrigation technique using # 25 stainless steel files and ultrasonic activation for one minute; group 3) passive ultrasonic irrigation technique applied three times of one minute each. The teeth were ...