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Abdelnaby P, Ibrahim M, ElBackly R. In vitro evaluation of filling material removal and apical debris extrusion after retreatment using Reciproc blue, Hyflex EDM and ProTaper retreatment files. BMC Oral Health 2023; 23:902. [PMID: 37990209 PMCID: PMC10664678 DOI: 10.1186/s12903-023-03579-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES To evaluate the amount of remaining filing material and apical debris extrusion after retreatment using Reciproc Blue, Hyflex EDM and ProTaper Retreatment Files. MATERIALS AND METHODS Thirty-six extracted permanent mandibular first molars with moderately curved mesial roots were selected. Mesiobuccal canals were prepared using the ProTaper Next system up to size X2 and filled using gutta-percha and Adseal sealer via cold lateral compaction. Teeth were randomly divided into three equal groups (n = 12): Group 1: Reciproc Blue (RB)(VDW, Germany), Group 2: Hyflex EDM (HEDM)(Coltene/Whaledent, Switzerland), Group 3: ProTaper Universal Retreatment file system + ProTaper Next file system (PTUR + PTN)( Dentsply Maillefer, Switzerland). Eppendorf tubes were used to collect the apically extruded debris. Cone-beam computed tomographic scans were taken prior to and after retreatment and the volume of remaining filling material was assessed at the coronal, middle and apical levels. Statistical analysis was performed using the Kruskal-Wallis test, Friedman's test and Wilcoxon Sign Rank test. Significance level was set at p value 0.05. RESULTS There were no statistically significant differences among the three groups in the reduction of the volume of the filling material or in the amount of apically extruded debris. CONCLUSION All the tested filing systems showed similar efficacy in removing the filling material, however, none of them could achieve its complete removal. Apical extrusion of debris occurred with all the systems used with no significant difference between the three groups.
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Affiliation(s)
- Passent Abdelnaby
- Conservative Dentistry Department, MS Student, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Ibrahim
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania ElBackly
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
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Bhargava K, Newase P, Paunikar M, Bhawalkar A, Kumar T, Sarode G. Comparative evaluation of the effect of hand file, different nickel-titanium retreatment files, and self-adjusting file system on the incidence of dentinal microcrack formation during the removal of root canal filling material: An in vitro stereomicroscopic study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_328_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ruivo LM, Rios MDA, Villela AM, de Martin AS, Kato AS, Pelegrine RA, Barbosa AFA, Silva EJNL, Bueno CEDS. Fracture incidence of Reciproc instruments during root canal retreatment performed by postgraduate students: a cross-sectional retrospective clinical study. Restor Dent Endod 2021; 46:e49. [PMID: 34909413 PMCID: PMC8636080 DOI: 10.5395/rde.2021.46.e49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. Materials and Methods From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ2 test (p < 0.01). Results Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. Conclusions The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.
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Affiliation(s)
- Liliana Machado Ruivo
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil
| | - Marcos de Azevedo Rios
- Department of Endodontics, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
| | | | | | - Augusto Shoji Kato
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil
| | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.,Department of Endodontic, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
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Ajina MA, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J 2021; 55 Suppl 1:119-152. [PMID: 34674279 DOI: 10.1111/iej.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Despite enjoying high favourable outcome rates, root canal treatment is not always successful. Root canal retreatment is a widely practised option for managing a non-healing root treated tooth. A basic distinction between retreatment and initial treatment is the requirement to remove the existing root filling material occupying the root canal space. Only then, can the technical deficiencies and possible causes of failure be addressed. Hence, the successful removal of the root filling material is critical to achieving the objectives of retreatment. Many different materials and techniques have been used for root canal filling, which have been documented in a plethora of studies; these are mainly laboratory studies investigating the removal of root filling materials. To help guide future research, which may then better inform clinical practice in relation to retreatment procedures, the focus of this narrative review is on the research methods and experimental models employed to study the removal of root filling materials. The current available literature demonstrates great variation in the research methodologies used to study the removal of root filling material, including direct visualization by splitting tooth samples or clearing, three-dimensional radiographic imaging including using microcomputed tomography or cone-beam computed tomography, and a combination of these techniques. Depending on the research method employed, variation also exists in quantification of root filling material removal; these include measurements of surface area, volume or weight, and criteria-based (semi-quantitative) assessment. Experimental models, using human teeth or resin models, differ with respect to standardization techniques and replication of the clinical scenario including initial sample preparation, canal filling, allocation and technical aspects of retreatment procedures. Future models should replicate, as closely as possible, the clinical scenario. Currently, microcomputed tomography provides a highly detailed, non-invasive and non-destructive method of objectively assessing and quantifying root filling removal.
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Affiliation(s)
- Mahdi A Ajina
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Shah
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Bun San Chong
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Serefoglu B, Kandemir Demirci G, Miçooğulları Kurt S, Kaşıkçı Bilgi İ, Çalışkan MK. Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment. Restor Dent Endod 2021; 46:e5. [PMID: 33680894 PMCID: PMC7906842 DOI: 10.5395/rde.2021.46.e5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/03/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated. Materials and Methods Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level. Results Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05). Conclusions All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.
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Affiliation(s)
- Burcu Serefoglu
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | | | | | | | - Mehmet Kemal Çalışkan
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
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Amini K, Nouri H, Jahromi M. Comparison of full rotation and reciprocating movements in regaining apical patency during endodontic retreatment. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.328753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Crozeta BM, Chaves de Souza L, Correa Silva-Sousa YT, Sousa-Neto MD, Jaramillo DE, Silva RM. Evaluation of Passive Ultrasonic Irrigation and GentleWave System as Adjuvants in Endodontic Retreatment. J Endod 2020; 46:1279-1285. [PMID: 32553874 DOI: 10.1016/j.joen.2020.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Nonsurgical endodontic retreatment continues to be a challenge in endodontics, particularly when dealing with a complex tooth anatomy. This study evaluated the efficacy of passive ultrasonic irrigation (PUI) and the GentleWave system as supplementary techniques to remove remaining filling materials from oval-shaped root canals. METHODS Twenty distal roots of human mandibular molars with single and oval-shaped canals were shaped with R40 (40.06) instrument and filled with gutta-percha and AH Plus sealer using warm vertical obturation. Initial filling material removal was performed with R50 (50.05) instrument, followed by the use of PUI (n = 10) or GentleWave system (n = 10). Micro-computed tomographic images were obtained after obturation, initial material removal, and after the use of PUI and GentleWave. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed by using analysis of variance, Kruskal-Wallis and Mann-Whitney tests. P ≤ .05 was considered significant. RESULTS The use of PUI and GentleWave as supplementary techniques significantly reduced the volume of remaining filling material after initial instrumentation (P < .05). However, none of these techniques was able to render canals free from filling materials. PUI showed better performance by removing 18% of the remaining filling material, whereas the GentleWave system was able to remove approximately 10% (P = .02). CONCLUSIONS The use of supplementary techniques optimized filling material removal after initial instrumentation. PUI enhanced the overall cleaning of the root canal system during endodontic retreatment in oval-shaped canals.
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Affiliation(s)
| | - Letícia Chaves de Souza
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas
| | | | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - David Enrique Jaramillo
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas
| | - Renato Menezes Silva
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas.
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Crozeta BM, Lopes FC, Menezes Silva R, Silva-Sousa YTC, Moretti LF, Sousa-Neto MD. Retreatability of BC Sealer and AH Plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment. Clin Oral Investig 2020; 25:891-899. [PMID: 32506324 DOI: 10.1007/s00784-020-03376-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of supplementary techniques (ultrasonic tip/XP-endo Finisher R) in removing remaining filling materials (gutta-percha/AHPlus/BCSealer) from oval-shaped root canals during non-surgical endodontic retreatment. MATERIAL AND METHODS Twenty-eight distal roots of human mandibular molars with single and oval-shaped canals were initially shaped with a R40 instrument and filled with gutta-percha points and AH Plus (n = 14) or BC Sealer (n = 14) followed by an initial micro-CT scanning. Initial filling material removal was performed in all 28 samples with an R50 instrument, and all samples submitted to a second micro-CT. Supplementary techniques with ultrasonic tips or XP-endo Finisher R instruments were performed in each sealer group, and all samples submitted to a third micro-CT. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed using T, ANOVA 3-way, and Tukey tests. RESULTS Lower values of remnant filling material were found for BC Sealer (16.06 ± 14.34) compared to AH Plus (28.30 ± 10.54) (P < 0.001), and considering the supplementary technique, lower values of remnant filling material were found for the ultrasonic tip (18.95 ± 11.05) compared to XP-endo Finisher R (25.41 ± 15.81) (P = 0.025). Ultrasonic instruments significantly reduced the percentage of remaining filling material for both AH Plus (P = 0.04) and BC Sealer (P = 0.02) while XP-endo Finisher R was effective for AHPlus only (P = 0.04). The remaining filling material was observed in all samples regardless the filling material or the supplementary technique employed. CONCLUSIONS Supplementary techniques increased filling material removal; however, none of them was able to render root canals completely free from root fillings. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for bioceramic cases. CLINICAL RELEVANCE Supplementary instrumentation techniques are effective tools to reduce the amount of filling materials during root canal retreatment.
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Affiliation(s)
- Bruno Monguilhott Crozeta
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.,Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Renato Menezes Silva
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
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Neelakantan P, Ahmed HMA, Chang JWW, Nabhan MS, Wei X, Cheung GSP, Gomes BPFA. Effect of instrumentation systems on endotoxin reduction from root canal systems: A systematic review of clinical studies and meta‐analysis. AUST ENDOD J 2018; 45:407-413. [DOI: 10.1111/aej.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Prasanna Neelakantan
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur Malaysia
| | - Jeffrey Wen Wei Chang
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry Faculty of Dentistry Ain Shams University Cairo Egypt
| | - Xi Wei
- Department of Operative Dentistry and Endodontics Guanghua School of Stomatology, Affiliated Stomatological Hospital Guangdong Provincial Key Laboratory of Stomatology Sun Yat‐sen University Guangzhou China
| | - Gary Shun Pan Cheung
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Brenda P. F. A. Gomes
- Department of Restorative Dentistry Endodontics Division Piracicaba Dental School State University of Campinas ‐ UNICAMP Piracicaba São Paulo Brazil
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Aboud LRDL, Santos BCD, Lopes RT, Viana LAC, Scelza MFZ. Effect of Aging on Dentinal Crack Formation after Treatment and Retreatment Procedures: a Micro-CT Study. Braz Dent J 2018; 29:530-535. [DOI: 10.1590/0103-6440201802134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract In order to evaluate the volume of dentinal cracks taking into account the age of the dentin and the type of file system used for endodontic procedures, forty freshly extracted single-rooted lower incisive teeth presenting similar root volume, were divided into two groups according to the age of the patient: Group Young (18 - 30 years old) and Group Old (60 years old or more). Each specimen was scanned by microcomputed tomography (micro-CT) in three stages: (i) before any treatment, (ii) after endodontic treatment with Reciproc files (REC), and (iii) after subsequent endodontic retreatment. Each group was subdivided into two subgroups, according to the retreatment technique used: retreatment with REC or with ProTaper Universal Retreatment (PUR) files. For each subgroup, the images were analyzed for differences in the volume of dentinal cracks in the middle and apical thirds of the teeth , according to the dentin age. In both stages (before and after instrumentation), the micro-CT images of the old root dentin presented with higher volume of cracks than those of the young root dentin, statistical significance notwithstanding (p>0.01). The use of REC files appeared to have no statistically significant differences in the generation of cracks in any type of root dentin when compared with PUR files (p>0.01). When retreated with PUR, the old root dentin presented with a significantly higher volume of cracks (p<0.01) when compared with the old root dentin initially.
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CASTRO RFD, MELO JDSS, DIAS JUNIOR LCDL, SILVA EJNL, BRANDÃO JMDS. Evaluation of the efficacy of filling material removal and re-filling after different retreatment procedures. Braz Oral Res 2018; 32:e94. [PMID: 30231174 DOI: 10.1590/1807-3107bor-2018.vol32.0094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 07/25/2018] [Indexed: 11/22/2022] Open
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