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Valerio L, Oda LY, Copelli FA, Rodrigues CT, Carneiro E, Duarte MAH, Cavenago BC. Effect of the filling technique on the filling removal from oval-shaped canals. Clin Oral Investig 2024; 28:453. [PMID: 39060471 DOI: 10.1007/s00784-024-05853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES This ex vivo study aimed to evaluate the influence of different filling techniques on the filling removal from oval root canals filled with bioceramic sealer. METHODS Thirty-six mandibular incisors with single oval canals were filled with bioceramic sealer following the techniques (n = 12): single-cone, modified McSpadden, or continuous wave of condensation, and scanned by micro-computed tomography (micro-CT). The filling was removed using the Clearsonic ultrasound tip and Reciproc system up to the R40 instrument, and the working time was recorded. The teeth were scanned again by micro-CT. Percentage of remnant volume (mm³) of the filling material, dentin thickness, and root canal transportation were measured. The data was analyzed using parametric and non-parametric tests with a significance level of 5%. RESULTS It took more time to remove the filling material using the continuous wave of condensation technique (p < 0.05), followed by the modified McSpadden and single-cone techniques. There was no difference (p > 0.05) when comparing the percentage of remaining filling material among the three groups, nor did it among the segments of each tooth. There was also no difference in the analysis of dentin thickness and transportation when comparing the groups (p > 0.05). CONCLUSIONS The filling technique did not influence the amount of remaining filling material, dentin thickness, and transportation. The working time was longer with thermoplastic filling techniques. CLINICAL RELEVANCE Endodontic retreatment in teeth filled with bioceramic sealers increases with their use. Several techniques are used to fill the root canals, thus, it is important to know whether the filling technique influences the non-surgical endodontic retreatment.
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Affiliation(s)
- Lislaine Valerio
- Postgraduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Lisa Yurie Oda
- Postgraduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
- , Av. Prefeito Lothário Meissner no. 632, Curitiba, Paraná, 80210-170, Brazil.
| | | | | | - Everdan Carneiro
- Department of Endodontics, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
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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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Madarati AA, Sammani AMN, Alnazzawi AA, Alrahlah A, Pedullà E. Efficiency of reciprocating systems reciprocated at different angles in removing root-canals fillings with an MTA-type sealer: an Ex-vivo study. BMC Oral Health 2022; 22:357. [PMID: 35978330 PMCID: PMC9387022 DOI: 10.1186/s12903-022-02390-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/10/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. METHODS 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals' fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials' (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. RESULTS The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P < 0.05). The longest time required to remove the filling materials was recorded with the RB-270/30 group (6.06 min) [P = 0.00]. The times required when the WOG, RB and RM files reciprocated at 90/30 angles (3.59, 3 and 3.05 mins, respectively) were shorter than those when files were reciprocated at 150/30 angles (5.25, 4.98 and 3.67 min, respectively) [P < 0.05]. CONCLUSIONS The WOG and RB systems removed more MTA-type sealer-based root-canals fillings than the RM system. Lower counterclockwise reciprocating angles improve the retreatment ability of reciprocating systems, especially the WOG system and can reduce the time required for retreatment procedures.
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Affiliation(s)
- Ahmad A. Madarati
- grid.412892.40000 0004 1754 9358Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia ,Present Address: Riyadh (12252), Kingdom of Saudi Arabia
| | - Aya M. N. Sammani
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ahmad A. Alnazzawi
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ali Alrahlah
- grid.56302.320000 0004 1773 5396Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Eugenio Pedullà
- grid.8158.40000 0004 1757 1969Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Kaloustian MK, Hachem CE, Zogheib C, Nehme W, Hardan L, Rached P, Kharouf N, Haikel Y, Mancino D. Effectiveness of the REvision System and Sonic Irrigation in the Removal of Root Canal Filling Material from Oval Canals: An In Vitro Study. Bioengineering (Basel) 2022; 9:bioengineering9060260. [PMID: 35735503 PMCID: PMC9219995 DOI: 10.3390/bioengineering9060260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the effectiveness of the Endostar REvision system (Poldent, Warsaw, Poland) in the removal of filling materials from oval root canals using sonic irrigation as an additional cleaning method. Thirty human-extracted mandibular premolars with oval canals were prepared using the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland) up to instrument F1 (20/.07), and then filled by the continuous wave vertical compaction technique using pulp canal sealer EWT (Sybron Dental Specialties, Orange, CA, USA). The teeth were randomly divided into two groups (n = 15) according to the instrumentation system and the additional cleaning method, as follows: REvision (30/.08, 25/.06) with EQ-S sonic activation (Meta Biomed, Chungcheongbuk-do, Korea), REvision (30/.08, 25/.06) without additional activation. All specimens were sectioned longitudinally at 3 and 7 mm from the apex, and analyzed using digital microscopy (KEYENCE, Osaka, Japan) to measure the total area of the residual obturation materials, followed by SEM analysis. The data on the percentage of remaining filling material were analyzed by Kruskal−Wallis one-way Analysis of Variance on ranks. None of the retreatment protocols completely removed the filling material from the root canals (p > 0.05); the retreatment technique using sonic activation showed statistically less residual filling materials than the retreatment technique using irrigants without activation at the coronal third (p < 0.05), whilst no significant difference was found between both tested groups at the apical and middle thirds (p > 0.05). The REvision system showed promising results in the removal of filling materials from oval canals.
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Affiliation(s)
- Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Walid Nehme
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon; (M.K.K.); (C.Z.); (W.N.)
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon;
| | - Pamela Rached
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.:+33-66752-2841
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (P.R.); (Y.H.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaires, 67000 Strasbourg, France
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Sameh R, Omaia M. The Efficacy of Two Novel Retreatment Systems in the Removal of Root Canal Obturating Materials (An In vitro Study). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The complete removal of root filling material is one of the main goals of non-surgical endodontic retreatment. Thus, the development of new techniques and instruments aiming to promote this task presents clinical significance.
AIM: The purpose of the study was to assess the amount of residual root canal filling materials (gutta-percha/sealer) after using two different endodontic retreatment systems and ultrasonic tip.
METHODS: Forty-five mandibular premolar teeth were mechanically instrumented and obturated. Retreatment was performed using two different Endostar RE (Group 2), Rogin retreatment system (Group 3), and ultrasonic tip (Group 1). Roots were separated buccolingually into two halves. A digital camera connected to the stereomicroscope captured images to each half. Image-J software was used to evaluate and measure the areas with remaining filling material in each third (cervical, middle, and apical).
RESULTS: Data analysis revealed significant differences between the groups in the coronal, middle, and apical thirds (p < 0.05). The ultrasonic retreatment tips (G1) were significantly more efficient in removing the gutta-percha and sealers compared to the Rogin (G3) and Endostar (G2) retreatment endodontic kits.
CONCLUSIONS: All the file systems left some filling material in the canals. Ultrasonic retreatment tip had maximum efficacy for the removal of filling materials in comparison with the retreatment file systems under investigation.
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Bis BM, Silva-Sousa YTC, Macedo LMDD, Oliveira OP, Alfredo E, Leoni GB, Rached-Junior FJA. Removal of filling material using rotating or reciprocating systems with or without solvent: microCT analysis. Braz Oral Res 2021; 35:e117. [PMID: 34816905 DOI: 10.1590/1807-3107bor-2021.vol35.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/02/2021] [Indexed: 11/22/2022] Open
Abstract
This study evaluated by the efficacy of rotary and reciprocating systems to remove filling material by micro-CT. Sixty human canines were instrumented up to F3 by ProTaper Universal system and filled with AH Plus/ gutta-percha. Specimens were submitted to 1,200 thermal cycles, scanned by microCT SkyScan 1176 and randomly distributed in groups according to the filling material removal protocol (n = 10): ProTaper Universal, ProTaper Universal/xylol, ProTaper Next, ProTaper Next/xylol, Reciproc and Reciproc/xylol. After filling removal, specimens were analyzed by microCT to separately verify the presence of gutta-percha and sealer remnants. The data (mm3) were analyzed by two way ANOVA and Tukey´s test (5%). For the remaining gutta-percha, the use of xylol provided the highest values for Reciproc (7.60 ± 0.73), which was statistically different from the other groups (p < 0.05) that presented lower values and were statistically similar to each other (p > 0.05). For the remaining sealer, xylol provided the highest values (21.25 ± 6.94) different (p < 0.05) from the use of instruments alone (11.47 ± 9.45). ProTaper Next presented the lowest values (8.16 ± 1.37) for the remaining sealer, different (p < 0.05) from that of Reciproc (24.67 ± 6.32). The qualitative analysis revealed that all groups presented some remaining root filling material, with the highest volumes presented by Reciproc and Reciproc/xylol. In conclusion the rotary systems provided greater removal of filling material regardless of the use of xylol. The use of xylol negatively interfered with the action of the reciprocating system in the removal of the gutta-percha and sealer.
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Affiliation(s)
- Bárbara Maria Bis
- Universidade de Ribeirão Preto, School of Dentistry, Department of Endodontics, Ribeirão Preto, SP, Brazil
| | | | | | - Orestes Pereira Oliveira
- Universidade de Ribeirão Preto, School of Dentistry, Department of Endodontics, Ribeirão Preto, SP, Brazil
| | - Edson Alfredo
- Universidade de Ribeirão Preto, School of Dentistry, Department of Endodontics, Ribeirão Preto, SP, Brazil
| | - Graziela Bianchi Leoni
- Universidade de Ribeirão Preto, School of Dentistry, Department of Endodontics, Ribeirão Preto, SP, 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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Abiad RS, Neelakantan P, Buscema I, Ali IA, Conte G, LA Rosa GR, Generali L, Cicciù M, Pedullà E. A micro-computed tomographic analysis of obturation quality and retreatability of an epoxy resin-based sealer. Minerva Dent Oral Sci 2021; 71:131-138. [PMID: 34636216 DOI: 10.23736/s2724-6329.21.04588-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To evaluate the voids percentage and the retreatability by different supplementary irrigation techniques of a matched-taper single cone and epoxy resin-based sealer. METHODS A total of 72 single-rooted premolars were prepared and filled with gutta-percha and MM-Seal. The percentage of voids in the whole root canal and each anatomical part were evaluated by Micro-CT scans. After root filling removal, the teeth were randomly allocated (n=24) to group A, syringe irrigation; group B, Tornado Brush and group C, ultrasonically activated irrigation and rescanned to establish the volume of remnant root filling material. The data relative to voids and retreatment techniques were established by Kruskal-Wallis test. Differences in retreatment time were examined using one-way ANOVA and Tukey's test (P< .05). RESULTS No significant difference was found in the voids percentage between the different root-thirds and between the supplementary irrigation groups in the MM-Seal remnants for the whole root canal and each section. In all groups, the coronal region exhibited more remaining material than other sections. CONCLUSIONS MM-Seal showed low voids percentage and its removal was not significantly improved by supplementary irrigation techniques.
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Affiliation(s)
- Roula S Abiad
- Division of Endodontology, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Prasanna Neelakantan
- Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Ivan Buscema
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Islam A Ali
- Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Gianluca Conte
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giusy R LA Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy -
| | - Luigi Generali
- Endodontic Section, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), School of Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, Azienda Ospedaliera Universitaria G. Martino, University of Messina, Messina, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Bago I, Plotino G, Katić M, Ferenac A, Petričević GK, Gabrić D, Anić I. Effect of a novel laser-initiated photoacoustic activation of a solvent or sodium hypochlorite in the removal of filling remnants after retreatment of curved root canals. Photodiagnosis Photodyn Ther 2021; 36:102535. [PMID: 34536606 DOI: 10.1016/j.pdpdt.2021.102535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/30/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to evaluate the effect of Er:YAG laser-initiated shockwave-enhanced emission of photoacoustic streaming (SWEEPS®) and passive ultrasonic irrigation (PUI) combining thymol-based solvent or sodium hypochlorite (NaOCl) in the removal of filling remnants from curved canals. METHODS Forty-eight curved root canals were instrumented and filled with an epoxy-resin-based sealer and gutta-percha. The canals were retreated with a Wave One Gold primary file (tip size 25; variable taper) and sodium hypochlorite (NaOCl). After the retreatment, the samples were randomly divided into four groups according to the additional irrigation protocol: PUI/NaOCl, PUI/solvent, SWEEPS®/NaOCl or SWEEPS®/solvent. The volume of filling material in root canal was measured after root canal filling, after mechanical retreatment, after final irrigation protocol and after additional irrigation protocol, using micro-CT. The results were analyzed using Kruskal-Wallis test with the post-hoc Mann-Whitney U test and Wilcoxon test (α=0.05). RESULTS In the PUI group, irrigation with the solvent or NaOCl resulted in similar filling reduction (p = 0.224). In the SWEEPS® group, irrigation with NaOCl resulted in a significantly greater filling reduction compared to the solvent (p = 0.021). The SWEEPS®/NaOCl group was more effective than the PUI/NaOCl group (p = 0.008). No significant differences were found between PUI/solvent and SWEEPS® groups (p>0.05) and PUI/NaOCl and SWEEPS®/solvent group (p>0.05). CONCLUSION Although all tested protocols improved the removal of filling remnants from curved root canal, the SWEEPS® was more successful than PUI when NaOCl was used. Both tested techniques showed similar efficacy when in combination with the solvent.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.
| | - Gianluca Plotino
- Private Practice, Grande Plotino & Torsello - Studio di Odontoiatria, Via Calabria 25, Rome, Italy
| | - Marko Katić
- Department of Quality - National Laboratory for Length, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Croatia
| | - Adriana Ferenac
- Student of the 5th year of the School of Dental Medicine University of Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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A comparative study of dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow, iRoot SP, and AH Plus with different obturation techniques. Clin Oral Investig 2021; 25:4163-4173. [PMID: 33638051 PMCID: PMC8137581 DOI: 10.1007/s00784-020-03747-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/15/2020] [Indexed: 12/17/2022]
Abstract
Objectives This study aimed to evaluate dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow (HiFlow), iRoot SP, and AH Plus when using the single-cone (SC) or continuous wave condensation (CWC) technique. Materials and methods Sixty-five single-rooted teeth were instrumented and randomly divided into 5 groups: group 1, AH Plus/CWC; group 2, iRoot SP/CWC; group 3, iRoot SP/SC; group 4, HiFlow/CWC; and group 5, HiFlow/SC. The ability to re-establish patency during endodontic retreatment was recorded, as was the time taken to reach the working length. Dentinal tubule penetration and remaining debris after retreatment were evaluated by confocal microscopy and scanning electron microscopy. Data were analyzed by Kruskal-Wallis test and Dunn’s multiple comparisons test (α = 0.05). Results The HiFlow/CWC and iRoot SP/CWC groups required more time to reach the working length than groups that underwent the SC technique regardless of the sealer used (P < .05). The HiFlow/CWC group showed a significantly higher percentage of sealer penetration area than that of the iRoot SP/SC at 4 mm from the apex (P < .05) and penetrated deeper into dentinal tubules than iRoot SP/SC at both 8-mm and 12-mm levels (P < .05). Moreover, the HiFlow/CWC and HiFlow/SC groups demonstrated less remaining sealer along the canal wall than AH Plus/CWC group at 4-mm level (P < .05). Conclusions HiFlow/CWC technique showed better performance in dentinal tubule penetration than that of iRoot SP/SC. Both HiFlow and iRoot SP combined with CWC technique groups required more retreatment time than the other groups. Furthermore, using HiFlow with either the CWC or SC technique left less remaining sealer at 4-mm level than using AH Plus with the CWC technique during retreatment. Clinical relevance With favorable performance in dentinal tubule penetration and retreatability in endodontic retreatment, the combined use of EndoSequence BC Sealer HiFlow with the recommended continuous wave condensation technique may be a worthwhile choice in root canal treatment.
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Almeida A, Romeiro K, Cassimiro M, Gominho L, Dantas E, Silva S, Albuquerque D. Micro-CT analysis of dentinal microcracks on root canals filled with a bioceramic sealer and retreated with reciprocating instruments. Sci Rep 2020; 10:15264. [PMID: 32943675 PMCID: PMC7498450 DOI: 10.1038/s41598-020-71989-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022] Open
Abstract
This study aimed to analyze the potential occurrence of dentinal defects after the removal of a root canal filling with two different sealers using Reciproc (RC) or Reciproc Blue (RB). The mesial roots of 60 mandibular molars with a Vertucci type IV configuration were selected. The samples were initially instrumented with Reciproc (R25) and then divided into the following four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC); BC Sealer/Reciproc Blue (BCRB); AH Plus/Reciproc (AHRC); and AH Plus/Reciproc Blue (AHRB). Then, the samples were scanned under micro-CT after obturation and removal of the filling material. Two analyses were conducted. First, an evaluation was performed on all the axial images, and another analysis evaluated each millimeter of the 10 mm from the apex. Dentinal defects were observed in all the samples. All of the identified defects in the images after filling material removal were present in the corresponding images after obturation. The use of AH Plus and EndoSequence BC Sealer, and filling material removal using RC and RB instruments did not induce dentinal defects.
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Affiliation(s)
- Andressa Almeida
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil.
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Marcely Cassimiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Luciana Gominho
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Eugênia Dantas
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Silmara Silva
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
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The Efficacy of Rotary, Reciprocating, and Combined Non-Surgical Endodontic Retreatment Techniques in Removing a Carrier-Based Root Canal Filling Material from Straight Root Canal Systems: A Micro-Computed Tomography Analysis. J Clin Med 2020; 9:jcm9061989. [PMID: 32630387 PMCID: PMC7355862 DOI: 10.3390/jcm9061989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems. The study was performed on 99 single-rooted extracted teeth using the ProTaper Gold endodontic rotary system up to the F2 file (Dentsply Maillefer, Baillagues, Switzerland), which were sealed with GuttaCore (Dentsply Maillefer, Ballaigues, Switzerland) and AH plus epoxy resin sealer (Dentsply DeTrey, Konstanz, Germany) and randomly assigned to the following non-surgical retreatment techniques: ProTaper Retreatment endodontic rotary instruments (D1–D3 files, Dentsply Maillefer, Ballaigues, Switzerland; n = 33, PTR), Reciproc Blue endodontic reciprocating instrument (R50, VDW, Munich, Germany; n = 33, RCB50), and a combined root canal retreatment technique between Gates-Glidden drills (sizes #3 and #2, Dentsply Maillefer, Ballaigues, Switzerland) and Hedstrom files (file size 35, 30, and 25, Dentsply Maillefer, Ballaigues, Switzerland; n = 33; H-GG). All of the teeth were submitted twice to a micro-computed tomography (micro-CT) scan, before and after non-surgical endodontic retreatment procedures. The volume of root canal filling material (mm3), volume of remaining root canal filling material (mm3), non-surgical endodontic retreatment working time (min), proportion of remaining root canal filling material (%), and efficacy of root canal filling material removal between the non-surgical endodontic retreatment techniques were analyzed using ANOVA one-way statistical analysis. Statistically significant differences were observed between the proportions of remaining root canal filling material of PTR and H-GG (p = 0.018), between the non-surgical endodontic retreatment working times (min; p < 0.001), and between the efficacies of root canal filling material removal by the non-surgical endodontic retreatment techniques (p = 0.009). However, the non-surgical endodontic retreatment systems allow for similar carrier-based root canal filling material removal.
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Hatzke MW, Daigle FC, Augsburger RA, Kesterke MJ, Jalali P. Retrograde Instrumentation of Surgically Resected Roots Using Controlled Memory Files: A Human Cadaver Study. J Endod 2020; 46:1317-1322. [PMID: 32553877 PMCID: PMC7295473 DOI: 10.1016/j.joen.2020.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The purpose of this study is to evaluate the amount of residual obturation material of retroinstrumented surgically resected roots using controlled memory files and to evaluate the incidence of adverse treatment outcomes. METHODS Thirty maxillary anterior teeth in human cadavers were selected, and nonsurgical root canal treatment was performed on these teeth. A standardized 4-mm osteotomy and a 3-mm root resection with as close to 0° bevel as possible were made on each tooth. A microsurgical diamond tip was used to create a 1- to 2-mm starting point for each retropreparation. A 25/06 and 30/06 VTaper 2H were bent at about 90° angle to mimic the clinical and anatomic restrictions and used to create a retropreparation to a depth of 14 mm. Micro-computed tomography scans were taken and analyzed for volume and percentage of residual obturation material at 5 and 10 mm. In addition, the incidences of instrument separation and crack and ledge formation in the teeth were recorded. RESULTS The median volume of residual obturation at 5 and 10 mm was 0.18 mm3 (interquartile range, 0.36 mm3) and 1.97 mm3 (interquartile range, 1.99 mm3), respectively. The overall incidence of file separation during retropreparation was 13.33% (4/30). Among the cases analyzed with micro-computed tomography, none showed crack or ledge formation. CONCLUSIONS Retroinstrumentation of surgically resected roots using controlled memory files cleans the canal effectively with relatively low adverse treatment outcomes. Although this novel technique is limited in application, it is a safe and effective way to achieve a deep, clean retropreparation.
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Affiliation(s)
- Matthew W Hatzke
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Francesca C Daigle
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | | | - Matthew J Kesterke
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
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Secondary Root Canal Treatment with Reciproc Blue and K-File: Radiographic and ESEM-EDX Analysis of Dentin and Root Canal Filling Remnants. J Clin Med 2020; 9:jcm9061902. [PMID: 32570806 PMCID: PMC7355850 DOI: 10.3390/jcm9061902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022] Open
Abstract
Secondary root canal treatment requires the complete removal of filling materials with different chemical-physical properties. A newly developed single-use NiTi instrument (Reciproc Blue, RB) may be more effective in root canal retreatment. The aim of the present study was to evaluate morphology and composition of remnants after retreatment with RB compared to traditional K-File technique, in canals obturated with Thermafil/AH Plus. Twenty-four single-rooted human teeth were shaped with NiTi obturated with AH-Plus/Thermafil and retreated using RB NiTi instruments or manual K-Files. Radiographs were taken to evaluate endodontic space and radiopacity of residual filling-material before/after procedures. After retreatment, samples were longitudinally split and observed by environmental scanning electron microscopy connected to energy dispersive X-Ray spectroscopy (ESEM-EDX) to analyze the debris/remnant position, microchemistry, and dentinal surface morphology. Time for retreatments was recorded and compared using one-way ANOVA (p-value = 0.05). Radiopaque filling residuals were found in both groups. RB system resulted statistically faster than manual K-File in retreatment procedure (p < 0.001). Root canal space radiographic appearance obtained after retreatment with RB was wider than K-File (p < 0.05). ESEM-EDX revealed 4 different morphological dentin area. Area-1: debris-free with typical Ca, P, and N composition of dentin and detected in 70% of the surface. Area-2: presence of deproteinized smear layer free from N and debris in 15% of the surface. Area-3: a thick packed smear layer N-free and with fine debris consisting of trace elements from sealer in 10% of the surface. Area-4: packed with debris and trace elements. No difference was observed between both instruments regarding root canal space appearance and ESEM-EDX analysis. Both systems were able to remove filling material but created a dentine morphology composed of packed debris and filling materials embedded into the smear layer. Dentin surface composition resulted in collagen depleted by irrigation procedures. The reciprocating system required less time to complete retreatment.
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Bago I, Plotino G, Katić M, Ročan M, Batinić M, Anić I. Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth. Int Endod J 2020; 53:962-973. [PMID: 32159859 DOI: 10.1111/iej.13287] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Affiliation(s)
- I. Bago
- Department of Endodontics and Restorative Dentistry School of Dental Medicine University of Zagreb Zagreb Croatia
| | - G. Plotino
- Grande Plotino & Torsello – Studio di Odontoiatria Private Practice Rome Italy
| | - M. Katić
- Department of Materials Faculty of Mechanical Engineering and Naval Architecture University of Zagreb Zagreb Croatia
| | - M. Ročan
- School of Dental Medicine University of Zagreb Zagreb Croatia
| | - M. Batinić
- School of Dental Medicine University of Zagreb Zagreb Croatia
| | - I. Anić
- Department of Endodontics and Restorative Dentistry School of Dental Medicine University of Zagreb Zagreb Croatia
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Saricam E, Ince-Yusufoglu S, Ocak M, Geneci F, Celik HH. The retreatment abilities of ProTaper Next and F6 Skytaper: a micro-computed tomography study. Eur Oral Res 2020; 55:74-79. [PMID: 34250473 PMCID: PMC8244941 DOI: 10.26650/eor.20210009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 08/07/2020] [Accepted: 12/14/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this study was to evaluate the retreatment abilities of the ProTaper Next (PTN) and F6 SkyTaper (F6) systems by using micro-computed tomography (microct), radiographic and microscopic imaging techniques. Materials and methods The root canals of twenty-six extracted mandibular premolar teeth were prepared and obturated. For the retreatment procedure, the teeth were randomly divided into two equal groups according to endodontic instruments: PTN (X4) and F6 (#40/.06). Pre- and post-operative filling material volumes were measured with micro-ct, and areas were measured with radiographic and microscopic imaging techniques. The percentages of residual material were calculated, and then statistically compared. The significance level was set at p<0.05. Results There was no statistically significant difference between F6 and PTN for retreatment efficacy in the micro-ct and radiographic imaging techniques (p>0.05). PTN demonstrated better cleaning ability when evaluated by microscopic imaging. (p<0.05). The correlation was moderate between micro-ct and radiographic, and micro-ct and microscopic imaging groups; however, it was strong between radiographic and microscopic imaging methods. Conclusion The PTN and F6 files had similar effects in the removal of filling material with microct evaluation. The radiographic imaging method gave similar results with micro-ct imaging.
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Affiliation(s)
- Esma Saricam
- Department of Endodontics, Faculty of Dentistry, Ankara Yildirim Beyazit University, Ankara, Turkey
| | | | - Mert Ocak
- Department of Anatomy, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara Turkey
| | - Ferhat Geneci
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara,Turkey
| | - H Hamdi Celik
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara,Turkey
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Micro–computed Tomographic Assessment of the Residual Filling Volume, Apical Transportation, and Crack Formation after Retreatment with Reciproc and Reciproc Blue Systems in Curved Root Canals. J Endod 2020; 46:238-243. [DOI: 10.1016/j.joen.2019.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 12/19/2022]
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De-Deus G, Belladonna FG, Zuolo ADS, Cavalcante DM, Simões Carvalho M, Marinho A, Souza EM, Lopes RT, Silva EJNL. 3-dimensional Ability Assessment in Removing Root Filling Material from Pair-matched Oval-shaped Canals Using Thermal-treated Instruments. J Endod 2019; 45:1135-1141. [DOI: 10.1016/j.joen.2019.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/01/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
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