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Santos-Junior AO, Tavares KIMC, Pinto JC, Torres FFE, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Flatsonic Ultrasonic Tip Optimizes the Removal of Remaining Filling Material in Flattened Root Canals: A Micro-computed Tomographic Analysis. J Endod 2024; 50:612-618. [PMID: 38278319 DOI: 10.1016/j.joen.2024.01.011] [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: 09/12/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION The aim of this study was to evaluate the effectiveness of the XP-endo Finisher R (XPFR; FKG Dentaire, La Chaux-de-Fonds, Switzerland) or the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) in removing remaining filling material after the retreatment of flattened root canals using micro-computed tomographic imaging. METHODS Twenty-four flattened distal root canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were prepared with Reciproc Blue (RB) R40 (VDW GmbH, Munich, Germany) and filled using the Tagger hybrid technique. All canals were retreated with RB R40, and apical enlargement was performed with RB R50 (VDW GmbH). The specimens were randomly distributed into 2 groups: XPFR or Flatsonic (n = 12). The percentage of remaining filling material after retreatment and centralization ability was evaluated. Data were submitted to Mann-Whitney, Wilcoxon, and unpaired t tests (α = 5%). RESULTS Greater capacity to remove remaining filling material in the entire canal and the cervical and middle thirds was observed for the Flatsonic compared with the XPFR (P < .05). However, both supplementary cleaning techniques showed a similar percentage of residual filling material in the apical third (P > .05). No difference was observed in the centralization ability between the techniques (P > .05). CONCLUSIONS The Flatsonic promotes greater removal of remaining filling material than the XPFR in the retreatment of flattened root canals. However, both supplementary cleaning approaches were similar in the apical third. The XPFR and Flatsonic were able to maintain root canal centralization.
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Affiliation(s)
| | | | - Jáder Camilo Pinto
- Departament of Dentistry, Centro Universitário Presidente Antônio Carlos, Barbacena, Minas Gerais, Brazil; Department of Dentistry, Centro Universitário Presidente Tancredo de Almeida Neves, São João del Rei, Minas Gerais, Brazil
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University, School of Dentistry, Araraquara, São Paulo, Brazil.
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Wei C, Wang D, Shen L, Lu P, Meng Z, Zhou R. Treatment opinions for dens invaginatus: A case series. Exp Ther Med 2024; 27:138. [PMID: 38476914 PMCID: PMC10928843 DOI: 10.3892/etm.2024.12426] [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: 06/24/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Dens invaginatus (DI) is a rare congenital dental malformation characterized by enamel or cementum folded into dentine. Such teeth are susceptible to caries, pulp infection or necrosis and periradicular lesion. The complex anatomy of this disease results in difficult treatment and a high rate of therapeutic failure. Therapeutic options, such as debriding and filling invagination, root canal treatment (RCT) and intentional replantation, vary according to the morphology and infection of the involved tooth. The present study reports five cases of DI with chronic apical periodontitis. The treatment strategies and procedures, including RCT, removing the invagination, intentional replantation and surgical treatment, are discussed according to the classification and the condition of pulp and periapical tissue. The study also reports the prognosis: All patients were followed up for ≥12 months and all teeth demonstrated periapical healing and clinical asymptomatic. In summary, appropriate treatment is based on accurate analysis of the anatomical variation in different types of DI and intentional replantation is a reliable and viable treatment to preserve the tooth.
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Affiliation(s)
- Chengshi Wei
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Dong Wang
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Lili Shen
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Ping Lu
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Zhen Meng
- Biomedical Laboratory, Medical School of Liaocheng University, Liaocheng, Shandong 252000, P.R. China
| | - Rongjing Zhou
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
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Al Akam H, Kim HC, Jeong JW. Retreatment Strategies for Cases Containing Calcium Silicate-Based Root Canal Sealers: A Comprehensive Review. Dent J (Basel) 2024; 12:41. [PMID: 38392245 PMCID: PMC10888468 DOI: 10.3390/dj12020041] [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: 01/02/2024] [Revised: 02/04/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
This review explores the field of retreatment strategies for cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocompatibility, bioactivity, and sealing ability. Therefore, effective retreatment strategies are indispensable. This article aims to identify the challenges associated with the removal of calcium silicate-based sealers themselves and removal of gutta-percha with the sealers during retreatment, evaluate current techniques and materials, and provide future directions for research in this field. Regarding the strategies of removal of root canal sealers, calcium silicate-based sealers are still relatively new materials for clinicians compared with traditional sealers such as epoxy- or eugenol-based sealers. First, no clinically established solvents have been reported. Second, calcium silicate-based sealers are currently utilized by clinicians in either the cold sealer-based technique or the warm vertical condensation technique. Third, the setting process of calcium silicate-based sealers generates byproducts, primarily calcium hydroxide and secondarily hydroxyapatite, that could interact with dentine. Lastly, there is a lack of clinical studies evaluating the efficacy of retreatment protocols for teeth filled with calcium silicate-based sealers. Therefore, it is important to investigate the chemo-mechanical properties of calcium silicate-based sealers themselves and their reactions to solvents and/or mechanical instruments and identify the interfacial properties of calcium silicate-based sealers with respect to dentine and gutta-percha. In addition, researchers in the clinical field need to actively gather and report data on retreatments of teeth filled with calcium silicate-based sealers.
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Affiliation(s)
- Hussain Al Akam
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX 77054, USA
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Yangsan 50612, Republic of Korea
| | - Ji Wook Jeong
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX 77054, USA
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da Rosa AF, Fischer BV, Dias-Junior LCDL, Serique AVC, Bortoluzzi EA, Teixeira CDS, da Fonseca Roberti Garcia L. Effectiveness of different supplementary protocols for remaining filling material removal in endodontic reintervention: an integrative review. Odontology 2024; 112:51-73. [PMID: 37561273 DOI: 10.1007/s10266-023-00845-6] [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: 05/02/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
The aim of this study was to perform an integrative review to identify the most effective supplementary protocols used after filling material (FM) removal and root canal reinstrumentation, during endodontic reintervention. The literature search was performed on the electronic databases PubMed and Latin American and Caribbean Health Sciences Literature (LILACS), using a combination of specific scientific descriptors. Selection criteria accepted articles published in English, Spanish and Portuguese languages, up to August 2021, involving in vitro and ex vivo studies. After applying the eligibility criteria, 46 articles were included for qualitative analysis. The tool for qualitative analysis of quasi-experimental studies of the Joanna Briggs Institute was used to determine the risk of bias of the included articles. The selected articles provided important data regarding the following supplementary protocols: sonic and ultrasonic activation of the irrigating solution; the use of ultrasonic inserts, XP-endo system instruments, and photon-induced photoacoustic streaming for mechanical debridement; and new devices as GentleWave system, and the self-adjusting file. Overall, all supplementary protocols demonstrated efficacy in removing the remaining FM. The implementation of various supplementary protocols can effectively remove the remaining FM from the root canal walls, although complete removal is not always achieved. However, it was not possible to determine the most effective protocol. Conversely, their association can enhance remaining FM removal. Remaining FM attached to root canal walls hinders proper chemical-mechanical preparation during endodontic reintervention. Supplementary protocols optimize the remaining FM removal, enhancing cleaning and disinfection of root canal.
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Affiliation(s)
- Amanda Freitas da Rosa
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Bruna Venzke Fischer
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Luiz Carlos de Lima Dias-Junior
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Anna Victoria Costa Serique
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Endodontics Division, University of Louisville, Louisville, KY, USA
| | - Cleonice da Silveira Teixeira
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil.
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Tsenova-Ilieva I, Dogandzhiyska V, Raykovska M, Karova E. Micro-CT Study on the Supplementary Effect of XP-Endo Finisher R after Endodontic Retreatment with Mtwo-R. Niger J Clin Pract 2023; 26:1844-1849. [PMID: 38158351 DOI: 10.4103/njcp.njcp_360_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/25/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND During the course of a non-surgical orthograde endodontic retreatment, supplementary instrumentation is usually required for better removal of root canal filling material. AIM The aim of this study was to assess the effectiveness of XP-Endo Finisher R in endodontic retreatment of oval root canals. MATERIALS AND METHODS The study was performed on extracted mandibular incisors preliminary cut at the cementoenamel junction. The root canals of 12 extracted lower central incisors were initially shaped with the rotary nickel-titanium system XP-Endo Shaper (30/.04) and filled with continuous waves of condensation. Root canal retreatment was performed with the МTwo Retreatment - R1 (15/.05) and R2 (25/.05) files, followed by the XP-Endo Finisher R (30/.00). Three micro-computed tomography scans were performed during the course of the experiment: 1) after the filling of the root canals, 2) after the first retreatment procedures, and 3) after the supplementary shaping. Kolmogorov-Smirnov test for normality and Friedman and Kruskal-Wallis tests for comparison of several independent samples. RESULTS There were no statistically significant differences in the percentage of removed obturation material in the different parts of the root canal after the use of Mtwo-R (P = 0.649) and XP-Endo Finisher R (P = 0.934). The additional instrumentation with XP-FR reduced the percentage of the remaining root canal filling insignificantly (P = 0.190). CONCLUSIONS The combined action of Mtwo-R retreatment files and XP-Endo Finisher R resulted in significant reduction of the amount of root canal filling material. Nevertheless, none of the examined rotary systems guaranteed its complete removal.
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Affiliation(s)
- I Tsenova-Ilieva
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical Saff University of Sofia, Sofia, Bulgaria
| | - V Dogandzhiyska
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical Saff University of Sofia, Sofia, Bulgaria
| | - M Raykovska
- Institute of Information and Communication Technologies, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - E Karova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical Saff University of Sofia, Sofia, Bulgaria
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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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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Rezaei G, Liu X, Jalali P. Efficacy of Different Solvents for Achieving Patency in Teeth Obturated Using Bioceramic Sealer. J Endod 2023; 49:219-223. [PMID: 36526108 DOI: 10.1016/j.joen.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The retreatment of teeth obturated with bioceramic sealers has been shown to be challenging. The purpose of this study was to compare the efficacy of 10% formic acid (FA), 20% hydrochloric acid (HCl), and chloroform for achieving patency in teeth obturated with a bioceramic sealer. METHODS Forty-five extracted single-canal teeth were instrumented and obturated 1.5 mm short of the working length using gutta-percha and EndoSequence BC Sealer (Brasseler USA, Savannah, GA). Two weeks later, gutta-percha was removed, and apical patency was attempted with a 10 C-file and a solvent (FA, HCl, or chloroform). The time to gain patency through EndoSequence BC Sealer was recorded. Five additional teeth were irrigated with the solvents, and scanning electron microscopy was used to evaluate the effect of solvents on the dentin. The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis. RESULTS Patency was achieved in all canals, except for 1 in the chloroform group. Regarding the time to achieve patency, no significant difference was noted between chloroform and FA (P > .05). However, there was a significant difference between chloroform and HCl (P < .05) and between FA and HCl (P < .05). The erosion of dentinal tubules was more evident when HCl was used compared with the other irrigants. CONCLUSIONS Twenty percent HCl was superior to 10% FA and chloroform in achieving patency in teeth obturated with EndoSequence BC Sealer. Regardless of the solvent used, patency may be achieved for most of the cases obturated with gutta-percha and EndoSequence BC Sealer.
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Affiliation(s)
- Ghazaleh Rezaei
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Xiaohua Liu
- 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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Chatchawanwirote Y, Yanpiset K, Jantarat J. Effect of solvent on root canal filling material removal by two different rotary file systems in C-shaped root canals. AUST ENDOD J 2022; 48:487-493. [PMID: 34928529 DOI: 10.1111/aej.12604] [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: 05/17/2021] [Revised: 10/21/2021] [Accepted: 12/06/2021] [Indexed: 12/14/2022]
Abstract
This study compared the percentage reduction of total obturation materials, gutta-percha and sealer, using two rotary file systems with/without solvent in retreating C-shaped root canals and to evaluate the effect of the solvent on instrument separation. C-shaped root canals were scanned using micro-CT to identify the root canal morphology and randomly assigned to four groups (n = 12). Retreatment was performed using ProTaper Universal Retreatment (PTUR) or XP-endo systems with/without solvent. The number of separated instruments were recorded. The samples were scanned pre- and post-retreatment. The percentage reduction of total obturation materials, gutta-percha and sealer, were calculated. The percentage reduction of gutta-percha in the PTUR without solvent group was significantly lower than the other groups (P = 0.018). The number of separated instruments in the solvent groups were significantly lower than the no solvent groups (P < 0.05). Solvent increased gutta-percha removal, when using PTUR and decreased the occurrence of separated instruments for both systems.
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Affiliation(s)
- Yanisa Chatchawanwirote
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jeeraphat Jantarat
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Matoso FB, Quintana RM, Jardine AP, Delai D, Fontanella VRC, Grazziotin-Soares R, Kopper PMP. XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals. Braz Oral Res 2022; 36:e053. [DOI: 10.1590/1807-3107bor-2022.vol36.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Debora Delai
- Universidade Federal do Rio Grande do Sul, Brazil
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11
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Sinsareekul C, Hiran-Us S. Comparison of the efficacy of three different supplementary cleaning protocols in root-filled teeth with a bioceramic sealer after retreatment-a micro-computed tomographic study. Clin Oral Investig 2021; 26:3515-3521. [PMID: 34854988 DOI: 10.1007/s00784-021-04320-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study evaluated the efficacy of three different supplementary cleaning protocols on the removal of bioceramic-based root canal filling materials from oval-shaped canals. MATERIALS AND METHODS A total of 36 human mandibular premolars were instrumented and obturated with gutta-percha and iRoot SP using the single-cone technique. Retreatment was performed with ProTaper Universal retreatment files. The samples were randomly divided into the following supplementary cleaning protocols: conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher R (XPR). The samples underwent micro-CT scanning to quantify the amount of residual filling materials after retreatment and after performing the cleaning protocols. The volume of filling material removal was analyzed by one-way analysis of variance and post hoc Bonferroni and Games-Howell tests (P < 0.05). RESULTS There were significant differences in the amount of root canal filling material removal in every comparison group (P < 0.05). The XPR removed significantly more residual filling materials (P < 0.01) followed by PUI and CSI (P < 0.05). Similar efficacy was found in the total root canal and all root thirds. CONCLUSIONS The additional use of XP-endo Finisher R and passive ultrasonic irrigation effectively removed the bioceramic-obturated root filling materials from the oval-shaped canals. However, none of the techniques completely removed the filling materials. CLINICAL RELEVANCE The XP-endo Finisher R and passive ultrasonic irrigation exhibited greater efficacy compared with syringe irrigation in the reduction of residual filling materials after retreatment in root-filled teeth with a bioceramic sealer.
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Affiliation(s)
- Chanakarn Sinsareekul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirawut Hiran-Us
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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12
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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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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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14
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Ferreira I, Babo PS, Braga AC, Lopes MA, Gomes ME, Pina-Vaz I. Supplementary solvent irrigation efficacy on filling remnants removal comparing XP-endo Finisher R vs IrriSafe. Sci Rep 2021; 11:12659. [PMID: 34135434 PMCID: PMC8209217 DOI: 10.1038/s41598-021-92175-2] [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: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to compare the efficacy of XP-endo Finisher R and IrriSafe, with a solvent mixture of Methyl ethyl ketone/Tetrachloroethylene (MEK/TCE), in the removal of root filling residues. Twenty-four human mandibular incisors were pair-matched by micro-computed tomography according to volume and aspect ratio. After retreatment, specimens were allocated to two experimental groups (n = 12), according to the supplementary instrument used. The volume of residual filling material after each irrigating step and the time for retreatment was calculated. Statistical analyses were carried out using Mann-Whitney test, with a significance level of 5%. The volume of initial root canal filling material between the groups was similar (p > 0.05). With the final irrigation protocol (NaOCl and EDTA) the volume of the filling remnants decreased significantly (p < 0.05) with no differences between IrriSafe or XP-endo Finisher R (p > 0.05). The additional solvent mixture MEK/TCE increased the efficiency of filling materials reduction, regardless of the agitating instruments employed, IrriSafe or XP-endo Finisher R (p < 0.05). There was no difference between the two groups regarding the time (p = 0.149). Both supplementary instruments were effective in the reduction of filling remnants. The additional step with a solvent mixture of MEK/TCE enabled a total recovery of patency and the achievement of cleaner canals, independently of the agitation instrument.
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Affiliation(s)
- Inês Ferreira
- CINTESIS, Faculty of Medicine of University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Pedro S Babo
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence On Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4805-017, Braga/Guimarães, Portugal
| | - Ana Cristina Braga
- Department of Production and Systems, ALGORITMI Center, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Maria Ascensão Lopes
- REQUIMTE-LAQV, Department of Metallurgical and Materials Engineering, Faculty of Engineering, University of Porto, R. Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Manuela E Gomes
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence On Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4805-017, Braga/Guimarães, Portugal
| | - Irene Pina-Vaz
- CINTESIS, Faculty of Dental Medicine of University of Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
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15
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Zhou J, Liu T, Guo L. Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis. BMC Oral Health 2021; 21:294. [PMID: 34107959 PMCID: PMC8191128 DOI: 10.1186/s12903-021-01644-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01644-7.
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Affiliation(s)
- Jiani Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Tingjun Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Lihong Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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16
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Ferreira I, Braga AC, Lopes MA, Pina-Vaz I. Adjunctive procedure with solvent mixtures in non-surgical endodontic retreatment: does it affect root dentin hardness? Odontology 2021; 109:812-818. [PMID: 33811311 DOI: 10.1007/s10266-021-00603-6] [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: 01/05/2021] [Accepted: 03/26/2021] [Indexed: 01/02/2023]
Abstract
The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root's middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p < 0.05). Comparing to NaOCl + EDTA sequence, dentin hardness increased significantly with the additional exposure to MEK/TCE (3%NaOCl + 17%EDTA + MEK/TCE) or MEK/OOil (3%NaOCl + 17%EDTA + MEK/OOil) (p < 0.05). There were no significant differences regarding agitation effects on dentin hardness decrease. The irrigation protocols affected dentin hardness significantly. However, the additional solvent proposals do not seem to address further concerns on dentin's mechanical properties. Agitation did not show any influence on dentin's hardness reduction.
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Affiliation(s)
- Inês Ferreira
- Faculty of Medicine, CINTESIS, University of Porto, Porto, Portugal. .,Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Ana Cristina Braga
- Department of Production and Systems, ALGORITMI Center, University of Minho, Braga, Portugal
| | - Maria Ascensão Lopes
- Department of Metallurgical and Materials Engineering, Faculty of Engineering, REQUIMTE-LAQV, University of Porto, Porto, Portugal
| | - Irene Pina-Vaz
- Faculty of Dental Medicine, CINTESIS, University of Porto, Porto, Portugal
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17
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Efficacy of Removing Thermafil and GuttaCore from Straight Root Canal Systems Using a Novel Non-Surgical Root Canal Re-Treatment System: A Micro-Computed Tomography Analysis. J Clin Med 2021; 10:jcm10061266. [PMID: 33803810 PMCID: PMC8003142 DOI: 10.3390/jcm10061266] [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: 01/31/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022] Open
Abstract
The present study aims to evaluate the effectiveness of an XP-endo non-surgical root canal re-treatment system in removing both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems using micro-computed tomography (micro-CT) analysis. The study was performed on 20 single-rooted upper teeth, which were randomly allocated into the following study groups: Group A, Thermafil and AH Plus sealer (n = 10); Group B, GuttaCore and AH Plus sealer (n = 10). Before and after the non-surgical root canal re-treatment procedure, the samples were submitted for a micro-CT analysis. The volume of the root canal filling material (mm3), the volume of the remaining root canal filling material (mm3) and the time (minutes) needed to remove the root canal filling material were also recorded. Student's t-test was used to analyze the results. No statistically significant differences were found between the volume of the remaining root canal filling material in the GuttaCore and Thermafil root canal filling systems at the coronal third (p = 0.782), middle third (p = 0.838) or apical third (p = 0.882) of the straight root canal systems; however, the GuttaCore required a statistically significant (p = 0.037) shorter amount of time (4.72 ± 0.76 min) to be removed than the Thermafil carrier-based root canal filling material (5.92 ± 1.42 min). The XP-endo Finisher non-surgical endodontic re-treatment system removes both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems, although removal of the GuttaCore gutta-percha carrier-based root canal filling material required less time.
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18
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Uzunoglu-Özyürek E, Küçükkaya Eren S, Karahan S. Contribution of XP-Endo files to the root canal filling removal: A systematic review and meta-analysis of in vitro studies. AUST ENDOD J 2021; 47:703-714. [PMID: 33713515 DOI: 10.1111/aej.12503] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
This review was designed to analyse whether the supplementary use of XP-Endo Finisher and XP-Endo Finisher R contributes to the removal of root canal filling materials. Databases were searched up to November 2020. Studies were critically assessed according to inclusion and exclusion criteria. Risk of bias evaluation was performed. Pooled standardised mean differences (SMD) and 95% confidence intervals (95% CI) were calculated. Ten studies involving 192 teeth were eligible for systematic review and meta-analysis could be performed with eight of these studies. Strong evidence showed that XP-Endo Finisher R file contributed significantly to filling material removal from root canals (SMD (95% CI): 0.41 (0.06-0.76)). Although the evidence was conflicting, XP-Endo Finisher R file was superior than other irrigant activation techniques (SMD (95% CI): 0.47 (0.02-0.93)). The supplementary use of XP-Endo Finisher and XP-Endo Finisher R is beneficial in further removal of root canal filling materials from root canal system.
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Affiliation(s)
- Emel Uzunoglu-Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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19
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Dotto L, Sarkis-Onofre R, Bacchi A, Pereira GKR. The use of solvents for gutta-percha dissolution/removal during endodontic retreatments: A scoping review. J Biomed Mater Res B Appl Biomater 2020; 109:890-901. [PMID: 33155731 DOI: 10.1002/jbm.b.34753] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/05/2022]
Abstract
This scoping review study aimed to map the evidence about solvents' use for gutta-percha dissolution and removal during endodontic retreatments. The study protocol followed the Joanna Briggs Institute guidelines, available online (https://osf.io/5vy8n/). Reporting was based on PRISMA Extension for Scoping Reviews. We selected dentistry studies that considered the effectiveness of solvents in gutta-percha dissolution in endodontic retreatments and compared their performance to the use of instrumentation techniques without solvents. The search and study screening were performed in PubMed and Scopus databases by two independent researchers. A descriptive analysis considered the study design, method/technique used for obturation, method/technique used for instrumentation during retreatment, solvent solutions tested, exposure time, and main findings. A total of 41 studies were included. Despite that, most studies suggested that solvents' use may complicate root canal cleanliness, regardless of the type of instrumentation used, and facilitate the presence of gutta-percha remnants in the root surface. Thus, the use of solvents should be avoided and its use should only be considered if the previous working length was not possible to access without it. Despite that, high heterogeneity was observed, further studies are still encouraged comparing the performance and effects of different solvents in different clinical scenarios.
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Affiliation(s)
- Lara Dotto
- MSciD Post-Graduate Program in Dentistry, School of Dentistry, Meridional Faculty-IMED, Passo Fundo, Brazil
| | - Rafael Sarkis-Onofre
- MSciD Post-Graduate Program in Dentistry, School of Dentistry, Meridional Faculty-IMED, Passo Fundo, Brazil
| | - Ataís Bacchi
- MSciD Post-Graduate Program in Dentistry, School of Dentistry, Meridional Faculty-IMED, Passo Fundo, Brazil
| | - Gabriel Kalil Rocha Pereira
- MSciD and Phd Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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20
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Tavares SJO, Gomes CC, Marceliano-Alves MF, Guimarães LC, Provenzano JC, Amoroso-Silva P, Machado AG, Siqueira JF, Alves FRF. Supplementing filling material removal with XP-Endo Finisher R or R1-Clearsonic ultrasonic insert during retreatment of oval canals from contralateral teeth. AUST ENDOD J 2020; 47:188-194. [PMID: 33030235 DOI: 10.1111/aej.12451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/13/2020] [Accepted: 09/15/2020] [Indexed: 11/28/2022]
Abstract
This study compared the efficacy of XP-Endo Finisher R and R1-Clearsonic insert in removing filling material remnants from oval canals. Twelve pairs of contralateral premolars were treated and subsequently retreated with Reciproc 50. A supplementary procedure with XP-Endo Finisher R or R1-Clearsonic was performed. Micro-computed tomography was used to quantify the filling material volume in the full canal and apical segment lengths. Intragroup analyses revealed significant reduction of filling material after both procedures, not only in the full canal but also in the apical segment (P < 0.05). The amount of filling material removed with XP-Endo Finisher R and R1-Clearsonic was 47.9% and 52.2% in the apical segment (P > 0.05), and 82.1% and 64.6% in the full canal (P < 0.05). None of the instruments was effective in completely removing the filling material from the apical canal, but better results were obtained with XP-Endo Finisher R in the total canal length.
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Affiliation(s)
- Sandro J O Tavares
- Faculty of Dentistry, Department of Endodontics, Federal Fluminense University, Nova Friburgo, RJ, Brazil
| | - Cinthya C Gomes
- Faculty of Dentistry, Department of Endodontics, Federal Fluminense University, Nova Friburgo, RJ, Brazil
| | | | - Ludmila C Guimarães
- Faculty of Dentistry, Department of Endodontics, Federal Fluminense University, Nova Friburgo, RJ, Brazil
| | - José C Provenzano
- Faculty of Dentistry, Department of Endodontics, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Pablo Amoroso-Silva
- PostGraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - André G Machado
- Faculty of Dentistry, Department of Endodontics, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - José F Siqueira
- Faculty of Dentistry, Department of Endodontics, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.,PostGraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - Flávio R F Alves
- Faculty of Dentistry, Department of Endodontics, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.,PostGraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brazil
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21
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Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, Silva ASDS, Bueno CEDS. Micro-computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod 2020; 46:1901-1906. [PMID: 32961214 DOI: 10.1016/j.joen.2020.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study was to conduct a micro-computed tomographic assessment of the effectiveness of 3 supplementary cleaning techniques in reducing the residual volume of gutta-percha and a bioceramic sealer after performing endodontic retreatment procedures in teeth with oval canals. METHODS Thirty-six mandibular premolars were instrumented with the ProTaper Next system (instruments X1-X3; Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and Bio-C Sealer (Angelus, Londrina, PR, Brazil) using the single-cone technique. The teeth were reinstrumented with the Reciproc R40 instrument (VDW, Munich, Germany) and divided into 3 groups according to the supplementary cleaning technique used (n = 12): ultrasonic-assisted irrigation (UAI), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) irrigation (EAI), or the XP-endo Finisher R system (XPR; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Micro-computed tomographic imaging was used to quantify the residual volume of filling material. One-way analysis of variance complemented by the Tukey test was used to perform the statistical analysis (P < .05). RESULTS Significant reductions were obtained in the residual filling material after supplementary cleaning (P < .05). XPR (47.5%) led to significantly greater (P < .05) filling material removal than UAI (16.6%) or EAI (22.6%). The removal values of the 2 latter systems were not significantly different. CONCLUSIONS XPR was more effective than UAI and EAI in removing filling material in mandibular premolars with oval canals. None of the tested supplementary cleaning techniques completely removed the residual filling material.
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Affiliation(s)
- Andrea Volponi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Saddock de Sá Silva
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Ferreira I, Babo PS, Braga AC, Gomes ME, Pina-Vaz I. Effect of Sonic Agitation of a Binary Mixture of Solvents on Filling Remnants Removal as an Alternative to Apical Enlargement-A Micro-CT Study. J Clin Med 2020; 9:E2465. [PMID: 32752148 PMCID: PMC7464987 DOI: 10.3390/jcm9082465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. METHODS Twenty-four mandibular incisors were prepared with ProTaper Next (X1, X2) and obturated with the single-cone technique and AH Plus sealer. The teeth were retreated with ProTaper Universal Retreatment and ProTaper Next and divided into two groups (n = 12) according to the final instrument (X3 or X4). All canals were submitted to a supplementary procedure consisting of a mixture of solvents-methyl ethyl ketone/tetrachloroethylene, agitated with EndoActivator. The volume of filling remnants was assessed through micro-computed tomography in the apical 5 mm. Statistical analysis was performed with a significance level of 5%. RESULTS The supplementary procedure of agitation of the solvent mixture was beneficial in both groups (p < 0.05). There were no statistically significant differences between canals re-prepared until X4 and canals re-prepared until X3 plus solvent (p > 0.05). CONCLUSIONS An additional step with a two-solvent solution potentiated by EndoActivator showed to be very effective for the removal of gutta-percha and resinous sealer remnants from apical root canals of mandibular incisors, avoiding further enlargement.
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Affiliation(s)
- Inês Ferreira
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- CINTESIS, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Pedro S. Babo
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal; (P.S.B.); (M.E.G.)
- ICVS/3B’s – PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Ana Cristina Braga
- Department of Production and Systems, ALGORITMI Center, University of Minho, Campus de Gualtar 4710-057 Braga, Portugal;
| | - Manuela E. Gomes
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal; (P.S.B.); (M.E.G.)
- ICVS/3B’s – PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Irene Pina-Vaz
- CINTESIS, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
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Comparison of Obturation Removal Efficiency from Straight Root Canals with ProTaper Gold or Reciproc Blue: A Micro-Computed Tomography Study. J Clin Med 2020; 9:jcm9041164. [PMID: 32325751 PMCID: PMC7230688 DOI: 10.3390/jcm9041164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background: The objective was to evaluate the efficiency of ProTaper Gold (PTG) and Reciproc Blue (RB) NiTi files in obturation material removal from straight root canals assessed by micro-computed tomography. Methods: Fifty-two anterior human teeth were shaped with a PTG rotary system until F2 (25/.08). Specimens were obturated with a continuous wave of condensation technique. For retreatment, specimens were randomly distributed in two experimental groups: PTG group (F4 file) and RB (R40 file). Micro-CT scans were performed before and after retreatment procedures. The percentage of the remaining obturation material compared to the original volume was calculated, as well as the retreatment time. The presence of separated files was recorded. A descriptive analysis was carried out, and nonparametric tests were employed. Results: The mean percentages of remaining obturation material in the PTG group and the RB group were 4.14 ± 4.30% and 4.18 ± 4.29%, respectively. The mean retreatment times for the PTG and RB groups were 144 ± 51 and 163 ± 88 s, respectively. There were no statistically significant differences, neither in removal efficiency (p > 0.05) nor in retreatment time (p > 0.05), between the two groups. The coronal and middle thirds presented significantly more remaining obturation material than the apical third (p < 0.05). No file separation occurred. Conclusions: ProTaper Gold and Reciproc Blue present with comparable efficiency in removing the obturation material, with a similar mean retreatment time.
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