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Hakeem FF, Hakeem MM, Abdulaziz Baik A, Omar Aldadjan R, Ali Alsahli R, Jafar Almarwani A, Abu Zaid BM. Prevalence of Apical Periodontitis in Saudi Arabia: A Systematic Review and Meta-analysis. Saudi Dent J 2024; 36:1078-1085. [PMID: 39176162 PMCID: PMC11337961 DOI: 10.1016/j.sdentj.2024.06.009] [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: 03/04/2024] [Revised: 05/19/2024] [Accepted: 06/02/2024] [Indexed: 08/24/2024] Open
Abstract
Objective This systematic review was aimed to assess the prevalence of apical periodontitis (AP) in Saudi Arabia, focusing on individual-level prevalence and the frequency of AP in endodontically versus untreated teeth. Methods This review followed the PRISMA guidelines and involved searches in several databases, including PubMed-MEDLINE, Cochrane-CENTRAL, and EMBASE, without date restrictions until August 19th, 2023. Eligibility criteria encompassed studies using CBCT, panoramic, and periapical radiographs to diagnose AP in the Saudi population. The meta-analysis employed a random-effects model due to high heterogeneity among studies. Results From 359 records, 13 studies were included, indicating a 40% prevalence of AP in individuals and a 6% prevalence across all teeth within the Saudi population. Root canal-treated teeth demonstrated a higher prevalence at 47%. The data revealed a substantial prevalence of AP compared to global averages, with first molars being the most affected. Studies showed moderate risk of bias and significant heterogeneity. Conclusion The high occurrence of AP in Saudi Arabia, particularly in root-treated teeth, emphasizes the need for enhanced endodontic care and more accurate diagnostics. Urgent improvements in dental health policies and further research are essential to understand AP's impact and improve oral health outcomes.
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Affiliation(s)
- Faisal F. Hakeem
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Muhannad M. Hakeem
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | | | - Rasha Omar Aldadjan
- College of Dentistry, Taibah University Dental College & Hospital, Madinah, Saudi Arabia
| | - Razan Ali Alsahli
- College of Dentistry, Taibah University Dental College & Hospital, Madinah, Saudi Arabia
| | - Arina Jafar Almarwani
- College of Dentistry, Taibah University Dental College & Hospital, Madinah, Saudi Arabia
| | - Basim M. Abu Zaid
- College of Dentistry, Taibah University Dental College & Hospital, Madinah, Saudi Arabia
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Atmeh AR, Alshaiji D, Abdunabi F, Alamri M, Khamis AH. Comparing the softening effect of three gutta-percha solvents on different types of gutta-percha with different application durations. Saudi Dent J 2024; 36:281-285. [PMID: 38419989 PMCID: PMC10897599 DOI: 10.1016/j.sdentj.2023.10.025] [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: 05/20/2023] [Revised: 09/27/2023] [Accepted: 10/31/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction During non-surgical endodontic retreatment, gutta-percha (GP) solvents are indispensable in difficult cases when used with mechanical removal, however studies comparing their efficacy against different types of GP are limited. The purpose of this study was to investigate the softening effect of three solvents on the conventional (CGP), cross-linked carrier-based (CLGP), and thermoplasticized (TGP) and compare the effect of time on the softening effect of the solvents. Methods Tested GP were embedded in cuboidal blocks of stone with their upper surfaces exposed (1 mm diameter). Three commercial GP solvents based on D-Limonene (DL), Eucalyptol oil (EO), and orange oil (OO) were added to the exposed GP before an indenter (weight = 1Kg) was applied. Using a digital camera, the indentation depth was measured (mm) directly after applying the solvent and indenter (T = 0), and after 1, 2, and 3 min of application (T = 1,2,3). The means of indentation depth were calculated and compared using a two-way analysis of variance and Tukey's post-hoc test to assess the effect of the types of solvent, GP for each application duration, and Friedman's test to evaluate the effect of application duration on the softening effect of solvents. Results The type of GP (F = 261.43, p < 0.001), type of solvent (F = 3.57, p = 0.015), and application duration (F = 53.088, p < 0.001) were all found to significantly affect GP softening. DL exhibited the highest and only significant effect on CGP after 1 min (p < 0.05), while OO had the only significant effect against CLGP when applied for at least 2 min (p < 0.05). Both OO and EO had significant softening effects on TGP instantly or after 1 min of application, respectively. Conclusions The results of this study revealed that the softening effect of GP solvents varies depending on their type, their application duration, and the type of GP.
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Affiliation(s)
- Amre R Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Dhary Alshaiji
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Farida Abdunabi
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Mohammed Alamri
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
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Paixão S, Rodrigues C, Grenho L, Fernandes MH. Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of in vitro studies. Acta Odontol Scand 2022; 80:588-595. [PMID: 35430959 DOI: 10.1080/00016357.2022.2061591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation. METHOD Systematic literature review was implemented, using 12 databases. All in vitro studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included. RESULTS At the apical level, pooling the data in the random-effects model (I2=64%, p = .1) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; p = .03). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; p = .002) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; p < .0001) of the root canal. CONCLUSIONS Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.
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Affiliation(s)
- Sara Paixão
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
| | - Cláudia Rodrigues
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
| | - Liliana Grenho
- Faculdade de Medicina Dentária, Laboratory for Bone Metabolism and Regeneration, U. Porto, Porto, Portugal
- LAQV/REQUIMTE, U. Porto, Porto, Portugal
| | - Maria Helena Fernandes
- Faculdade de Medicina Dentária, Laboratory for Bone Metabolism and Regeneration, U. Porto, Porto, Portugal
- LAQV/REQUIMTE, U. Porto, Porto, Portugal
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Gover E, Rakhra D. COLD LATERAL CONDENSATION ROOT CANAL TREATMENT TO RETAIN FRACTURED CANINES OF A FERRET (MUSTELA PUTORIUS FURO). J Exot Pet Med 2022. [DOI: 10.1053/j.jepm.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sharma S, Raghu R, Shetty A, Rajasekhara S, Lakshmisetty H, Bharath G. An in vitro comparative evaluation of retreatability of a bioceramic and resin sealer using cone-beam computed tomography analysis. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baranwal HC, Mittal N, Garg R, Yadav J, Rani P. Comparative evaluation of retreatability of bioceramic sealer (BioRoot RCS) and epoxy resin (AH Plus) sealer with two different retreatment files: An in vitro study. J Conserv Dent 2021; 24:88-93. [PMID: 34475687 PMCID: PMC8378486 DOI: 10.4103/jcd.jcd_657_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 11/26/2022] Open
Abstract
Aim: The aim of the study was to evaluate and compare the retreatability of BioRoot RCS and AH Plus sealer with two different retreatment file systems using cone-beam computed tomography (CBCT) for assessing the filling remnants. Materials and Methods: A total of sixty mandibular premolars with single and oval root canals were prepared till size F3 and obturated with GP/AH Plus (Group 1) and GP/BioRoot RCS (Group 2). Canals were then retreated using two different retreatment file systems – ProTaper Universal Retreatment (PTUR) system and NeoEndo Retreatment system. The ability to re-establish working length (WL) and apical patency was recorded, and the percentage volume of residual filling material was evaluated using CBCT at the coronal, middle, and apical thirds. Data from the study were analyzed using one-way analysis of variance with Pearson's Chi-squared analysis and the Kruskal–Wallis test. Results: No statistically significant difference was found in the amount of residual sealer (AH Plus and BioRoot RCS) after retreatment throughout the whole study (P > 0.05) at various root canal levels. Furthermore, the BioRoot RCS group retreated with the PTUR system showed a higher frequency of failure in re-establishing WL and regaining apical patency than the other groups. Conclusion: Complete removal of root canal sealers could not be achieved regardless of the type of sealer used and the retreatment technique employed. Furthermore, in clinical settings, the retreatability of novel BioRoot RCS may be deemed feasible.
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Affiliation(s)
- Harakh Chand Baranwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Neelam Mittal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Riya Garg
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jyoti Yadav
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Prachi Rani
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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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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8
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Uzunoglu-Özyürek E, Askerbeyli-Örs S, Türker SA. Evaluation of the amount of remained sealer in the dentinal tubules following re-treatment with and without solvent. J Conserv Dent 2021; 23:407-411. [PMID: 33623245 PMCID: PMC7883780 DOI: 10.4103/jcd.jcd_445_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 11/09/2022] Open
Abstract
Background: The effect of solvent and sealer type (BioRoot RCS [BRRCS], mineral trioxide aggregate [MTA] Fillapex, and AH26) on the root canal residues was evaluated by confocal laser scanning microscopy (CLSM). Materials and Methods: Distal root canals of 60 mandibular molars prepared up to ProTaper-F4 were filled using one of the sealers labeled with 0.1% rhodamine-B (n = 20 per sealer). Samples were divided into two according to reprocessing methods as follows: ProTaper Universal Reprocessing System (PTUR) or solvent plus PTUR. Samples were sectioned at 2–5 and 8 mm from the apex and the samples were observed under CLSM. Penetration depth, percent penetration depth, and percent penetration into canal walls were evaluated. Statistical analysis was performed using the repeated measures of the two-way ANOVA and Bonferroni post hoc test at P = 0.05. Results: The highest penetration depth was measured in BRRCS in all root canal thirds with or without chloroform addition. Percentage of penetration depth values of MTA Fillapex and BRRCS was statistically similar and higher than AH26 in all sections, except the apical section re-treated with the addition of chloroform. Conclusion: None of the sealers were completely removed. The type of sealant and the use of chloroform changed the amount of sealant remaining in the root canal system.
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Affiliation(s)
- Emel Uzunoglu-Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli-Örs
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinç Aktemur Türker
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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Purba R, Sonarkar SS, Podar R, Singh S, Babel S, Kulkarni G. Comparative evaluation of retreatment techniques by using different file systems from oval-shaped canals. J Conserv Dent 2020; 23:91-96. [PMID: 33223649 PMCID: PMC7657436 DOI: 10.4103/jcd.jcd_167_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/26/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Endodontic failure resolves after complete removal of obturating material followed by disinfection, cleaning, shaping and three-dimensional obturation. Materials and Methods: Seventy single-rooted mandibular premolars, with single oval-shaped root canal were included. They were decoronated at a length of 16 mm from the apex. Shaping and cleaning were performed, and obturation was done using the warm lateral compaction technique. The teeth were divided into seven groups according to retreatment procedures (Hand files; ProTaper Universal retreatment files; MTwo® Retreatment system; R-Endo® Retreatment system; ProTaper Universal retreatment files with solvent and ultrasonics; MTwo® R with solvent, and ultrasonics and R-Endo® with solvent and ultrasonics). The data were obtained and subjected to the statistical analysis. Results: All instrumentation techniques left obturating material with least in Group 6 and maximum Group 5. The mean time taken for complete retreatment procedure was minimum in Group 2 and maximum with Group 1. Conclusion: MTwo® R with solvent and ultrasonics, R-Endo®, and R-Endo® with solvent and ultrasonics were effective in gutta-percha removal from coronal third, middle third, and apical third, respectively. Significance: Nonsurgical endodontic retreatment using rotary files helps in gaining access to infected teeth. During retreatment procedure, this helps disinfectant to reach in critical areas of the root canal system, thereby decreasing the microbial load, leading to achieve healthy periradicular tissues.
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Affiliation(s)
| | - Snehal S Sonarkar
- Department of Conservative Dentistry and Endodontics, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rajesh Podar
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navimumbai, Maharashtra, India
| | - Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navimumbai, Maharashtra, India
| | - Shashank Babel
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navimumbai, Maharashtra, India
| | - Gaurav Kulkarni
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navimumbai, Maharashtra, India
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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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Donyavi Z, Shokri A, Pakseresht Z, Tapak L, Falahi A, Abbaspourrokni H. Comparative Evaluation of Retreatability of Endodontically Treated Teeth using AH 26, Fluoride Varnish and Mineral Trioxide Aggregate-based Endodontic Sealers. Open Dent J 2019. [DOI: 10.2174/1874210601913010183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
Endodontic sealers are used to fill the gap between the root filling material and canal walls. Retrievability is an important requirement for sealers and root filling materials in non-surgical endodontic retreatment. This study sought to assess the retreatability of fluoride varnish, AH 26 and Mineral Trioxide Aggregate (MTA)-based sealers using Cone-Beam Computed Tomography (CBCT).
Materials and Methods:
This in vitro, experimental study evaluated 45 extracted single-rooted, single-canal human mandibular premolars. Teeth with cracks or fracture were excluded. The root canals were prepared using ProTaper Universal rotary system up to size F4 according to the manufacturer’s instructions. The teeth were then randomly divided into three groups of 5% fluoride varnish, AH 26 and MTA Fillapex. CBCT scans were obtained of the teeth with 200 μm voxel size. MATLAB R2012 software was used to quantify the amount of sealer remaining in the canal. Two observers evaluated the images. Data were analyzed using SPSS via the Kruskal-Wallis and Mann Whitney tests.
Results:
The amount of sealer remaining in the root canals was significantly different among the three groups (P<0.05). The amount of AH 26 sealer remaining in the root canals (1.91±1.46) was significantly greater than MTA Fillapex (0.62±0.26) and fluoride varnish, but the latter two were not significantly different in this respect (P>0.05).
Conclusion:
Considering the adequate adhesion of fluoride varnish to dentin, its cariostatic effect and low cost, it seems to be a suitable alternative to the commonly used endodontic sealers.
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12
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Jiang S, Zou T, Li D, Chang JWW, Huang X, Zhang C. Effectiveness of Sonic, Ultrasonic, and Photon-Induced Photoacoustic Streaming Activation of NaOCl on Filling Material Removal Following Retreatment in Oval Canal Anatomy. Photomed Laser Surg 2015; 34:3-10. [PMID: 26682489 DOI: 10.1089/pho.2015.3937] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to assess the effectiveness of sonic, ultrasonic and laser [photon-induced photoacoustic streaming (PIPS)] irrigation activation in removing filling remnants from oval root canals after standard canal retreatment procedures with the ProTaper universal rotary retreatment system. METHODS Twenty-eight maxillary first premolars were instrumented with ProTaper NiTi rotary instruments and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. After storage at 37°C and 100% humidity for 1 week, the specimens were retreated with the ProTaper universal retreatment system for the removal of filling material. Teeth were then randomly assigned into four groups (n = 7): group 1, positive control; group 2, retreated with sonic irrigation; group 3, retreated with ultrasonic irrigation; and group 4, retreated with laser irradiation. The specimens were scanned using micro-CT before instrumentation, after obturation and mechanical retreatment, and after additional activation procedures. The percentage volume of the filling remnants was measured. Specimens were split longitudinally after micro-CT scan, canal walls were examined using scanning electron microscopy (SEM), and the amount of residual filling material was scored. RESULTS The filling materials' removal efficacy in the three experimental groups was higher than that of the control group (p < 0.05), whereas filling materials ranging from 1.46 ± 0.30 to 2.21 ± 0.46 mm(3) remained in the canal in all three experimental groups. Additionally, there was a significantly greater reduction in the amount of filling remnants in the PIPS group than in the sonic and ultrasonic groups (both p < 0.05), and significantly greater reduction in the ultrasonic group than the sonic group (p < 0.05). CONCLUSIONS Activation of NaOCl with PIPS showed significantly better performance than sonic and ultrasonic techniques in removing the filling remnants following mechanical retreatment of oval root canals. The ultrasonic technique also performed better than the sonic technique. However, none of the additional activation procedures was able to completely eliminate the filling remnants.
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Affiliation(s)
- Shan Jiang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Ting Zou
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Dongxia Li
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China .,3 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China
| | - Jeffery W W Chang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Xiaojing Huang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Chengfei Zhang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
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13
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Chandrasekar, Ebenezar AVR, Kumar M, Sivakumar A. A comparative evaluation of gutta percha removal and extrusion of apical debris by rotary and hand files. J Clin Diagn Res 2015; 8:ZC110-4. [PMID: 25584299 DOI: 10.7860/jcdr/2014/10203.5199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/20/2014] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study was to evaluate the efficacy of Protaper retreatment files in comparison with RaCe, K3 and H-files for removal of gutta-percha and apically extruded debris using volumetric analysis. MATERIALS AND METHODS Forty extracted single rooted maxillary incisor teeth with straight canals and mature apices were selected for the study. After access cavity preparation, apical patency was confirmed with a size 10 K-file extending 1mm beyond the point at which it was first visible at the apical end. Working lengths were determined with the use of size 15 K-file. The canals were prepared in a step-back technique and the master apical file was size 30 for all teeth. 3% sodium hypochlorite was used as an irrigant after each instrumentation. Before final rinse, size 20 K-file was passed 1mm beyond the apex to remove any dentinal shaving plugs and maintain the apical patency. Then the canals were dried with paper points. The root canal was filled using standard gutta-percha points and zinc oxide eugenol sealer under lateral condensation technique. The teeth were then randomly divided into four groups of ten teeth each based on the instrument used for gutta percha removal. All the rotary instruments used in this study were rotated at 300rpm. The instruments used were: Group 1 - RaCe Files, Group 2 - ProTaper retreatment Files, Group 3 - K3 Files and Group 4 - H Files. The volume of the obturating material was calculated before and after removal using volumetric analysis with spiral CT. The removal efficacy with each instrument was calculated and statistically analysed. RESULTS The results of the study show that the ProTaper retreatment files (Group 2) (97.4%) showed the highest efficiency in the removal of obturating material, which was followed by RaCe (95.74%), K3 (92.86%) and H files (90.14%) with the efficiency in the decreasing order. Similarly the mean apical extrusion in H files (0.000 ± 0.002) was significantly lower than all the rotary instruments. However, the difference among the rotary files were not statistically significant (p>0.05). CONCLUSION ProTaper retreatment files show significant difference over other groups in removal of obturating material and can be the system of choice in endodontic retreatment procedures.
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Affiliation(s)
- Chandrasekar
- Lecturer, Department of Conservative Dentistry & Endodontics, JKK Dental College , Komarapalayam, Tamilnadu, India
| | - A V Rajesh Ebenezar
- Professsor, Department of Conservative Dentistry & Endodontics, Madha Dental College , Kundrathur, Chennai, Tamilnadu, India
| | - Mohan Kumar
- Professsor, Department of Conservative Dentistry & Endodontics, JKK Dental College , Komarapalayam, Tamilnadu, India
| | - A Sivakumar
- Principal and Professor, Department of Conservative Dentistry & Endodontics, JKK Dental College , Komarapalayam, Tamilnadu, India
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