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Lyngdoh D, Alam S, Iftekhar H, Mishra SK. Evaluation of canal patency and cleanliness following retreatment of bioceramic sealer-obturated root canals using three different irrigant activation protocols. AUST ENDOD J 2024. [PMID: 38745548 DOI: 10.1111/aej.12855] [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: 04/04/2023] [Revised: 04/28/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
This study evaluated the effectiveness of three different irrigant activation techniques in cleaning and establishing patency during retreatment of root canals obturated with gutta-percha and bioceramic sealer. 60 extracted premolars with oval-shaped canals were instrumented and obturated with gutta-percha and EndosequenceBC sealer using the 'warm hydraulic condensation' technique. The teeth were retreated using Protaper Universal Retreatment and XP-Endo Shaper system and divided into four groups according to the irrigant activation protocol used: control, passive ultrasonic irrigation (PUI), Endovac irrigation (EVI) and XP-Endo Finisher R (XPFR). Apical patency was achieved in all the samples of the XPFR group (100%), which showed a significantly higher success rate compared with the control (73.3%) and EVI groups (73.3%) (p < 0.05). The scanning electron microscopic evaluation revealed significantly cleaner middle and apical third root canals in the PUI and XPFR groups compared with the control group (p < 0.05). These findings suggest that XPFR effectively cleans and establishes patency in root canals filled with bioceramic sealers.
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Affiliation(s)
- Daiasharailang Lyngdoh
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Sharique Alam
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Huma Iftekhar
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
| | - Surendra Kumar Mishra
- Department of Conservative Dentistry and Endodontics, Dr Z.A Dental College, Aligarh Muslim University, Aligarh, India
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Elzanaty TK, Elashiry MM, Mahran AH. Retreatability of NeoSEALER Flo obturated with warm vertical compaction versus single-cone technique using two different retreatment systems. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:286-292. [PMID: 38634031 PMCID: PMC11019814 DOI: 10.4103/jcde.jcde_314_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 04/19/2024]
Abstract
Aim The aim of this study was to compare the retreatability of NeoSEALER Flo obturated with warm vertical compaction (WVC) and single-cone (SC) techniques using two different retreatment systems. Materials and Methods Thirty-two root canals were shaped and obturated with NeoSEALER Flo either in an SC obturation technique or a WVC technique. Samples were retreated using ProTaper retreatment or EdgeFile XR retreatment system. The percentage of remaining debris after retreatment was analyzed under a scanning electron microscope using ImageJ software. The time taken to reach full working length (WL) and induce patency was recorded. Statistical Analysis Statistical analysis was performed using an unpaired t-test and a one-way analysis of variance test. Results The percentage of remaining debris after retreatment was significantly higher in the SC technique than in the WVC technique, regardless of the retreatment system used. EdgeFile XR system removed more filling material than the ProTaper retreatment system, regardless of the obturation technique. The apical region showed significantly higher remaining debris than other regions in all groups. The WL and patency were achieved faster in the SC group, while in the WVC group, the EdgeFile XR system was faster. Conclusions The WVC technique showed better retrieval of the filling material; however, a longer time was taken for retreatment. EdgeFile XR system performed better in removing filling materials from inside the canals.
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Affiliation(s)
| | - Mohamed M. Elashiry
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Abeer Hashem Mahran
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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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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Rodriguez-López A, Moreno-Chavez K, Mingo-Zambrano E, Noguera-García M, Ballester-Palacios ML, Berástegui E. Root canal retreatment of root canals filled with "Neo MTA 2" and epoxy resin, using continuous and asymmetric reciprocal rotation systems: In vitro study. J Clin Exp Dent 2024; 16:e166-e171. [PMID: 38496817 PMCID: PMC10943684 DOI: 10.4317/jced.61266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/18/2023] [Indexed: 03/19/2024] Open
Abstract
Background The study aimed to compare the amount of extrusion, the time taken to achieve apical patency and duration for removing filling material during the retreatment of teeth filled with NeoMTA 2® (Avalon Biomed, Houston, TX, USA), a calcium silicate hydraulic cement and AHPlus™ (Denstsply, Konstanz, Germany), a resin-based cement, using continuous rotation and asymmetric reciprocating rotation instruments. Material and Methods 60 monoradicular human teeth were selected and instrumented with Race #35.06 (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The teeth were randomly assigned to two groups based on the cement used for filling (n = 30 each) AHPlus™ and NeoMTA 2®. Both groups were obturated with gutta-percha, using the lateral condensation technique. During non-surgical retreatments, each group was further divided into two subgroups: D-Race (FKG) and Reciproc (VDW, Munich, Germany) (n = 15 each). The total time to achieve apical patency and complete the retreatment were recorded. Extruded debris were collected and weighted. Student t-tests were employed for mean comparisons to assess significant differences between variables. Results No statistically significant differences were found in terms of type of cement and apical extrusion. Regarding the rotation system, using the Reciproc system resulted in longer time to achieve patency and retreatment times compared to D-Race system, with statistically significant differences (P< 0.05). Conclusions All systems used in retreatment led to apical extrusion. Apical patency was achieved in all cases. Key words:D-Race, Reciproc, calcium silicate-based cement, root canal retreatment.
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Affiliation(s)
| | - Keilin Moreno-Chavez
- DDS. Master in Advanced and Experimental Endodontics. University of Barcelona, Spain
| | - Elisabet Mingo-Zambrano
- DDS. Professor on Master in Advanced and Experimental Endodontics. University of Barcelona, Spain
| | - Maria Noguera-García
- DDS. Professor on Master in Advanced and Experimental Endodontics. University of Barcelona, Spain
| | - Maria-Lluïsa Ballester-Palacios
- PhD, DMD, DDS. Professor on Master's Advanced and Experimental Endodontics. University of Barcelona. Researcher of the Idibell Institute
| | - Esther Berástegui
- PhD, DMD, DDS. Director of Master's Advanced and Experimental Endodontics. University of Barcelona. Researcher of the Idibell Institute
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Sarı M, Yılmaz K. The Effect of Different Obturation Techniques Using Different Root Canal Sealers on the Residual Filling Material After Retreatment Procedures. Niger J Clin Pract 2024; 27:174-179. [PMID: 38409144 DOI: 10.4103/njcp.njcp_33_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: 01/14/2023] [Accepted: 01/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND This study aimed to compare the effect of different obturation techniques with root canal sealers on the residual filling material after retreatment using SEM. MATERIAL AND METHOD Sixty (60) single rooted mandibular premolars were selected and instrumented with rotary files using the Mtwo system up to file size 30/.05 taper. The samples were randomly divided to two groups based on the type of sealer and three sub-groups (n=10) based on the obturating technique used. The root fillings were removed using the PTUR system files and the specimens were longitudinally sectioned while digital images were obtained from the root canals with SEM. The time required to reach working lenght were recorded. RESULTS There was no difference in terms of the smear score when comparing both sealer and obturation technique groups in the apical third. Smear scores were significantly affected by the type of sealer and obturation technique in the medium and coronal thirds of root canals (p<0.05). Higher smear scores were obtained with GFB than AH Plus (p<0.05). The time required to reach working length with GFB was longer than AH Plus (p<0.05). CONCLUSION Residual filling material was observed in all samples, regardless of the root canal sealer or the obturation technique used. There was a significantly lower smear scores in the AH Plus groups as compared to the GFB.
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Affiliation(s)
- M Sarı
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
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Gupta A, Showkat R, Singh TK. Innovative ex vivo exploration: A comparative study of novel approaches of root canal filling material removal efficiency. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:713-718. [PMID: 38292747 PMCID: PMC10823978 DOI: 10.4103/jcde.jcde_162_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 02/01/2024]
Abstract
Introduction Retention of the natural tooth without any symptoms in the oral cavity is one of the prime desires of endodontic treatment. Root canal therapy usually leads to failure when treatment is not up to the mark of acceptable standards. To address these deficiencies, non-surgical endodontic retreatment is the most accepted option with the success rate ranging from 65% to 83%. Forty-five single-rooted mandibular premolars with undeviated canals (as per Schneider's criteria) were obtained and divided further into three groups with 15 specimens along with resin-based sealer solvent in each group: Group 1 - Retreatment rotary file system, Group 2 - Ultrasonics, and Group 3 - Diode laser. Specimens were then evaluated under a stereomicroscope at ×10 after cutting in two halves followed by evaluation of the remaining filling material using Hulsmann and Bluhm criteria. Context Nonsurgical retreatment. Aims The aim of the study was to evaluate and compare the efficacy of various retreatment techniques for the elimination of root canal filling material. Settings and Design The sample size was determined using the formula n = (Zα/2)2 s2/d2. The design of the study is in vitro experimental study. Subjects and Methods A sum of 45 single-rooted extracted human permanent mandibular premolars were included in this study. All teeth were biomechanically prepared and obturated followed by decoronating the samples. All specimens were randomly divided into 3 groups comprising 15 specimens along with solvent based on the technique for the filling material elimination from the root canal, i.e. Group I: retreatment rotary files, Group II: ultrasonics, and Group III: diode laser. Statistical Analysis Used The Tukey's post hoc tests and one-way analysis of variance were used for comparison of the study parameters among the groups. Results Results revealed that ultrasonics showed the least amount of remaining filling material within the root canal which had a significant difference from other groups, i.e. retreatment rotary files and diode laser. Conclusions Ultrasonics with a resin-based sealer solvent can be considered a preferred option for nonsurgical retreatment. However, none of the groups shows complete elimination of filling material inside the root canal system.
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Affiliation(s)
- Aakash Gupta
- Department of Dentistry, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Rukhsar Showkat
- Department of Dentistry, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Tarun Kumar Singh
- Department of Dentistry, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Asgary S, Parhizkar A. Healing of large endodontic lesions using a new combination of triple antibiotics: A case report. Clin Case Rep 2023; 11:e6879. [PMID: 36703762 PMCID: PMC9871415 DOI: 10.1002/ccr3.6879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/09/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
In the case report presented, three cases of large endodontic lesions, which were the consequences of endodontic treatment failure, were studied. In all cases, a novel combination of triple antibiotics was used to successfully manage and heal the lesions, showing the promising potential of the antibiotic combination in resolving pathosis.
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Affiliation(s)
- Saeed Asgary
- Iranian Centre for Endodontic Research, Research Institute for Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Ardavan Parhizkar
- Iranian Centre for Endodontic Research, Research Institute for Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
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Jurić Kaćunić D, Tadin A, Dijanić P, Katunarić A, Matijević J, Trutina-Gavran M, Galić N. Efficacy of Reciprocating Instruments in Retreatment of Bioactive and Resin-Based Root Canal Sealers. Acta Stomatol Croat 2022; 56:338-350. [PMID: 36713274 PMCID: PMC9873006 DOI: 10.15644/asc56/4/1] [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: 08/25/2022] [Accepted: 11/22/2022] [Indexed: 12/29/2022] Open
Abstract
Objective To compare the effectiveness of reciprocating instruments in removing gutta-percha and bioactive-based (BioRoot RCS and MTA Fillapex) and epoxy resin-based (AH Plus) sealers from root canals based on filling residues and the time required for root canal revision. Material and methods Root canals of 90 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and with one of the selected sealers. Samples with oval, straight canals were used and randomly divided into three groups: (i) filled with AH Plus sealer and gutta-percha (n=30); (ii) filled with MTA Fillapex and gutta-percha (n=30); (iii) filled with BioRoot RCS and gutta-percha (n=30). Each group was divided into two subgroups (n=15) according to the retreatment instrument used (Reciproc M-Wire R25/R40 or Reciproc blue RB25/RB40). Root canals were longitudinally split and analyzed with a stereomicroscope at 15 × magnifications in the coronal, middle, and apical third. Computational analyses were performed with the Image J software. Data were compared using the Kruskal-Wallis test and Mann-Whitney U test. Results While no statistically significant differences in the residual material surface were found for Reciproc Blue, Reciproc M-Wire showed significantly higher residual material surface for AH Plus and MTA Fillapex compared to BioRoot RCS. For AH plus. Residual material surface was significantly lower for Reciproc Blue than for Reciproc M-Wire. In contrast, BioRoot RCS showed a significantly higher residual material surface for Reciproc Blue. Conclusions Calcium silicate-containing sealers were more retrievable compared to AH Plus, with fewer sealer remnants and shorter retreatment time. Retreatment with Reciproc M-Wire instruments was superior to Reciproc blue instruments in retreatment of BioRoot RCS. However, none of the sealers were removed completely.
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Affiliation(s)
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | | | - Adriana Katunarić
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Jurica Matijević
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Milena Trutina-Gavran
- Department of Morphology and Anthropology, Study of Dental Medicine, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Nada Galić
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Singh AK, Raj K, Mailankote S, Gopakumar R, Jayachandran M, Uthman US. Assessment of the Dentinal Surface Adaptation Efficacy of Different Obturation Systems with Bioceramic Sealer: A Scanning Electron Microscope Study. J Contemp Dent Pract 2022; 23:834-838. [PMID: 37283019 DOI: 10.5005/jp-journals-10024-3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM Aim of this study was to evaluate the dentinal surface adaptation effectiveness of different obturation methods with bioceramic sealer. MATERIALS AND METHODS Sixty recently removed human permanent premolars of the mandible having a solitary, straight as well as completely produced root were chosen on the basis of clinical/radiographic evaluation. The coronal parts of the premolars were subjected to sectioning at the cementoenamel junction (CEJ) with the aid of a water-cooled diamond disk. The regular access opening was done, following which the working length was visually estimated by deducting 1 mm from the length of a 10 size K-file (Dentsply, OK, USA) at the apex. Subsequent to preparing the radicular canal, the premolar specimens were randomly allocated to one of the following three groups. Group I: Lateral compaction (LC) technique; group II: Warm vertical compaction (WVC) technique; and group III: Thermafil obturation technique. Following obturation, the samples were subjected to sectioning in the horizontal direction at three dissimilar points as follows: First at the cervical third, then at the middle, and at the apical third employing a minitom under water irrigation to put off overheating. Internal spaces amid the radicular dentin as well as the obturating agents were appraised with the use of a scanning electron microscope (SEM). RESULTS Intragroup analysis showed that higher gaps were noted at the coronal level (2.30 ± 0.04), in pursuit by middle part (1.12 ± 0.02) and apical third (0.70 ± 0.02) for the LC method. With the WVC procedure, higher gaps were situated in the coronal level (1.96 ± 0.07), again in pursuit by middle part (1.02 ± 0.02) and apical third (0.86 ± 0.04). Even with the Thermafil obturation method, higher gaps were noted at the coronal level (0.92 ± 0.10), in pursuit by middle part (0.67 ± 0.05) and apical third (0.57 ± 0.01). No statistically significant difference was noted within the group. Upon intergroup comparative assessment of dentinal surface adaptation with dissimilar obturation systems at coronal, middle and apical thirds, there was a statistically noteworthy disparity amid the groups (p <0.001). CONCLUSION This research arrived at a conclusion that the most superior dentinal adaptation of bioceramic sealer was procured when the Thermafil obturation method was employed for obturating the root canals compared to the WVC technique as well as the LC technique. CLINICAL SIGNIFICANCE Numerous endodontic substances have been promoted for obturating the root canal areas. Majority of the methods use a core substance, in addition to a sealer. Despite the type of core agent, a sealer indispensable to each technique offers a fluid-tight sealing. The oral physicians' comprehension of the characteristics of the endodontic sealer plus method used, enhances the therapeutic effect.
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Affiliation(s)
- Abhinav Kumar Singh
- Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India, Phone: +91 9576969374, e-mail:
| | - Kavita Raj
- Department of Dentistry, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Shilpa Mailankote
- Department of Public Health Dentistry, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Rethi Gopakumar
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Trivandrum, Kerala, India
| | - Mahesh Jayachandran
- Department of Periodontics, Noorul Islam College of Dental Sciences, Trivandrum, Kerala, India
| | - Uthman S Uthman
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Saudi Arabia
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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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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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Bhandi S, Mashyakhy M, Abumelha AS, Alkahtany MF, Jamal M, Chohan H, Raj AT, Testarelli L, Reda R, Patil S. Complete Obturation-Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4013. [PMID: 34300930 PMCID: PMC8304925 DOI: 10.3390/ma14144013] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 01/31/2023]
Abstract
To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods-cold lateral condensation and warm gutta-percha techniques-using micro-CT (PROSPERO reg no. 249815). MATERIALS AND METHODS A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies. RESULTS A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation. CONCLUSION Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.
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Affiliation(s)
- Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - Abdulaziz S. Abumelha
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Mazen F. Alkahtany
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Mohamed Jamal
- Department of Endodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health Care City, Dubai 505055, United Arab Emirates;
| | - Hitesh Chohan
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (S.B.); (M.M.); (H.C.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (L.T.); (R.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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13
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Dasari L, Anwarullah A, Mandava J, Konagala RK, Karumuri S, Chellapilla PK. Influence of obturation technique on penetration depth and adaptation of a bioceramic root canal sealer. J Conserv Dent 2021; 23:505-511. [PMID: 33911361 PMCID: PMC8066675 DOI: 10.4103/jcd.jcd_450_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: 09/04/2020] [Revised: 10/29/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022] Open
Abstract
Aim: Evaluation of the impact of three different obturation techniques on the penetration depth and adaptation of a bioceramic root canal sealer(BioRoot RCS) to root dentin using scanning electron microscope and confocal laser scanning microscope. Materials and Methods: Recently extracted ninety mandibular premolar teeth of similar dimensions (±0.2 mm) with single canals and straight roots were segregated into three experimental groups (n = 30 each) based on the method of obturation used, i.e., lateral compaction technique, warm vertical compaction technique, and injectable thermoplasticized technique. After obturation, half of the root samples (n = 15) in each group were sectioned horizontally by hard tissue microtome at 3, 6, and 9 mm, respectively, from root apex for measuring sealer penetration depth with a confocal laser scanning microscope. Longitudinal sections of the samples (n = 15) were used for measuring the adaptation of sealers to radicular dentin using a scanning electron microscope. Statistical Analysis: Intergroup comparison of sealer penetration depth and adaptation to root dentin was analyzed using one-way ANOVA, and pairwise comparisons were made using Tukey's post hoc test. Results: Warm vertical condensation technique showed deeper root dentin penetration of the sealer. Better adaptation of the sealer to apical root dentin with minimal voids (P ≤ 0.05) was achieved with warm vertical condensation in comparison to the injectable gutta-percha method and lateral condensation obturating techniques. Conclusion: At all three root levels (coronal, middle, and apical), warm vertical condensation technique exhibited more sealer penetration with minimum gaps, whereas lateral condensation technique exhibited more gaps and less sealer penetration.
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Affiliation(s)
- Lohita Dasari
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Anupreeta Anwarullah
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Srujana Karumuri
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Praveen Kumar Chellapilla
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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