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N KP, R P, Ravindran S, John J, U S, Rahman F. In Vitro Cone Beam CT Analysis of the Efficacy of Three Supplementary Steps In the Removal of Obturation Material in Endodontic Retreatment. Cureus 2024; 16:e62285. [PMID: 39006571 PMCID: PMC11245723 DOI: 10.7759/cureus.62285] [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] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
OBJECTIVES To evaluate and compare the efficacy of XP-endo Finisher R (FKG Dentaire, Le Locle, Neuchatel, Switzerland), EDDY (VDW Dental, Munich, Germany), and passive ultrasonic irrigation (PUI) as supplementary steps following the D-RaCe retreatment file system (FKG Dentaire) in the removal of root canal obturation material using cone beam CT. MATERIALS AND METHODS A total of 45 two-rooted permanent maxillary first premolars were selected. Following access preparation, cleaning, and shaping with Hero Shaper (Micro Mega, Besançon, BFC, France) rotary file up to 25/04%, thermoplasticized obturation was performed with TotalFill BC sealer (FKG Dentaire) and gutta-percha. The specimens were subjected to routine retreatment using the D-RaCe retreatment file system. Cone beam computed tomography (CBCT) and volumetric analysis were performed before and after this procedure. The samples were divided into group A (XP-endo Finisher R: n=15), group B (EDDY: n=15), and group C (PUI: n=15). Finally, a third CBCT was taken and a volumetric analysis was done. Statistical analysis was done using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). RESULTS The lowest mean residual volume of obturation material was seen with XP-endo Finisher R (1.6 mm3), followed by PUI (1.7 mm3). The EDDY showed the least efficiency in complete debridement of the root canals (3.6 mm3). This difference in values was statistically significant. CONCLUSION The XP-endo Finisher R and PUI showed superior performance than EDDY in the removal of remaining obturation material from the root canal system after retreatment with the D-RaCe retreatment file system. However, none of the systems were able to completely remove the root canal obturation materials.
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Affiliation(s)
- Krishna Priya N
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
| | - Priya R
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
| | - Sonu Ravindran
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
| | - Jis John
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
| | - Suraj U
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
| | - Fazalu Rahman
- Conservative Dentistry and Endodontics, Malabar Dental College and Research Center, Malappuram, IND
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Alves LS, Ormiga F, de Lima CO, Lopes RT, Gusman H. Root canal dentin wear during final irrigation in endodontic retreatment with passive ultrasonic irrigation and easy clean instruments. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:246-251. [PMID: 38634025 PMCID: PMC11019816 DOI: 10.4103/jcde.jcde_137_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: 08/16/2023] [Revised: 09/29/2023] [Accepted: 01/05/2024] [Indexed: 04/19/2024]
Abstract
Context Complementary procedures have been proposed to improve the endodontic retreatments. Aim The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment. Methods Thirty-six mesial roots of the lower first molars were divided into four groups (n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group. Results Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers (P < 0.05). Conclusion Both complementary cleaning procedures promoted dentin wear and must be used cautiously.
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Affiliation(s)
- Louise Schmitt Alves
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabiola Ormiga
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ricardo Tadeu Lopes
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Sairaman S, Solete P, Jeevanandan G, Antony SDP, Kavoor S, Adimulapu HS. Comparative analysis of novel heat-treated retreatment file system on the removal of obturating material using nano-computed tomography. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:82-86. [PMID: 38389750 PMCID: PMC10880466 DOI: 10.4103/jcde.jcde_224_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: 10/13/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 02/24/2024]
Abstract
Introduction The aim of nonsurgical retreatment is to remove the previous filling material followed by chemo-mechanical preparation of the canal to achieve proper disinfection of the root canal system. This is then followed by re-obturation. This study evaluates the time taken to retrieve the gutta-percha and the quantity of remaining filling material after retreatment with two different file systems. The quantity of remaining filling material was assessed using nano-computed tomography (CT) due to its increased accuracy. Materials and Methods Forty extracted single-rooted teeth were split into two groups at random and decoronated and obturated at a standard root length of 16 mm. Solite RS3 (SRS-3) Retreatment and ProTaper Universal Retreatment (PTUR) systems were used to retrieve the gutta-percha after a preoperative nano-CT scan. Postoperative nano-CT scan was taken and both the scans were superimposed to quantify the remaining filling material. The time taken to remove gutta-percha was measured using a stopwatch. The statistical analysis comparing the two groups was conducted using the independent t-test. Results The quantitative analysis of remaining filling material using nano-CT showed no statistical difference between both the file systems used (P > 0.05). However, SRS-3 took significantly less time in the removal of gutta-percha (P < 0.05). Conclusion Hence, we can conclude that there is no significant difference in the amount of remaining filling material between both the file systems. However, time taken to remove the gutta-percha was lesser in SRS-3 compared to PTUR file system.
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Affiliation(s)
- Sruthi Sairaman
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Pradeep Solete
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Delphine Priscilla Antony
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Sowmya Kavoor
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Hima Sandeep Adimulapu
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Lavanya A, Tewari RK, Ali S, Mahajan P, Yusufi FNK. Prevalence and morphological analysis of isthmuses in mandibular molars of the Indian population: A micro-computed tomographic study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:584-589. [PMID: 38292355 PMCID: PMC10823948 DOI: 10.4103/jcde.jcde_52_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/18/2023] [Accepted: 08/11/2023] [Indexed: 02/01/2024]
Abstract
Objectives This study evaluated the prevalence, configurations, and correlation of isthmuses at coronal, middle, and apical root 3rd in mandibular molars of the Indian population using micro-computed tomography μCT). Materials and Methods One hundred and five permanent mandibular molar teeth were scanned under μCT. The axial sections were analyzed at the coronal, middle, and apical thirds of the root for isthmus types and classified according to Hsu and Kim's classification. Descriptive statistics for each isthmus type were calculated. The correlations between the apical, middle, and coronal thirds of the root were determined using Pearson's correlation coefficient. Results Type IV isthmus was the most common in the coronal third of the mesial root of mandibular 1st molar (42.9%), while Type V was prevalent in the coronal third of the mesial root of 2nd molar (42.9%). Type I isthmus was found to be highly prevalent in the middle 3rd (71.4%) and apical 3rd (61.9%) of mesial roots of 1st molars, and in the middle 3rd (71.4%) and apical 3rd (42.9%) of mesial roots of 2nd molars. Type V isthmus was the most prevalent in all the thirds of the distal roots of both 1st and 2nd molars, ranging from 40% to 50%. Furthermore, a strong correlation of 0.965 (P < 0.01) was found between the isthmuses in the apical and middle thirds of roots. Conclusion There are variations in the prevalence and type of isthmuses across different sections of the root, including the presence of atypical isthmuses. Micro-CT with high-resolution imaging and three-dimensional reconstruction is crucial for investigating root canal morphology. Clinicians could benefit from considering demographic characteristics to better predict the presence of isthmus variations. Clinical Relevance The isthmus configurations and frequency differ at each section of mandibular teeth.
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Affiliation(s)
- A. Lavanya
- Department of Conservative Dentistry and Endodontics, Dr. ZADC, AMU, Aligarh, Uttar Pradesh, India
| | - Rajendra Kumar Tewari
- Department of Conservative Dentistry and Endodontics, Dr. ZADC, AMU, Aligarh, Uttar Pradesh, India
| | - Sajid Ali
- Department of Conservative Dentistry and Endodontics, Dr. ZADC, AMU, Aligarh, Uttar Pradesh, India
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Monteiro LPB, de Sousa SEM, de Castro RF, da Silva EJNL, da Silva Brandão JM. Mechanical activation with Easy Clean device enhanced organic tissue removal from simulated internal root resorption in a laboratory evaluation. BMC Oral Health 2023; 23:385. [PMID: 37308853 DOI: 10.1186/s12903-023-03122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Considering the irregular shape of the root canal, removing inflamed pulp and granulation tissue completely from internal resorption cavities during chemomechanical preparation can be challenging. This study aimed to evaluate the effectiveness of passive ultrasonic irrigation (PUI) compared to mechanical activation with Easy Clean in the removal of organic tissue from simulated areas of internal root resorption. METHODS The root canals of 72 extracted single-rooted teeth with oval canals were instrumented with Reciproc R25 instruments. After root canal preparations, the specimens were split longitudinally, and semicircular cavities were prepared using a round bur on each half of the roots. Samples obtained from bovine muscle tissue were weighed and adapted into semicircular cavities. The roots were reassembled and joined, and the teeth were divided into six groups (n = 12) according to the irrigation protocol: Sodium hypochlorite (NaOCl) without activation; NaOCl + PUI; NaOCl + Easy Clean; distilled water without activation; distilled water + PUI; and distilled water + Easy Clean. After irrigation protocols, the teeth were disassembled, and the remaining organic tissue was weighed. Data were analyzed by two-way ANOVA and Tukey's post hoc test (p < 0.05). RESULTS None of the experimental protocols totally removed the bovine tissue from simulated cavities. Tissue weight reduction was significantly affected by the activation method (p < 0.05) and by irrigation solution (p < 0.05). Groups with NaOCl irrigation presented higher tissue weight loss when compared to distilled water, for all irrigation methods (p < 0.05). The use of Easy Clean resulted in the greatest tissue weight loss (42.0%-Distilled water/45.5%- NaOCl) compared to those of PUI (33.3%-Distilled water/37.7%- NaOCl) and no activation (33.4%-Distilled water/38.8%- NaOCl) (p < 0.05). However, no differences were observed between PUI and no activation groups (p > 0.05). CONCLUSIONS Mechanical activation with Easy Clean enhanced organic tissue removal from simulated internal resorption more effectively than PUI. Easy Clean for agitation of the irrigating solution is effective in removing simulated organic tissues from artificial internal resorption cavities, being an alternative to the use of PUI.
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Affiliation(s)
- Laise Pena Braga Monteiro
- Department of Endodontics, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, PA, 66075-110, Brazil.
| | | | - Roberta Fonseca de Castro
- Department of Endodontics, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, PA, 66075-110, Brazil
| | - Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
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