Removal of Obturation Material from Root Canals Using a Combination of Reciprocal Instrumentation and Different Final Irrigation Techniques
Iranian Endodontic Journal,
Vol. 15 No. 3 (2020),
1 July 2020
Introduction: The predictability of successful non-surgical endodontic retreatment is directly related to it’s ability to completely cleanse and remove obturation material from the canal system. The purpose of this study was to evaluate the removal of gutta-percha from curved canals using three final irrigation methods: passive ultrasonic irrigation (PUI) with a 20/01 E1 insert (Irrisonic); XP-endo Finisher (XPF); and Easy Clean (EC). Methods and Materials: Forty mesial roots of mandibular molars with an angle of curvature between 10° and 20°, two canals, and independent foramina were cut into 16-mm sections. The canals were instrumented using the Reciproc system (R25) and filled with a #25 gutta-percha cone and AH-Plus sealer by the continuous-wave condensation technique. The roots were double-sealed with Coltosol and photopolymerizable resin and stored at 37°C and 100% humidity for 30 days. They were then randomized into 4 groups (n=10): control (C), PUI, XPF, and EC. All specimens were scanned using cone-beam computed tomography (CBCT), and fill volume data (in square pixels) were calculated before retreatment, after retreatment, and after final irrigation. The images were analyzed using Tps Dig software 2.32 by two blinded, calibrated examiners (intra-class correlation coefficient=0.9967). The results were analyzed in BioEstat 4.0. The nonparametric Kruskal-Wallis test with Dunn's post-hoc and Friedman comparison were applied. Significance was accepted at 5% (P<0.05). Results: None of the final irrigation protocols completely removed remnants of obturation material from the root canal systems (P>0.05). On comparative analysis with specimens divided into thirds, all methods were found to remove material equally, with no significant differences (P>0.05). Conclusion: Based on this in vitro study, the additional cleaning methods tested were equivalent to each other and did not lead to an improvement in the removal of residual obturation material.
- Cone-beam Computed Tomography; Endodontic Retreatment; Gutta-Percha
How to Cite
Siqueira JF, Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34(1):1-10.
Hoen MM, Pink FE. Contemporary endodontic retreatments: an analysis based on clinical treatment findings. J Endod. 2002;28(12):834-6.
Bueno CES, Delboni MG, Araújo RA, Carrara HJ, Cunha RS. Effectiveness of rotary and hand files in gutta-percha and sealer removal using chloroform or chlorhexidine gel. Braz Dent J. 2006;17(2):139-43.
Stabholz A, Friedman S. Endodontic retreatment--case selection and technique. Part 2: Treatment planning for retreatment. J Endod. 1988;14(12):607-14.
Rios MA, Villela AM, Cunha RS, Velasco RC, Martin AS, Kato AS, Bueno CE. Efficacy of 2 reciprocating systems compared with a rotary retreatment system for Gutta-Percha removal. J Endod. 2014;40(4):543-6.
Ezzie E, Fleury A, Solomon E, Spears R, He J. Efficacy of retreatment techniques for a resin-based root canal obturation material. J Endod. 2006;32(4):341-4.
Barrieshi-Nusair KM. Gutta-percha retreatment: effectiveness of nickel-titanium rotary instruments versus stainless steel hand files. J Endod. 2002;28(6):454-6.
Cunha RS, Martin AS, Barros PP, Silva FM, Jacinto RC, Bueno CE. In vitro evaluation of the cleansing working time and analysis of the amount of gutta-percha or Resilon remnants in the root canal walls after instrumentation for endodontic retreatment. J Endod. 2007;33(12):1426-8.
Fruchi LC, Ordinola-Zapata R, Cavenago BC, Duarte MAH, Bueno CE, Martin AS. Efficacy of reciprocating instruments for removing filling material in curved canals obturated with a single-cone technique: a micro-computed tomographic analysis. J Endod. 2014;40(7):1000-4.
Ma J, Al-Ashaw AJ, Shen Y, Gao Y, Yang Y, Zhang C, Haapasalo M. Efficacy of ProTaper Universal Rotary Retreatment system for gutta-percha removal from oval root canals: a micro-computed tomography study. J Endod. 2012;38(11):1516-20.
Somma F, Cammarota G, Plotino G, Grande NM, Pameijer CH. The effectiveness of manual and mechanical instrumentation for the retreatment of three different root canal filling materials. J Endod. 2008;34(4):466-9.
Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J. 2008;41(4):288-95.
Jayasenthil A, Sathish ES, Prakash P. Evaluation of manual and two-rotary niti retreatment systems in removing gutta-percha obturated with two root canal sealers. ISRN Dent. 2012;2012:208241.
Schirrmeister JF, Wrbas KT, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod. 2006;32(5):469-72.
Betti LV, Bramante CM. Quantec SC rotary instruments versus hand files for gutta-percha removal in root canal retreatment. Int Endod J. 2001;34(7):514-9.
Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-5.
Nevares G, Diana S, Freire LG, Romeiro K, Fogel HM, Santos M, Cunha RS. Efficacy of ProTaper NEXT compared with Reciproc in removing obturation material from severely curved root canals: a micro–computed tomography study. J Endod. 2016;42(5):803-8.
Bernardes RA, Duarte MAH, Vivan RR, Alcalde MP, Vasconcelos BC, Bramante CM. Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. Int Endod J. 2016;49(9):890-7.
Zuolo AS, Zuolo ML, Bueno CES, Chu R, Cunha RS. Evaluation of the efficacy of TRUShape and reciproc file systems in the removal of root filling material: An ex vivo micro-computed tomographic study. J Endod. 2016;42(2):315-9.
Berutti E, Chiandussi G, Paolino DS, Scotti N, Cantatore G, Castellucci A, Pasqualini D. Effect of canal length and curvature on working length alteration with WaveOne reciprocating files. J Endod. 2011;37(12):1687-90.
Kato AS, Cunha RS, Bueno CES, Pelegrine RA, Fontana CE, Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: An environmental scanning electron microscopic study. J Endod. 2016;42(4):659-63.
van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007;40(6):415-26.
Ahmad M, Pitt Ford TJ, Crum LA. Ultrasonic debridement of root canals: acoustic streaming and its possible role. J Endod. 1987;13(10):490-9.
Alves FR, Marceliano-Alves MF, Sousa JC, Silveira SB, Provenzano JC, Siqueira JF, Jr. Removal of Root Canal Fillings in Curved Canals Using Either Reciprocating Single- or Rotary Multi-instrument Systems and a Supplementary Step with the XP-Endo Finisher. J Endod. 2016;42(7):1114-9.
Cavenago BC, Ordinola-Zapata R, Duarte MA, del Carpio-Perochena AE, Villas-Boas MH, Marciano MA, Bramante CM, Moraes IG. Efficacy of xylene and passive ultrasonic irrigation on remaining root filling material during retreatment of anatomically complex teeth. Int Endod J. 2014;47(11):1078-83.
Karamifar K, Mehrasa N, Pardis P, Saghiri MA. Cleanliness of Canal Walls following Gutta-Percha Removal with Hand Files, RaCe and RaCe plus XP-Endo Finisher Instruments: A Photographic in Vitro Analysis. Iran Endod J. 2017;12(2):242-7.
Horvath SD, Altenburger MJ, Naumann M, Wolkewitz M, Schirrmeister JF. Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: a scanning electron microscopic study. Int Endod J. 2009;42(11):1032-8.
Yared G. Canal preparation using only one Ni-Ti rotary instrument: preliminary observations. Int Endod J. 2008;41(4):339-44.
Fidler A. Kinematics of 2 reciprocating endodontic motors: the difference between actual and set values. J Endod. 2014;40(7):990-4.
Khedmat S, Azari A, Shamshiri AR, Fadae M, Bashizadeh Fakhar H. Efficacy of ProTaper and Mtwo retreatment files in removal of Gutta-Percha and GuttaFlow from root canals. Iran Endod J. 2016;11(3):184-7.
Rodrigues CT, Duarte MAH, Guimaraes BM, Vivan RR, Bernardineli N. Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment. Braz Oral Res. 2017;31:e113.
Hammad M, Qualtrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentation for retreatment of canals filled with different materials. J Endod. 2008;34(11):1370-3.
Roggendorf MJ, Legner M, Ebert J, Fillery E, Frankenberger R, Friedman S. Micro-CT evaluation of residual material in canals filled with Activ GP or GuttaFlow following removal with NiTi instruments. Int Endod J. 2010;43(3):200-9.
Rodig T, Hausdorfer T, Konietschke F, Dullin C, Hahn W, Hulsmann M. Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals - a micro-computed tomography study. Int Endod J. 2012;45(6):580-9.
Rubino GA, Candeiro GTM, Freire LG, Iglecias EF, Lemos EM, Caldeira CL, Gavini G. Micro-CT evaluation of Gutta-Percha removal by two retreatment systems. Iran Endod J. 2018;13(2):221-7.
Justo AM, Rosa RA, Santini MF, Ferreira MBC, Pereira JR, Duarte MAH, Reis Só MV. Effectiveness of final irrigant protocols for debris removal from simulated canal irregularities. J Endod. 2014;40(12):2009-14.
Rodig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hulsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J. 2014;47(10):942-8.
Martins MP, Duarte MA, Cavenago BC, Kato AS, Bueno CES. Effectiveness of the ProTaper Next and Reciproc Systems in removing root canal filling material with sonic or ultrasonic irrigation: A micro-computed tomographic study. J Endod. 2017;43(3):467-71.
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