EFFICACY OF THREE DIFFERENT RETREATMENT FILE SYSTEMS FOR GUTTA-PERCHA REMOVAL USING CONE BEAM COMPUTED TOMOGRAPHY

Document Type : Original Article

Authors

1 Dentist, Ministry of health, Alexandria, Egypt.

2 Professor of Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

3 Assistant professor of Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

Abstract

Introduction: The maximum ability of retreatment files to remove defective obturation materials is very important during endodontic retreatment.
Aim of the study: The purpose of this study was to compare the efficiency of three different retreatment systems in root canal filling removal using chloroform as solvent.
Materials and Methods: Thirty six extracted single rooted mandibular human premolars were used in this study following appropriate institutional ethical consent. Teeth were accessed and prepared chemo-mechanically to a standard working length of 17mm using Revo-S files. Obturation was done with lateral condensation using Total Fill bioceramic sealer and gutta percha. Teeth were randomly divided into three groups (n=12) according to retreatment files used: ProTaper-D group, R-ENDO group and M-Two-R group using Chloroform as solvent. Specimens were labeled then preoperative and postoperative CBCT scans were conducted and volume of remaining obturation material was measured by Osirix 32-bits software to be compared. Data were collected and statistical analysis was done where P value was set as P< 0.05.
Results: All systems significantly removed gutta percha. However, none of the used files completely removed the root canal filling material from the canals. The Protaper D group left significantly more root canal filling material than the M-Two R and R-Endo groups (P <0.05). No statistically significant difference was found between the M-Two R and R-Endo groups (Wilcoxon test used, P<0.05). ProTaper D left more remnants in the coronal third (18.48%) showing statistically significant difference with the other groups. No Statistically significant differences were found at the middle or apical thirds between all groups (Friedman, Kruskal-Wallis tests used, P<0.05).
Conclusion: The R-Endo and M-two R were more effective in removing root canal filling material than the ProTaper D. 

Keywords

Main Subjects

References

  1. Schirrmeister J, Wrbad KT, Meyer K, Altenburger M, Hellwig E.  Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod. 2006;32:469-72.
  2. Mollo A, Botti G, Goldoni NP, Randellini E, Paragliola R, Chazine M, et al. Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals. Int Endod J. 2012;45:1-6.
  3. Hulsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J. 2004;37:468-76.
  4. Saad AY, Al-Hadlaq SM, Nasser H, Al-Katheeri. Efficacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod. 2007;33:38-41.
  5. Marfisi K, Mercade M, Plotino G, Duran-Sindreu F, Bueno R, Roig M. Efficacy of three different rotary files to remove gutta percha and Resilon from root canals. Int Endod J. 2010;43:1022-8.
  6. Imura N, Kato AS, Hata GI, Uemura M, Toda T, Weine F. A comparison of the relative efficacies of four hand and rotary instrumentation techniques during endodontic retreatment. Int Endod J. 2000;33:361-6. 
  7. Schirrmeister JF, Hermanns P, Meyer KM, Goetz F, Hellwig E. Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study. Int Endod J. 2006;39:558-65.
  8. Unal GC, Kaya B, Tac AG, Kececi AD. A comparison of efficacy of conventional and new retreatment instruments to remove gutta-percha in curved root canals, an ex vivo study. Int Endod J. 2009;42:344-50.
  9. Yadav P, Bharath MJ, Sahadev CK, Makonahalli Ramachandra PK, Rao Y, Ali A, et al. An in vitro CT Comparison of Gutta-Percha Removal with Two Rotary Systems and Hedstrom Files. Iran Endod J. 2013;8:59-64.

10. Barletta FB, Rahde Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007;73:65-9.

 11. Khedmat S, Azari A, Shamshiri AR, Fadae M, Fakhar HB. Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals. Iran Endod J. 2016;11:184-9.

12. Gad HM, Zaazou AM, El Backly RM. Reciprocation versus rotary motion for endodontic retreatment. Alex Dental J. 2016;41:72-7.

  1. Saad AY, Al-Hadlaq SM, Al-Katheeri NH. Efficacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod. 2007;33:38-41.

 14. Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment. J Endod. 2008;34:1381-4.

15. 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;34:466-9.

16. Reddy N, Admala SR, Dinapadu S, Pasari S, Reddy MP, Rao MS. Comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal in root canal retreatment: an in vitro study. J Contemp Dent Pract. 2013;14:635-43.

17. Mittal N, Jain J. Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system. J Conserv Dent. 2014;7:8-12.

18. Joseph M, Ahlawat J, Malhotra A, Rao M, Sharma A, Talwar S. In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment. JCED. 2016;8:e355-e60.

19. Bergmans L, Van Cleynenbreugel J, Wevers M, Lambrechts P. Mechanical root canal preparation with NiTi rotary instruments: rationale, performance and safety. Status report for the American Journal of Dentistry. Am J Dent. 2001;14:324-33.

20. Deka A, Bhuyan AC, Bhuyan D. A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivocone-beam computed tomographic analysis. Contemp Clin Dent. 2015;6:79-83.

  1. 21.  Zachrisson BU. Clinical outcome with mandibular second versus first premolar extractions in orthodontic treatment. World J Orthod. 2005;6:296-303.

22. Jensen LE. Mechanical preparation of oval-shaped root canalsin mandibular premolars with the TRUShape 3DConforming File: a micro-computed tomography study. University of Iwoa. USA. 2017.

23. Tasdemir T, Kursat Er, Celik D, Yildirim T. Effect of passive ultrasonic irrigation on apical extrusion of irrigating solution. Eur J Dent. 2008;2:198-203. 

24. Al-Sudani D. Radiovisiography versus conventional radiography for estimation of canal length: an in vitro study. Pakistan Oral & Dent J. 2002;22:171-73.

25. Kosti E, Lambrianidis T, Economides N, Neofitou C. Ex vivo study of the efficacy of H-files and rotary Ni-Tiinstruments to remove gutta-percha and four types of sealer. Int Endod J. 2006;39:48-54.

26. Zmener O, Pameijer CH, BanegasG. Retreatmentefficacy of hand versus automated instrumentation in oval-shaped root canals: An ex vivo study. Int Endod J. 2006;39:521-6.

27. De Carvalho Maciel AC, Zaccaro Scelza MF. Efficacy of automated versus hand instrumentation during root canal retreatment: An ex vivo study. Int Endod J. 2006;39:779-84.

28. Masiero AV, Barletta FB. Effectiveness of different techniques for removing gutta-percha during retreatment. Int Endod J. 2005;38:2-7.

29. Barletta FB, Rahde Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007;73:65.

  1. Kfir A, Tsesis I, Yakirevich E, Matalon S, Abramovitz I. The efficacy of five re-treatment techniques: Microscopic vs. radiographic evaluation. Int Endod J. 2012;45:35-41.

31. Ali SM, Pradeep PS, Paul S, Jhons DA, Ganesh PB. Comparative evaluation of efficiency and time of gutta percha removal using hedstorm files, protaper retreatment and r-endo files-an ex vivo study. JEBMH. 2015;49:8484-7.

32. Marques da Silva B, Baratto-Filho F, Leonardi DP, Henrique Borges A, Volpato L, Branco Barletta F. Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material. Int Endod J. 2012;45:927-32. 

33. Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of ProTaper Universal rotary retreatment system for GP removal from root canals. Int Endod J. 2008;41:288-95.

34. Malhotra K, Taneja S, Kumar P. Comparison of efficacy of hand and rotary instrumentation for removing a resin-based obturating material (EndoRez) in curved root canals during retreatment: An in vitro study. Endodontol. 2017;29:60-4.

35. Bhagavaldas MC, Diwan A, Kusumvalli S, Pasha S, Devale M, Chava DC. Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative in vitro study. J Conserv Dent, 2017;20:12-6.

36. Aksel H, Küçükkaya Eren S, Askerbeyli Örs S, Serper A, Ocak M, Çelik HH. Micro‐CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP‐Endo Finisher file. Int Endod J. 2019;52:1070-6.

37. Romeiro K, de Almeida A, Cassimiro M, Gominho L, Dantas E, Chagas N, et al. Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures. Clin Oral Investig. 2019;1-12.

38. Yared GM, Bou Dagher FE, Machtou P. Failure of Profile instruments used with high and low torque motors. Int Endod J. 2001;34:471-5.

1.     Schirrmeister J, Wrbad KT, Meyer K, Altenburger M, Hellwig E.  Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod. 2006;32:469-72.

2.     Mollo A, Botti G, Goldoni NP, Randellini E, Paragliola R, Chazine M, et al. Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals. Int Endod J. 2012;45:1-6.

3.     Hulsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J. 2004;37:468-76.

4.     Saad AY, Al-Hadlaq SM, Nasser H, Al-Katheeri. Efficacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod. 2007;33:38-41.

5.     Marfisi K, Mercade M, Plotino G, Duran-Sindreu F, Bueno R, Roig M. Efficacy of three different rotary files to remove gutta percha and Resilon from root canals. Int Endod J. 2010;43:1022-8.

6.     Imura N, Kato AS, Hata GI, Uemura M, Toda T, Weine F. A comparison of the relative efficacies of four hand and rotary instrumentation techniques during endodontic retreatment. Int Endod J. 2000;33:361-6. 

7.     Schirrmeister JF, Hermanns P, Meyer KM, Goetz F, Hellwig E. Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study. Int Endod J. 2006;39:558-65.

8.     Unal GC, Kaya B, Tac AG, Kececi AD. A comparison of efficacy of conventional and new retreatment instruments to remove gutta-percha in curved root canals, an ex vivo study. Int Endod J. 2009;42:344-50.

9.     Yadav P, Bharath MJ, Sahadev CK, Makonahalli Ramachandra PK, Rao Y, Ali A, et al. An in vitro CT Comparison of Gutta-Percha Removal with Two Rotary Systems and Hedstrom Files. Iran Endod J. 2013;8:59-64.

10.Barletta FB, Rahde Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007;73:65-9.

 

11.Khedmat S, Azari A, Shamshiri AR, Fadae M, Fakhar HB. Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals. Iran Endod J. 2016;11:184-9.

12.Gad HM, Zaazou AM, El Backly RM. Reciprocation versus rotary motion for endodontic retreatment. Alex Dental J. 2016;41:72-7.

13.  Saad AY, Al-Hadlaq SM, Al-Katheeri NH. Efficacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod. 2007;33:38-41.

 

14.Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment.J Endod. 2008;34:1381-4.

15.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;34:466-9.

16.Reddy N, Admala SR, Dinapadu S, Pasari S, Reddy MP, Rao MS. Comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal in root canal retreatment: an in vitro study. J Contemp Dent Pract. 2013;14:635-43.

17.Mittal N, Jain J. Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system. J Conserv Dent. 2014;7:8-12.

18.Joseph M, Ahlawat J, Malhotra A, Rao M, Sharma A, Talwar S. In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment. JCED. 2016;8:e355-e60.

19.Bergmans L, Van Cleynenbreugel J, Wevers M, Lambrechts P. Mechanical root canal preparation with NiTi rotary instruments: rationale, performance and safety. Status report for the American Journal of Dentistry. Am J Dent. 2001;14:324-33.

20.Deka A, Bhuyan AC, Bhuyan D. A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivocone-beam computed tomographic analysis. Contemp Clin Dent. 2015;6:79-83.

21. Zachrisson BU. Clinical outcome with mandibular second versus first premolar extractions in orthodontic treatment. World J Orthod. 2005;6:296-303.

22.Jensen LE. Mechanical preparation of oval-shaped root canalsin mandibular premolars with the TRUShape 3DConforming File: a micro-computed tomography study. University of Iwoa. USA. 2017.

23.Tasdemir T, Kursat Er, Celik D, Yildirim T. Effect of passive ultrasonic irrigation on apical extrusion of irrigating solution. Eur J Dent. 2008;2:198-203. 

24.Al-Sudani D. Radiovisiography versus conventional radiography for estimation of canal length: an in vitro study. Pakistan Oral & Dent J. 2002;22:171-73.

25.Kosti E, Lambrianidis T, Economides N, Neofitou C. Ex vivo study of the efficacy of H-files and rotary Ni-Tiinstruments to remove gutta-percha and four types of sealer. Int Endod J. 2006;39:48-54.

26.Zmener O, Pameijer CH, BanegasG. Retreatmentefficacy of hand versus automated instrumentation in oval-shaped root canals: An ex vivo study. Int Endod J. 2006;39:521-6.

 

27.De Carvalho Maciel AC, Zaccaro Scelza MF. Efficacy of automated versus hand instrumentation during root canal retreatment: An ex vivo study. Int Endod J. 2006;39:779-84.

28.Masiero AV, Barletta FB. Effectiveness of different techniques for removing gutta-percha during retreatment. Int Endod J. 2005;38:2-7.

29.Barletta FB, Rahde Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007;73:65.

 

 

30.  Kfir A, Tsesis I, Yakirevich E, Matalon S, Abramovitz I. The efficacy of five re-treatment techniques: Microscopic vs. radiographic evaluation. Int Endod J. 2012;45:35-41.

31.Ali SM, Pradeep PS, Paul S, Jhons DA, Ganesh PB. Comparative evaluation of efficiency and time of gutta percha removal using hedstorm files, protaper retreatment and r-endo files-an ex vivo study. JEBMH. 2015;49:8484-7.

32.Marques da Silva B, Baratto-Filho F, Leonardi DP, Henrique Borges A, Volpato L, Branco Barletta F. Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material. Int Endod J. 2012;45:927-32. 

33.Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of ProTaper Universal rotary retreatment system for GP removal from root canals. Int Endod J. 2008;41:288-95.

34.Malhotra K, Taneja S, Kumar P. Comparison of efficacy of hand and rotary instrumentation for removing a resin-based obturating material (EndoRez) in curved root canals during retreatment: An in vitro study. Endodontol. 2017;29:60-4.

35.Bhagavaldas MC, Diwan A, Kusumvalli S, Pasha S, Devale M, Chava DC. Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative in vitro study. J Conserv Dent, 2017;20:12-6.

36.Aksel H, Küçükkaya Eren S, Askerbeyli Örs S, Serper A, Ocak M, Çelik HH. Micro‐CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP‐Endo Finisher file. Int Endod J. 2019;52:1070-6.

37.Romeiro K, de Almeida A, Cassimiro M, Gominho L, Dantas E, Chagas N, et al. Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures. Clin Oral Investig. 2019;1-12.

Yared GM, Bou Dagher FE, Machtou P. Failure of Profile instruments used with high and low torque motors. Int Endod J. 2001;34:471-5.

Alexandria Dental Journal
Volume 45, Issue 3
December 2020
Pages 23-28

Files

Share

How to cite

Statistics