Abstract

The purpose of this study was to assess in vitro the efficacy of nickel-titanium K3 rotary files and hand files for removal of gutta-percha and sealer from obturated root canals using either chloroform or chlorhexidine as solvents. Sixty extracted single-rooted bovine teeth with straight, large canals were prepared, obtured and randomly assigned to 3 groups (n=20). The teeth were stored at 37 degrees C for 1 month and then the gutta-percha and sealer were removed using different techniques, as follows. Group I: size 3 Gates-Glidden drills plus size 30 hand K-files and Hedström files and chloroform; Group II: K3 NiTi rotary files and chloroform; and Group III: K3 NiTi rotary files and 2% chlorhexidine gel. Radiographs were taken and scanned and the images were digitized. The total area of the canal and the area with remaining obturation material were measured in millimeters using a computed image analysis system (ImageLab). Data were analyzed statistically by one-way ANOVA and Tukey test at 5% significance level. The groups differed statistically (p<0.05) with respect to the average percentage of remaining gutta-percha and sealer, presenting the following sequence of effectiveness (from most to least effective): Group I (15.48%), Group II (28.42%) and Group III (35.96%). The findings of this study showed that, despite the technique used for removal of filling material, none of the retreated canals were completely free of gutta-percha and sealer remnants. The use of stainless steel hand files resulted in a lesser amount of filling debris than the use of nickel-titanium rotary instruments.

Highlights

  • Advances in endodontic therapy have made endodontists more interested in retreatment and surgery

  • Endodontic retreatment is considered as the first choice, leaving surgery to correct a possible retreatment failure [1], caused by remaining microorganisms in the periradicular tissues [2]

  • Endodontic retreatment requires regaining of access to the entire root canal system through complete filling material removal

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Summary

Introduction

Advances in endodontic therapy have made endodontists more interested in retreatment and surgery. An intervention is needed to correct the failure of the initial root canal treatment, disinfecting and achieving a better design. Endodontic retreatment is considered as the first choice, leaving surgery to correct a possible retreatment failure [1], caused by remaining microorganisms in the periradicular tissues [2]. Endodontic retreatment requires regaining of access to the entire root canal system through complete filling material removal. The risk of misshaping the canal by producing perforations while removing the obturation material is related to the instrument and the motion used [3]. Nickel-titanium (NiTi) files have been used in root canal preparation due to their unique physical proprierties. The use of automated endodontic files result in an appreciable gain of time as well as improvement of the operator’s working conditions

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