Effectiveness of Three Different Retreatment Techniques in Canals Filled With Compacted Gutta-Percha or Thermafil: A Scanning Electron Microscope Study

Abstract

IntroductionThis study evaluated the root canal wall morphology under scanning electron microscopy magnification after removal of 2 types of root canal fillings by using ultrasonic tips, nickel-titanium (NiTi) rotary instruments, and hand K-files. MethodsThirty-six extracted roots were filled by using AH Plus (DeTrey-Dentsply, Konstanz, Germany) as a sealer with Thermafil (Tulsa Dental Products, Tulsa, OK) (18 roots) or warm vertically condensed gutta-percha (18 roots). All fillings were removed up to the middle third by using Gates Glidden drills. The retreatment was completed by using K-files (group 1), M-Two NiTi rotary instruments (group 2), or ESI ultrasonic tips (group 3) in 12 roots each. Root canals were irrigated by using 10% ethylenediaminetetraacetic acid and 2.5% NaOCl. The samples were split longitudinally and observed by scanning electron microscopy (100–2000×). The presence of smear layer, filling debris, and the surface profile was evaluated in each picture. Kruskal-Wallis (analysis of variance) and Mann-Whitney tests were used to evaluate the differences between the obturation techniques, the 3 retreatment methods, and the canal thirds (P < .05). ResultsResin sealer tags were observed inside dentinal tubules. No statistical differences (P > .05) were found among the 3 retreatment methods. No statistical differences were observed between Thermafil and vertically compacted warm gutta-percha for each group or between the coronal third used as control, middle, and apical thirds. ConclusionsAll retreatment techniques showed similar performances in terms of smear layer morphology, debris, and surface profile. None of them completely removed filling debris from dentinal tubules of apical third.