Abstract

Abstract Introduction The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. Objective To evaluate the efficacy of passive ultrasonic irrigation (PUI) in the removal of residual root filling material after removing the bulk of the root filling with nickel-titanium rotary instruments. Material and method Eighteen mesial isthmus-containing roots of human mandibular molars were prepared and filled. The root canal filling was removed with the ProTaper Retreatment system and K-files. The specimens were randomized into 2 groups (n = 9), both irrigated with 2.5% NaOCl and 17% EDTA. In the conventional group, an irrigation syringe was used. In the PUI group, the PUI technique was used. The roots were sectioned longitudinally and evaluated under stereomicroscopy. Student’s t test was used to compare groups and the general linear model was used to compare the apical, cervical, and middle root thirds within each group, in regard to the percentages of remaining residual filling material. Result There was no statistically significant intergroup difference, irrespective of which root third was evaluated (P > 0.05). In the PUI group, the apical third showed a significantly higher percentage of residual filling material, in comparison with the cervical (P = 0.038) and middle (P = 0.029) thirds. Conclusion The PUI technique was not more effective than the conventional irrigation technique in removing residual root filling material during endodontic retreatment in root canals with a complex anatomy.

Highlights

  • The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement

  • The cleaning and disinfecting of the root canal system may be hampered by its anatomical complexity

  • Irregular spaces in the canal walls, accessory canals, oval extensions, isthmuses, and apical deltas may harbor dentinal debris, necrotic tissue, or microorganisms and their by-products[3,4]

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Summary

Introduction

The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. The root canal filling was removed with the ProTaper Retreatment system and K-files. In the PUI group, the apical third showed a significantly higher percentage of residual filling material, in comparison with the cervical (P = 0.038) and middle (P = 0.029) thirds. Conclusion: The PUI technique was not more effective than the conventional irrigation technique in removing residual root filling material during endodontic retreatment in root canals with a complex anatomy. When nonsurgical retreatment is necessary, effective removal of the filling material and residual bacteria from the root canal system are essential to ensure a favorable outcome[2]. The anatomical complexity of the root canal system and the limitations of the techniques employed for the removal of filling material renders endodontic retreatment challenging. Studies have shown that none of these retreatment procedures can completely clean the root canal walls[9,10,11], in the apical third[12]

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