Endodontic Recontamination and Retreatment: The Concise Systematic Review

Abstract

Introduction: It is necessary to know the nature of the endodontic microbiota within the root canal system of teeth with necrotic pulp tissues. There are several methods of microbial identification, including techniques based on culture or non-predominance of facultative anaerobes and Gram-positive species, especially Enterococcus faecalis. The 16S ribosomal RNA (rRNA) gene sequencing approach has become the reference method. Polymerase chain reaction (PCR) is a molecular technique also used. A condition for successful endodontic retreatment is proper cleaning of the root canals. Objective: Evaluate through a systematic literature review the main contaminations, recontaminations, and endodontic retreatments in root canals. Methods: The present study was followed by a systematic literature review model, according to the PRISMA rules. Clinical studies included case reports, retrospective, prospective and randomized trials. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results: A total of 94 articles were found. A total of 58 articles were evaluated in full, and 34 were included and discussed in this study. The overall assessment did not result in significant risks that could compromise the science of the present study. According to the GRADE classification, the studies were of moderate quality. Conclusion: It was concluded that it is essential to characterize the microbiota of root canals with failed endodontic treatment through 16S ribosomal RNA (GS) gene sequencing and PCR. Furthermore, it can be stated that the root canal instrumentation system with rotating files maintains the quality of root preparation, reducing the operative time and also the risk of a torsional fracture within the root canal.