The Efficacy of Rotary, Reciprocating, and Combined Non-Surgical Endodontic Retreatment Techniques in Removing a Carrier-Based Root Canal Filling Material from Straight Root Canal Systems: A Micro-Computed Tomography Analysis.

Tarek-Fahed Alakabani,Álvaro Zubizarreta-Macho,Ignacio Faus-Matoses,Celia Ruiz-Sánchez,Vicente Faus-Llácer,Vicente Faus-Matoses,Salvatore Sauro

doi:10.3390/jcm9061989

Abstract

The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems. The study was performed on 99 single-rooted extracted teeth using the ProTaper Gold endodontic rotary system up to the F2 file (Dentsply Maillefer, Baillagues, Switzerland), which were sealed with GuttaCore (Dentsply Maillefer, Ballaigues, Switzerland) and AH plus epoxy resin sealer (Dentsply DeTrey, Konstanz, Germany) and randomly assigned to the following non-surgical retreatment techniques: ProTaper Retreatment endodontic rotary instruments (D1–D3 files, Dentsply Maillefer, Ballaigues, Switzerland; n = 33, PTR), Reciproc Blue endodontic reciprocating instrument (R50, VDW, Munich, Germany; n = 33, RCB50), and a combined root canal retreatment technique between Gates-Glidden drills (sizes #3 and #2, Dentsply Maillefer, Ballaigues, Switzerland) and Hedstrom files (file size 35, 30, and 25, Dentsply Maillefer, Ballaigues, Switzerland; n = 33; H-GG). All of the teeth were submitted twice to a micro-computed tomography (micro-CT) scan, before and after non-surgical endodontic retreatment procedures. The volume of root canal filling material (mm3), volume of remaining root canal filling material (mm3), non-surgical endodontic retreatment working time (min), proportion of remaining root canal filling material (%), and efficacy of root canal filling material removal between the non-surgical endodontic retreatment techniques were analyzed using ANOVA one-way statistical analysis. Statistically significant differences were observed between the proportions of remaining root canal filling material of PTR and H-GG (p = 0.018), between the non-surgical endodontic retreatment working times (min; p < 0.001), and between the efficacies of root canal filling material removal by the non-surgical endodontic retreatment techniques (p = 0.009). However, the non-surgical endodontic retreatment systems allow for similar carrier-based root canal filling material removal.

Highlights

Bacterial infection plays an important role in establishing pulp tissue inflammation, which may lead to subsequent pulp necrosis and the formation of periapical lesions [1]
Non-surgical endodontic retreatment is recommended after unsuccessful root canal treatment [4]; the prognosis of non-surgical endodontic retreatment is often associated with an insufficient disinfection of the root canal system, inadequate obturation, missed root canals, under-extended or over-extended root canal filling material, or coronal microleakage [5,6,7,8]
The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques for removing carrier-based root canal filling material from straight root canal systems, with a null hypothesis (H0) stating that there would be no difference between the non-surgical endodontic retreatment techniques with regard to the removal of carrier-based root canal filling material from the straight root canal systems

Summary

Introduction

Bacterial infection plays an important role in establishing pulp tissue inflammation, which may lead to subsequent pulp necrosis and the formation of periapical lesions [1]. The complete removal or at least a significant reduction of the bacterial load during root canal treatment is an important factor determining the final prognosis of the root canal treatment. The etiology of endodontic failure is related to persistent or secondary endodontic infections [3]. Antibacterial irrigation solutions such as sodium hypochlorite (NaOCl) can penetrate up to 130 μm into dentinal tubules, while some bacterial species are able to penetrate more than 250 μm deep and adhere to the collagen present in human serum, leaving bacteria harboring in deeper layers, accessory canals, anastomoses, and fins [11]. Secondary infections are often linked to facultative anaerobic Gram-positive microorganisms, Enterococcus faecalis, which has been shown to be highly resistant to conventional antimicrobial agents and is able to invade dentinal tubules, causing reinfection in the root canal system [12,13]

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Conclusion