ProTaper Retreatment Instruments Research Articles

Effect of solvent use on postoperative pain in root canal retreatment: a randomized, controlled clinical trial.

The aim of this randomized clinical trial was to assess the effect of solvent use during the removal of root canal filling on postoperative pain after retreatment. Ninety patients scheduled for root canal retreatment were randomly assigned to one of the following two groups according to the root canal filling removal procedure used: ProTaper retreatment (Dentsply Maillefer, Ballaigues, Switzerland) instruments or ProTaper retreatment instruments in combination with gutta-percha solvent. A single operator performed the retreatments in a single visit. The incidence and intensity of the postoperative pain were rated on a numeric rating scale by patients at 24, 48, and 72h after retreatment. The analgesic tablet intake number was also recorded. Data were analyzed using Mann‑Whitney U, Wilcoxon, and chi-square tests. For the intensity of postoperative pain, the difference between the two groups was not statistically significant. Moreover, no statistically significant difference was found between the two groups in terms of analgesic medication intake (P > 0.05). The processes involving the use and non-use of a solvent in the removal of root canal fillings were found to be equivalent in terms of postoperative pain intensity and analgesic intake. Some in vitro studies claimed that the use of a gutta-percha solvent in the removal of root canal fillings tends to reduce postoperative pain since extrusion of debris was significantly less. This randomized clinical trial indicates that the removal of root canal fillings with or without the use of a solvent was associated with equivalent postoperative pain intensity and analgesic intake. This study is registered in the www.ClinicalTrials.gov database with the identifier number NCT03756363.

The Efficacy of Reciprocating Instruments versus Continuous Rotary Nickel-Titanium Instruments in Root Canal Retreatment with Different Filling Materials

The aim of this study was directed to rate the quality of differentEngine-driven retreatment files: ProTaper Retreatment files, Wave One system and OneShape system in removal of different filling materials. Material and methods: Nighty-six freshly extracted mandibular first molars were prepared with universal ProTaper rotary files till size F3 then categorized into two main groups (I and II) on the basis of type of material used in obturation. Group I: obturated with Gutta-percha, Group II: obturated with EndoREZ. Each One of them was categorized into three subgroups : sub group A, B and C on the basis of the system use (16 each), Subgroup A: using ProTaper Universal retreatment system, Subgroup B: using Wave One file, Subgroup C: using One Shape. Each subgroup was divided into two divisions according to the use of solvent or not (8 each). The residual obturating material was evaluated by the use of the stereomicroscope. Results: there was a significance unlikeness among tested groups, subgroups and subdivisions in the percentage of the residual obturating material Conclusion: Protaper retreatment instruments and Wave One file remove more filling material in comparison with OneShape file, regardless the amount of residual gutta percha filling material ,it was greater than with EndoREZ, Retreatment without the use of solvent was significantly faster and more effective than with solvent.

Characterization of the nucleus, cutting edge and failure detection in NiTi instruments for endodontic retreatment

OBJECTIVE: To characterize the nucleus, cutting edge and to detect defects in surfaces of nickeltitanium (NiTi) instruments for endodontic retreatment.METHODS: The selected endodontic instruments (D-RaCe, ProTaper retreatment and Mtwo retreatment) were evaluated prior to their use in 30- and 50-fold magnification in scanning electron microscopy (SEM), for linear measurements of lateral cut edge areas and of the nucleus and the ratio between these measures. After use in simulated canals, faults in the active surface were analyzed by SEM with 30 and 50 times magnification, and 200 times magnification when faults were found. The images were examined by three evaluators, whose measurements were previously calibrated. The defects analyzed were crack, blunt and barb, and data were tabulated for analysis.RESULTS: The instruments studied differed in results. The D-RaCe system instruments had the highest nucleus:edge ratio, while ProTaper retreatment instruments yielded the lowest ratio. All instruments presented some defect, with the instruments Mtwo retreatment presenting two instruments with defects.CONCLUSION: All analyzed instruments presented some type of failure after using them for removal of the filling material of simulated root canals. The D-RaCe system presented the highest edge measurements and the smallest nucleus measurements, contrary to the ProTaper retreatment system, which presented the smallest edge measurements and the largest core measurements.

Apically extruded debris during the removal of canal filling material from root canals using three techniques.

In the present study, we evaluated the effect of the single-cone technique (SCT), cold lateral compaction (CLC), and wave vertical compaction (WVC) technique performed using two different sealers on the amount of apically extruded debris (AED) produced during the removal of canal filling material. Ninety extracted mandibular premolars were prepared with ProTaper instruments. The teeth were then randomly assigned to six groups (N=15) for root canal filling: (a) group 1, CLC+AH Plus; (b) group 2, SCT+AH Plus; (c) group 3, WVC+AH Plus; (d) group 4, CLC+MTA Fillapex; (e) group 5, SCT+MTA Fillapex; and (f) group 6, WVC+MTA Fillapex. In all groups, the removal of canal filling material was performed with ProTaper retreatment instruments. The mean weight of the AED was assessed with an analytical balance. The amount of AED was lowest in groups 2 and 5 (P<.05), with no difference between these groups (P>.05). Groups 3 and 6 produced the greatest amount of extruded debris (P<.05); there was no difference between these groups (P>.05). Additionally, there was no difference between groups 1 and 4 (P>.05). There was no significant difference among the groups regarding sealer type (P>.05). The canal filling technique used affected the amount of AED produced during the removal of canal filling material, but not sealer type.

Evaluation of the time required to perform three retreatment techniques with dental microscope and ultrasonic activation for removing filling material from the oval root canal.

BackgroundWhen endodontic treatment fails, retreatment consists of the complete removal of the root canal filling material for thorough cleaning and reobturation. Various techniques are available for the filling removal procedure, which present varying degrees of efficacy, and take a varying length of time to perform. The aim of this study was to compare the time required to carry out reciprocating, rotary, and manual techniques with dental microscope and ultrasonic activation for removing filling material from root canals.Material and MethodsNinety-nine extracted single-rooted teeth with straight and oval-shaped canals were selected. The samples were instrumented with ProTaper Gold System up to file F2 and obturated with AH Plus sealer and GuttaCore. The teeth were randomly divided into three groups (n=33) according to the instruments used for removal of filling material: Group (1) Reciproc blue R50 instrument; Group (2) ProTaper Retreatment instruments; Group (3) manual (Hedstrom files and Gates-Glidden drills), under dental microscope at X10 magnification with Ultrasonic retreatment tip. The time required to remove the filling materials was measured with a chronometer. Data were analyzed statistically applying the Kruskal-Wallis test followed by the Mann-Whitney U-test (p<0.05).ResultsThe time required to remove filling material was significantly shorter in Group 1, followed by Group 2, the slowest being Group 3 (P<0.05).ConclusionsThe reciprocating technique was the fastest method for removing root canal filling material. Key words:Endodontic retreatment, hedstrom file, ProTaper retreatment, reciproc blue.

Efficacy of rotary and reciprocating single-file systems on different access outlines for gutta-percha removal in retreatment: An in vitro study.

Introduction:The aim of this study is to compare the effectiveness of reciprocating and continuous rotary nickel-titanium instruments during retreatment performed through two different access outlines.Methodology:A total of 48 freshly extracted mandibular first and second premolars with single root and canal were selected. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented with F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into two groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity. Retreatment was initiated using ProTaper Retreatment instruments (D1–D3). Specimens were further divided (n = 12) and reinstrumented up to Neoniti 25/0.08 or WaveOne 25/0.08. Irrigation was performed using 3% sodium hypochlorite and 17% ethylene diamine tetraacetic acid. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation material was measured.Results:Data were collected, and statistical analysis was performed using one-way analysis of variance and Tukey honestly significant difference multiple post hoc procedures (P < 0.05).Conclusion:None of the systems completely removed the root filling material from root canals. However, ProTaper/Neoniti instruments removed more GP when compared to Protaper/WaveOne instruments with both the access outlines. Both the instruments with traditional access outline required less time for removal of obturating material when compared to CEC.

Effect of Instrument Design and Access Outlines on the Removal of Root Canal Obturation Materials in Oval-shaped Canals

IntroductionThe aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. MethodsInitial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1–D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α < 0.05). ResultsThe interaction between access design and instrument type showed that the combination of CEC-VB presented significantly higher amounts of remaining obturation materials on the canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P < .05). ConclusionsNeither retreatment protocol was able to completely eliminate all obturation materials from the root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals.

Scanning electron microscopy with energy dispersive X-ray spectrophotometry analysis of reciprocating and continuous rotary nickel-titanium instruments following root canal retreatment.

This study aimed to evaluate superficial defects and the composition of Reciproc R25 and ProTaper Retreatment file systems (Dentsply Maillefer, Ballaigues, Switzerland) used for retreatment. A total of 100 maxillary incisor teeth were randomly divided into the following two groups: Reciproc R25 (n = 25) and ProTaper Retreatment instrument (n = 75) groups. The nickel-titanium (Ni-Ti) compositions of the files before and after use were analyzed using energy dispersive X-ray spectrophotometry (EDX). Chi-square, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze the data. ProTaper Retreatment instrument group showed a significantly higher number of defects than the Reciproc group (P < 0.05). No instrument fracture was detected. The presence of debris was observed in both groups before use, although the level was significantly higher in the ProTaper Retreatment group, which consisted of metals (P < 0.05). There was no significant difference between new and used instruments with regard to Ni-Ti composition (P < 0.05). EDX analysis showed that both the Reciproc and ProTaper Retreatment instruments had a Ni-Ti composition that was within the standards specified by the American Society of Testing and Materials. This study confirmed the use of both the Reciproc R25 file and ProTaper Retreatment file system for root canal filling removal in straight root canals as a safe procedure. (J Oral Sci 58, 401-406, 2016).

Effectiveness of hand versus rotary instrumentation on retreatment of curved canals

Background: Various nickel–titanium (NiTi) rotary endodontic instruments have been developed to facilitate cleaning and shaping of root canals. This study aimed to evaluate the efficiency, cleaning ability and safety of two different rotary NiTi instruments with a solvent versus hand files in the removal of canal fillings. Methods: Forty five simulated canals with 35° curves made of clear polyester resin were used in this study. All canals were prepared with K-files and filled using cold lateral compaction of gutta-percha and AH Plus sealer. The teeth were randomly divided into three groups of 15 specimens each. Removal of gutta-percha was performed with the following techniques: Hedstrom files, ProTaper Universal rotary retreatment system and Mtwo-R. All techniques were used with the solvent chloroform. The followings factors were evaluated: time taken to reach working length, time for gutta-percha removal, total time, apically extruded material during filling removal and number of fractured instruments. Pre- and post-reinstrumentation weights of all the blocks were recorded and efficacy capacity of each retreatment technique was assessed. Results: The canal wall clearance efficiency of ProTaper retreatment files were more successful than Mtwo-R and hand instruments. With respect to the difference between pre- and post-reinstrumentation weights, Mtwo-R was the most effective instrumentation technique. Regarding the mean time of retreatment and time required for reaching the working length, Mtwo-R instruments were significantly faster than the others. In addition, the hand instrumentation was more successful comparing to others in terms of the amount of apically extruded material. Conclusion: Under experimental conditions, Mtwo-R/Mtwo and ProTaper retreatment instruments proved to be efficient and time-saving devices for the removal of gutta-percha .

Efficacy of Two Rotary Instruments For Gutta Percha Removal During Root Canal Retreatment

Aim - Evaluate the efficacy of Pro Taper and Pro Taper Retreatment instruments in the removal of gutta-percha during retreatment of straight root canals in comparison with Hedstrom files. Methodology -The root canals of 30 Maxillary central incisors were instrumented by step back procedure and obturated with lateral condensation before the teeth were randomly divided into three groups of 10 specimens each i.e. Group I-using Hfiles, Group 2- using Pro Taper and Group 3- using Pro Taper retreatment. Radiographs were taken after the filling removal and the canal wall cleanliness was evaluated. Roots were divided into apical, middle and coronal parts and scored on a scale of 0 (no debris), 1(25-50% of walls covered with debris and 3 (&gt;50% of walls covered with debris).Number of fractured instruments were also evaluated in each group. Results-There was no significant difference (p&gt;0.05) between the three groups in terms of the debris seen radio graphically after retreatment. Conclusion - All systems evaluated ex vivo were equally effective in removing gutta percha during retreatment. DOI: http://dx.doi.org/10.3329/bjdre.v4i2.20250 Bangladesh Journal of Dental Research and Education Vol.4(2) 2014: 56-60

Comparative Analysis of Efficacy and Cleaning Ability of Hand and Rotary Devices for Gutta-Percha Removal in Root Canal Retreatment: An in vitro Study

To evaluate the efficacy and cleaning ability of Hedstrom files, and ProTaper retreatment instruments in removing gutta-percha from root canals with and without xylene as solvent. Sixty extracted single rooted human teeth were selected and decoronated, straight access established working length determined 1 mm short of canal, chemomechanical preparation done and obturated with guttapercha and AH plus sealer. Samples were stored for 1 week in humidifier divided into four groups of 15 teeth each. • Group I: Hedstrom files without xylene. • Group II: Hedstrom files with xylene. • Group III: ProTaper retreatment instruments without xylene. • Group IV: ProTaper retreatment instruments with xylene. and the following criteria were assessed - Time taken for initial plunge of instrument into guttapercha. - Time taken for complete removal of gutta-percha to reach working length - Ability of H files and ProTaper retreatment files with/ without xylene to remove gutta-percha in coronal, middle and apical 1/3 of canal. The teeth were grooved in labiolingual cross section, observed under a steromicroscope and scored according to gutta-percha debris left in the canal. Results were evaluated using ANOVA test and multiple comparisons done using Scheffe test. The least time to reach working length was found with group IV followed by groups III, II and group I respectively. Also the fastest way to remove maximum gutta-percha was group IV followed by groups III, II, and I respectively with a statistically significant difference among all groups. Apical 1/3 has more amount of remaining gutta-percha debris than middle and coronal 1/3 in all groups. The amount of gutta-percha debris in apical 1/3 was least in group IV followed by groups III, II and I respectively. The better performance of ProTaper rotary instruments has been attributed to their special flute design which tends to pull gutta-percha coronally directing it toward orifice. Also the movements of engine driven instruments produce frictional heat which plasticises gutta-percha and aids in easy removal. Apical third of root canals showed more guttapercha debris compared to coronal and middle 1/3 and has been attributed to the greater anatomic variability and difficulty of instrumentation in the apical area. The existence of deep groves and depressions on dentine walls in this apical 1/3 make them less instrumented areas as it did be difficult to direct the file against the extreme root canal wall. The fastest technique to remove gutta-percha and the shortest time to reach working length was observed with ProTaper retreatment instruments with xylene followed by ProTaper retreatment files without xylene and Hedstrom files without xylene. After instrumentation for removal of gutta-percha, apical third was found to have more debris compared to coronal and middle 1/3 of the root canal.