Retreatment Files Research Articles

Effect of different retreatment files using different kinematics on the release of inflammatory mediators in root canal retreatment of single-rooted teeth: a randomized clinical trial.

This randomized clinical trial aimed to evaluate the effect of two rotaries (ProTaper Universal Retreatment (PTUR)), D-Race (DR) + XP-Endo Finisher R (XPFR) and one reciprocating (Reciproc Blue (RB) retreatment techniques on the release of neuropeptides (Substance P, calcitonin gene-related peptide (CGRP)), and cytokines (IL-6 and IL-10) in periapical fluid in root canal retreatment of single-rooted teeth. In this randomized clinical trial (ClinicalTrials.gov ID: NCT05039502), seventy-five patients scheduled for retreatment were randomly divided into 3 groups according to the file system used to remove root canal filling materials (n = 25): PTUR, RB, and DR + XPFR. After reshaping and disinfection of the root canals, periapical fluid samples were taken, and the levels of Substance P, CGRP, IL-6, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed using the Kruskal-Wallis and chi-square tests. The level of significance was set as p = 0. 05. All the allocated participants received the intervention and were analyzed. There was no statistically significant difference among groups in terms of gender, age, tooth localization, and the distribution of analgesic use after treatment (p values 0.799, 0.095, 0.637, 1.000, respectively). No statistically significant difference was found in terms of the levels of Substance P, CGRP, and IL-10 among groups (p > .05), except IL-6. PTUR, RB, and DR + XPFR files have comparable results in the expression of inflammatory mediators. Retreatment files powered with rotary or reciprocating motion produced similar neuropeptide and cytokine levels in patients.

Does the presence of full-coverage crown interfere with removal of obturation material: A cone-beam computed tomography image segmentation volumetric analysis.

The aim of this study was to assess and compare the influence of the presence of full-coverage crown on the obturation material removal efficiency of different retreatment file systems. Sixty extracted, human, maxillary premolars were accessed, instrumented, and obturated with gutta-percha and AH Plus sealer. The samples were scanned with cone-beam computed tomography and volume of obturating material was measured using ITK-SNAP volumetric software. Samples were divided (n = 30) into with and without all metal full-coverage crown groups. Each group was then subdivided into three subgroups (n = 10) based on retreatment file used (ProTaper URS, HyFlex Remover, and NeoEndo). The volume of remnants of obturating material was remeasured by image segmentation using ITK-SNAP volumetric software. One-way analysis of variance, followed by the Tukey's post hoc test, was used for data analysis, with a significance level of 5%. A significant difference in percentage remnant of obturating material after retreatment file was observed on overall comparison between with (29.84%) and without crown (21.79%) groups (P < 0.05). Each file system removed significantly more obturating material in without crown samples than with crown samples (P < 0.05). The percentage remnant of obturating material after retreatment file use was as follows: ProTaper URS > NeoEndo retreatment file > HyFlex Remover. All file systems showed significantly different (P < 0.05) efficiency in removal of obturating material. None of the retreatment file systems were able to remove obturating material completely. The presence of full-coverage crown negatively impacted the efficiency of retreatment files for the removal of obturating material. HyFlex Remover performed better than NeoEndo which was better than ProTaper URS.

Evaluation of the efficacy of TruNatomy, ProTaper retreatment, and RaCe file systems in retreatment of moderately curved mandibular molars: An in vitro study.

Endodontic retreatment is the first line of treatment in cases of failed primary endodontic treatment. Although associated with challenges such as incomplete removal of obturating material, increased clinical time, and extrusion of apical debris, endodontic retreatment still has considerable success rate in the general population. The aim of this study was to evaluate and compare the efficacy of TruNatomy, ProTaper retreatment, and RaCe file systems to remove the obturating material, time taken to remove the obturating material, and apical extrusion of debris using cone-beam computed tomography (CBCT). In vitro study. Forty-five moderately curved mesiobuccal roots of the mandibular molars were instrumented up to #25, 4% taper and obturated with bioceramic sealer and lateral compaction technique. Teeth were divided randomly into three groups (n = 15). Teeth were retreated with TruNatomy, ProTaper retreatment, and RaCe file systems, respectively. Preretreatment and postretreatment CBCT scans were recorded and percentage of obturating material removed was calculated. Time taken to remove the obturating material and apical extrusion of debris was noted. Descriptive statistics including percentage, mean, standard deviation, Tukey's post hoc test, Kruskal-Wallis test, and Mann-Whitney Post hoc test were used. The total time needed for the removal of obturating material was comparatively shorter in the RaCe group, followed by the ProTaper retreatment group and TruNatomy group (P < 0.001). TruNatomy files were significantly better in removing the obturating material than the ProTaper retreatment files (P = 0.04). Statically, no difference between RaCe and TruNatomy files was noted. Apically extruded debris was more in the TruNatomy group than in the RaCe and ProTaper retreatment groups (P = 0.01). All tested endodontic files were effective in removal of obturating material, although none could completely remove the filling material and no system could completely eliminate apical extrusion.

Retreatment of XP-endo Shaper and R-Endo files in curved root canals

ObjectivesTo compare the retreatment efficiency of XP-endo Shaper and R-Endo files in curved root canals using ImageJ software.MethodsForty extracted mandibular first molars with curved mesial canals (25°–35°) were chosen. Access cavities, preparation and obturation of root canals were performed. Roots were randomly distributed into two groups corresponding to the retreatment files used. Group 1 retreated with XP-endo Shaper file, and group 2 retreated with R-Endo files. Each root was sectioned and photographed. ImageJ software was used to estimate the percentage of residual filling material that existed on the three root canal segments. Mann–Whitney U and the Kruskal–Wallis tests were used to compare the percentages of residual filling material between the teeth segments (P < .05).ResultsThe R-Endo group showed a significantly higher median percentage of residual filling material than the XP-endo Shaper group. In both groups, the coronal segments had the highest median of the residual filling material, followed by the middle and apical segments.ConclusionXP-endo Shaper is significantly more effective than R-Endo in removing root canal filling materials in the coronal, middle, and apical segments.

Comparative Evaluation Of Amount Of Apically Extruded Debris In Endodontic Retreatment Procedures Using Four Different File Systems- An Invitro Study

Objective(s): To compare the amount of apical debris extruded during endodontic retreatment procedures performed using H files, R-Endo Retreatment files, GPR files and ProTaper Universal Retreatment files.&#x0D; Materials and Methods: The conventional coronal access cavity was prepared for 40 extracted Mandibular Premolars. The root canals were prepared with ProTaper Next Rotary files till X1. Obturation was done by combination of Lateral and Vertical Compaction technique. All the samples were later attached to Eppendorf tubes. The samples were then divided into four groups each containing 10 samples on the basis of different retreatment files to be used. After complete removal of root canal filling material, the debris and the root filling material remnants adhered was collected in preattached Eppendorf tubes. For final weight computation and comparison, the weight of empty tube was deducted from the weight of tube accommodating the debris. ANOVA and Tukey test were applied for statistical analysis.&#x0D; Results: The R-Endo retreatment files showed minimum apical extrusion of debris than all the other examined files in the study. The apical extrusion of debris for R Endo min to max was -0.045 to 0.009. However, there was no statistically significant difference in amount of apical extrusion of debris by different files system (p&gt;0.005).&#x0D; Conclusion(s): There was no significant difference between the groups in apical extrusion of debris. Also rotary retreatment files showed lesser apical of debris than Hedstrom hand files. R Endo extruded less debris apically in this study.&#x0D; Keywords: Apical extrusion of debris; Gutta-percha; Retreatment files.

Comparative Evaluation of Different Retreatment Files for Gutta-percha Removal from Curved Root Canals Accessed with Novel Ultra-conservative Opening: An In-vitro Study

Introduction: In endodontic retreatment, gutta-percha removal must be done correctly in order to assure a successful outcome following failed procedures. The goal of this study was to compare the effectiveness of stainless-steel hand files with three different nickel-titanium rotary instrument systems for removing guttapercha using ultra-conservative access opening in curved canals. Aim: To compare the efficacy of different rotary instruments for removing obturating material from root canals with Ninja access in mandibular mesiobuccal moderately curved canals measured radiographically using Cone-beam Computed Tomography (CBCT). Materials and Methods: An in-vitro study was conducted in the Conservative and Endodontics department, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India in the time period of June 2022 to July 2022. Forty extracted human mandibular molar teeth were accessed through Ultraconservative opening (Ninja Access). After preparing the root canals, they were sealed using gutta-percha and AH Plus sealer through lateral compaction. The teeth were then stored for one week. The samples were divided into four groups according to the rotary file used: Group I- Hedstrom Files; Group II- Pro taper Universal Retreatment (PTUR) Files; Group III- Neoendo Retreatment Files; Group IV- R-Endo Retreatment. The amount of remaining filling material after the retreatment procedure was checked with CBCT. The statistical analysis was performed using R statistical analysis software version 4.1.0 for windows. Results: In sagittal section, there was significant difference of residual filling material between the four file systems in middle third only (p=0.048) while significant difference was seen only in apical third in the coronal section (p=0.011). However, the three rotary retreatment files left significantly less remnants than Hedström files during removal of the gutta-percha. The time taken for retreatment was significantly higher for Hedström files (398.90±20.717) sec followed by R-endo retreatment files (274.30±14.407). Conclusion: H file was the least effective in removing guttapercha from the canals when compared to the other three file systems. The Neo-Endo rotary retreatment system was faster.

Comparative Evaluation of Time Taken to Retrieve Gp Using Two Different Retreatment Files In Root Canal Treated Teeth- An In Vitro Study

Comparative Evaluation of Time Taken to Retrieve Gp Using Two Different Retreatment Files In Root Canal Treated Teeth- An In Vitro Study

Buckling resistance, torque, and force generation during retreatment with D-RaCe, HyFlex Remover, and Mtwo retreatment files.

This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

Comparative Evaluation of Time Taken to Retrieve Gutta Percha Using Two Different Solvents and A Novel Heat Treated Retreatment File System In Root Canal Treated Teeth - An In Vitro Study

Comparative Evaluation of Time Taken to Retrieve Gutta Percha Using Two Different Solvents and A Novel Heat Treated Retreatment File System In Root Canal Treated Teeth - An In Vitro Study

Efficacy Of Novel Heat Treated Retreatment File System In Removing Gutta-Percha And Sealer From The Root Canal Walls- A Scanning Electron Microscope Analysis

Efficacy Of Novel Heat Treated Retreatment File System In Removing Gutta-Percha And Sealer From The Root Canal Walls- A Scanning Electron Microscope Analysis

A study on three rotary retreatment systems in removing Gutta-percha and sealer

Background: To study rotary retreatment systems in removal of gutta-percha and sealer.Materials and methods: A total of 15 subjects were enrolled. The samples were randomly divided into three groups according to the file system used to remove gutta-percha was performed (n=5): ProTaper Universal Retreatment, ProTaper NEXT and Edge File XR NiTi system. The p- value less than 0.05 was considered statistically significant. Results: The percentage of removal of root canal filling has been recorded. The Protaper Universal R shows median 95.12, minimum 92.03 and maximum 99.12. The Edge file XR shows median value 98.16 and maximum value of 99.80. Conclusion: Edge File XR can be used as an alternative to ProTaper Universal Retreatment files.

Efficacy of ProTaper retreatment files and Endostar RE in Removing TotalFill and ADSEAl

Efficacy of ProTaper retreatment files and Endostar RE in Removing TotalFill and ADSEAl

Influence of heat-treated retreatment files on the canal transportation and centering ability during retreatment: An in vitro cone beam computed tomography study

Influence of heat-treated retreatment files on the canal transportation and centering ability during retreatment: An in vitro cone beam computed tomography study

Comparison of time required by three different retreatment file systems for retrieval of Gutta Percha- An In Vitro Study

Comparison of time required by three different retreatment file systems for retrieval of Gutta Percha- An In Vitro Study

Efficacy of Endoscope and Periapical Radiography to Detect Residual Root Canal Filling Using Micro-CT as Reference

IntroductionTo evaluate the efficacy of examinations by endoscope of root canals to determine residual root canal filling materials by comparison with microcomputed tomographic (micro-CT) images as reference. MethodsThirty maxillary second premolars with oval canals received root canal treatment. Then D-Race retreatment files were used to remove the root canal fillings supplemented by XP-endo Finisher. Samples were scanned to reconstruct micro-CT reference images. Images were obtained of all samples from the mesiodistal and buccolingual directions by digital radiography. Then the root canals of specimens mounted in manikins were assessed by endoscope. The radiographic and endoscopic results were scored following comparison with the micro-CT images, which served as a reference, by 2 blinded observers. The interexaminer reliability of the assessments was evaluated by kappa test and the accuracy of endoscopic visualization according to the presence of residual root canal filling materials was compared using Kruskal–Wallis H test and Spearman’s rank order correlation with the level of significance set at 5%. ResultsThe efficiency of the periapical radiography and endoscopy to determine residual root canal filling material was similar in every third of the root canal (P > .05). ConclusionsThe endoscope detected residual root canal filling material as efficiently as periapical radiography.

Quantitative Assessment of Apically Extruded Debris after Single-Files Supplemental Retreatment considering Apical Patency Influence: In Vitro Study.

This study aims to assess the impact of re-establishing apical patency on the quantity of debris extruded through the apex after three supplementary retreatment files (TruNatomy (TRN), WaveOne Gold (WOG), and XP endo Finisher R (XPFR)). Eighty single-rooted mandibular premolars were prepared with ProTaper Universal rotary systems (PTU) up to F3 and obturated. The samples were divided into two main groups according to the presence or absence of the apical patency (n = 40), GI with apical patency and GII without apical patency. Based on the file system, which was adopted to eliminate the previous filling, each group had four subgroups (n = 10). In GI PTUR and GII PTUR, ProTaper Universal retreatment files (PTUR) were utilized only to remove the most primary filling material (control groups). In the other groups (PTUR) used, it was first followed by supplementary files. The quantity of debris extruded by different retreatment file systems was determined and compared to the corresponding control group with or without apical patency. Data were analyzed using a two-way ANOVA with a post hoc Tukey's multiple comparison test at a 5% significance level. There was a statistically significant difference among the control and experimental groups. XPFR had the least quantity of extruded debris. Apical patency did not affect the debris extrusion. All tested files led to a significant apical debris extrusion regardless of apical patency.

COMPARATIVE EVALUATION OF EFFICACY OF NEO ENDO RETREATMENT FILES BY AUTOCLAVE AND COLD STERILIZATION AFTER EACH USE - AN INVITRO STUDY

Aim: The aim of the study is comparative evaluation of efficacy of neo endo retreatment files after autoclave and cold sterilization. Materials And Methods: 45 human mandibular premolars with a single straight root canal were selected and decoronated leave 16mm of root.The working length was determined by subtracting 1mm from above measurment. Canal preparation was done with Neo endo flex rotary files (25/6) and were obturated with GP size 25/6% .After 2 weeks of storage in normal saline they were randomly divided into three groups .In Group A (5 sub-groups :A1, A2, A3, A4 and A5 of 3 sets of specimens) Neo endo retreatment files were subjected to sterilization by autoclaving.In group B files were sterilized by cold sterilization with 2.4% Glutaraldehyde solution for 12 hours.In Group C files were cleaned using soap and water . Statistical analysis was done with One-way ANOVA Test followed by Tukeys post hoc test to compare the mean remaining GP &amp; time taken between different groups and usage times. Result: All samples showed GP remnants. Irrespective of the sterilization methods used, the amount of remaining GP increased sequentially from first to fifth use along with usage time. The remaining GP was lesser in the group A where sterilization was done by autoclave, and remaining GP was highest in Group C where no sterilization was done. The remaining GP of Group B ( Cold sterilization) was higher than Group A and lower than Group C. Conclusion :From the findings of present study it can be concluded that Autoclave sterilization causes least changes to the physical properties of the files when compared to Gluteraldehyde sterilization which adversely effects the cutting efficiency of the files. Unsterilized files exhibits least cutting efficiency resulting in reduced gutta percha removal from the canals. Also the number of use was a determining factor for cutting efficiency. Reduction in the cutting effectiveness of instruments may increase operating time and it could take longer to remove the material from root canal.

To Evaluate the Accuracy Between Two Different Electronic Apex Locators to Detect the Root Canal Perforation During Retreatment - An Ex-Vivo Study

Objectives: To evaluate the accuracy between two different electronic apex locators in detecting the root canal perforation in the middle and apical portion during retreatment. Methods: Sixty freshly extracted mandibular premolars were taken in to this study, which were divided into three groups of twenty each. Group I: Control Group, Group II: Positive control without perforation, Group III: Negative control with perforation. In all the groups, access cavity preparation was done followed by cleaning and shaping using X smart Endomotor and Protaper Gold file system (Dentsply Maillefer, Switzerland). The specimens were prepared such that perforation was made in group III on the mesial side of the root at middle portion approximately 5mm from the apex after determining working length by direct visualization and stored for the database. All the specimens were obturated by using AH plus sealer and F3 Protaper gold gutta percha points and later stored in incubator at temperature of 37°C for 7days. After 7 days, gutta percha was removed from group III samples using gutta percha solvent (Xylene), Neo-Endo retreatment files. These teeth were mounted on Protrain Endodontic training kit (Simit Dental, Italy) and perforation were detected using apex locators Dentaport Root ZX (J,Morita) and Propex Pixi (Dentsply Maillefer, Switzerland). The apical perforation were made at a distance 2mm from apex after the middle perforation were restored by using Type II GIC by keeping the 35 K file inside the canal and apical perforations were detected and the reading were recorded and stored for the database. Statistical Analysis: The data obtained were analyzed by using descriptive statistics, ANOVA (Analysis of Variance), Paired t test through SPSS for window (version 22.0). Findings: In case of middle third perforation of the root canal Dentaport Root ZX showed accuracy of 87.37% and Propexpixi 82.89%. In apical perforations the accuracies of Root ZX and Propex Pixi are 89.28% and 79.76% respectively. In the both the perforations, there was a statistically significant difference (P < 0.05). In both the perforations, Dentaport Root ZX showed more accuracy in detecting the perforation when compared with Propex Pixi apex locator. Novelty : This study provides a novel approach as it compares the accuracy between the Dentaport Root Zx and Propex Pixi in detection of middle and apical perforation during retreatment in Ex Vivo study. Keywords: Dentaport root ZX; Electronic apex locator (EAL); Propex pixi; Protrain endodontic training kit; Root canal perforation

Healing Assessment of Osseous Defects after Surgical Removal of Periapical Lesions in the Presence of Hydroxyapatite, Nanohydroxyapatite, and a Combination of Nanohydroxyapatite and Platelet-rich Fibrin: A Clinical Study

Abstract: Aim: to evaluate the bone healing in failed endodontically treated teeth after surgical removal of periapical lesions and placement of hydroxyapatite (HA), nanohydroxyapatite (nHA) and a combination of nanohydroxyapatite with platelet rich fibrin (PRF) periapically. Subjects and methods: the study was conducted on twenty-four patients having periapical radiolucency in single rooted teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C; of 8 teeth each. All the teeth were retreated in two visits. In the first visit the old filling was removed using Protaper retreatment files (Dentsply Sirona®) then irrigation with sodium hypochlorite 2.5% was done. All canals were dried and filled with Di-antibiotic paste (metronidazole and ciprofloxacin). In the second visit the canals were obturated with Pro Taper gutta-percha points and root canal sealer (Adseal resin sealer) followed by surgical intervention in the same day. A periapical curettage along with apicoectomy were established. In all the groups, root end cavity was prepared and filled with MTA (ProRoot MTA; DENTSPLY Tulsa Dental Specialties). In Group A, hydroxyapatite powder was packed in the curetted periapical defect. In Group B, nanohydroxyapatite powder was packed in the curetted periapical defect. In Group C, nanohydroxyapatite with PRF were mixed and packed in the curetted periapical defect. In all groups, patients recall visits were scheduled at 1, 3, and 6 months’ time intervals for clinical and radiological evaluation. Results: after one month; there was a statistically significant difference between the median percentage changes in lesions size in the three groups. Pair-wise comparisons between groups revealed that there was no statistically significant difference between group B (nHA) and group C (PRF and nHA) groups. Both showed statistically significantly higher median percentage reduction in lesions size than group A (HA group). After three as well as six months; there was no statistically significant difference between the median percentage decreases in lesions size in the three groups. Conclusion: It was concluded that nHA combination with PRF produced faster periapical healing (bone regeneration) in the first three months than nHA alone. However, HA produce periapical healing (bone regeneration) after six months.

Comparative evaluation of efficacy of different endodontic file systems for removal of gutta percha from root canals using CBCT

Aim- To evaluate the removal of gutta percha by hand file system, rotary file system and reciprocating file system from root canals by using CBCT. Materials and Method: Root canals of 42 extracted human mandibular premolars were prepared using the ProTaper Universal rotary system and then obturated. Root filling quality was confirmed on CBCT images. Specimens were divided into 3 groups (n = 14) according to the system used for filling removal, group 1: H File, group 2: MTwo rotary retreatment file, and group 3:WaveOne file. Each specimen was sent for CBCT Analysis. Statistical Analysis Used: Evaluation of data was done statistically using One-way Analysis of Variance and Tukey’s post hoc test. Results: There was statistical difference in all the groups (P&gt;0.05). All systems demonstrated presence of remnants of filling material. Mean reduction in the volume of GP after retreatment of Group I was 0.006mm3, Group II was 0.002mm3 Group III was 0.003mm3. Conclusion: The system responsible for a better removal of root canal filling material was the MTwo Retreatment file system, followed by the WaveOne system and H File.