Retreatment System Research Articles

Impact of LASER activated irrigation on the retrievability of Guttaflow bioseal (in-vitro study)

BackgroundThis study aimed to evaluate the efficiency of diode LASER activated irrigation in the removal of GuttaFlow Bioseal root canal filling material during retreatment.Materials and subjectsRoot canals of forty-five single-rooted human mandibular premolar teeth were prepared with ProTaper Universal rotary system and obturated with lateral condensation obturation technique using Gutta Percha and Roeko GuttaFlow Bioseal root canal sealer. All specimens were retreated with ProTaper Universal Retreatment System files then divided to three different groups according to the technique of activation of irrigation. Samples were sectioned, and the residual filling remnants were captured using digital camera attached to microscope. Data was collected by three different interpreters, to eliminate the subjectivity of the process, using the ImageJ Software. The mean value of the data was obtained and evaluated statistically. The significance level was set at P ≤ 0.05.ResultsThe remaining filling materials in the canals irrigated with ultrasonic activation (6.17 ± 1.42 at coronal level, 10.93 ± 1.91at middle level, and 14.58 ± 2.23 at apical level) were less than these irrigated with LASER activation (15.87 ± 3.78 at coronal level, 21.28 ± 4.44 at middle level, and 27.06 ± 2.68 at apical level). Maximum amount of remaining filling materials was present in the canals irrigated with passive side-vented syringe (23.07 ± 3.22 at coronal level, 38.09 ± 7.27 at middle level, and 34.24 ± 9.77 at apical level).ConclusionThe activation of irrigation techniques used were incapable of complete removal of filling material at root canal walls.

The Efficiency of Different Supplementary Irrigation Techniques After Nickel-Titanium Rotary System in Endodontic Retreatment

Objective: To assess the efficiency of XP-Endo Finisher file (XPFF), EDDY, and diode laser as supplementary irrigation activation techniques following nickel-titanium rotary files in the endodontic retreatment. Methods: 48 mandibular premolars were collected. Each root canal was shaped and filled with EndoSequence BC sealer and gutta percha. After 14 days, endodontic retreatment was performed using D-Race instruments. Then, 48 samples were assigned into 4 groups (n=12) as control, diode laser, EDDY, and XPFF according to the supplementary irrigation methods. After the irrigation procedure, all samples were visualized under a stereomicroscope. The remaining root filling material was scored and compared statistically using Kruskal-Wallis and Post-hoc pairwise comparison tests. Results: In all thirds, there was a significant difference between the diode laser and control groups. The amount of remaining filling material in the diode laser group was significantly lower than in the control group. When the other groups were compared, a significant difference was observed only between the diode laser and XPFF groups in the coronal third. Conclusion: No supplemental method could eliminate the root obturation material. The diode laser can be used in addition to nickel-titanium rotary retreatment systems to improve the removal of gutta percha and bioceramic sealer.

Time Required for Root Canal Retreatment Using Continuous Rotation, Reciprocation, and Optimum Torque Reverse Motions: An In-Vitro Study.

Objective This study aims to evaluate the time required for canal preparation using three different movement kinematics during retreatment: continuous rotational motion, reciprocating motion, and optimum torque reverse (OTR) motion. Materials and methods The sample comprised 45 single-canal mandibular first premolars. The crowns were sectioned to standardize the root length to 16 mm. The root canals were prepared using the AF Gold mechanical preparation system (25/06). The roots were obturated using the lateral condensation technique and kept at 100% humidity at 37°C for seven days. The sample was randomly divided based on the movement pattern used during retreatment into three groups (N = 15): group 1 is continuous rotational motion using the ProTaper Universal Retreatment system; group 2 is reciprocating motion using the WaveOne Gold system; and group 3 is OTR motion using the ProTaper Universal Retreatment system. The retreatment time was measured in seconds by summing two times: T1 (time to reach the apex) and T2 (time to achieve adequate cleaning). The data were statistically analyzed using a one-way ANOVA with a significance level of α = 0.05. Results The results showed that the time required for canal preparation during retreatment with WaveOne Gold files using reciprocating motion was significantly longer than the time needed with ProTaper Universal Retreatment files using continuous rotary motion or OTR motion (P < 0.05). Conclusions The use of OTR motion did not affect the canal preparation time when used with files designed for continuous rotary motion retreatment. The use of WaveOne Gold files for canal preparation during retreatment was associated with a longer working time than ProTaper Universal Retreatment files.

Comparative evaluations on the canal-centering ability of novel heat-treated retreatment file system using nano-computed tomography

Abstract Introduction: The main goal of instrumentation during retreatment is to maintain the original curvature of the canal during retrieval of gutta-percha. The present study evaluates the canal-centering ability of two different retreatment file systems. Materials and Methods: Forty extracted single-rooted teeth were decoronated and obturated at the standardized root length of 16 mm. Samples were divided into two groups of each 20 single root teeth and they were instrumented using Solite RS3 Retreatment and ProTaper Retreatment files, respectively. Both pre- and postoperative nano-computed tomography scans were taken, and three-dimensional reconstruction was done for analysis. Sections of both the pre- and postoperative samples were taken at 7 mm, 5 mm, and 3 mm from the apex to calculate the canal-centering ratio. Independent t-test was used for statistical analysis between the two groups. Results: Solite RS3 retreatment files showed a significant difference at the 3 levels (P &lt; 0.000) compared to ProTaper retreatment files. Conclusion: From the above results, we can conclude that Solite RS3 caused minimal canal transportation and produced a relatively centered preparation in comparison to the ProTaper Retreatment system.

Effectiveness of H-files and Pro-Taper universal systems in removing Gutta-percha during endodontic retreatment: A comparative study

ObjectiveThis research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. MethodsThis ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. ResultsThe remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. ConclusionsPro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.

Comparative Evaluation of the Efficacy of ProTaper & Mtwo Rotary Retreatment System and Conventional Hand H-files for Removal of Gutta-percha from Root Canal - A Stereomicroscopic Study.

Root canal retreatment aims to eliminate or substantially reduce the microbial load from the root canal and removal of previous root filling materials is the primary goal of nonsurgical retreatment. To comparatively evaluate the effectiveness of ProTaper retreatment files, Mtwo retreatment files, and Hedstrom files along with Gates Glidden (GG) Drill by using a stereomicroscope for the detection of remaining gutta-percha after root canal retreatment using a stereomicroscope. Forty-five test samples were divided into three experimental groups (15 samples each), such as Group A-ProTaper retreatment files; Group B-Mtwo retreatment files; Group C-Hedstrom files along with Gates Glidden Drill. After routine endodontic treatment in the test samples, gutta-percha was removed from the test samples as per the division of different retreatment file systems. Further, test samples were divided longitudinally and were evaluated under the stereomicroscope. Stereomicroscopic images were captured and analysed under Image Analyser Software-Image J. One-way ANOVA test was used for comparison of gutta-percha removal between the groups and Tukey's post hoc test was used for pairwise comparisons. The least remaining filling material was seen in specimens retreated with the ProTaper universal system. The highest remaining filling material was seen in specimens retreated with Hedstrom file with Gates Glidden Drill. All experimental test techniques left gutta-percha remnants within the root canal. ProTaper universal rotary retreatment system proved to be an efficient method of removing gutta-percha and left relatively less volume in comparison with other test systems.

Retreatability of NeoSEALER Flo obturated with warm vertical compaction versus single-cone technique using two different retreatment systems.

The aim of this study was to compare the retreatability of NeoSEALER Flo obturated with warm vertical compaction (WVC) and single-cone (SC) techniques using two different retreatment systems. Thirty-two root canals were shaped and obturated with NeoSEALER Flo either in an SC obturation technique or a WVC technique. Samples were retreated using ProTaper retreatment or EdgeFile XR retreatment system. The percentage of remaining debris after retreatment was analyzed under a scanning electron microscope using ImageJ software. The time taken to reach full working length (WL) and induce patency was recorded. Statistical analysis was performed using an unpaired t-test and a one-way analysis of variance test. The percentage of remaining debris after retreatment was significantly higher in the SC technique than in the WVC technique, regardless of the retreatment system used. EdgeFile XR system removed more filling material than the ProTaper retreatment system, regardless of the obturation technique. The apical region showed significantly higher remaining debris than other regions in all groups. The WL and patency were achieved faster in the SC group, while in the WVC group, the EdgeFile XR system was faster. The WVC technique showed better retrieval of the filling material; however, a longer time was taken for retreatment. EdgeFile XR system performed better in removing filling materials from inside the canals.

Comparative evaluation of incidence of dentinal defects after root canal preparation using three different endodontic retreatment systems - An in vitro study.

Safe and efficient removal of all root filling materials from the root canal system without compromising radicular dentin structure is essential for optimal nonsurgical retreatment. The aim of this study was to evaluate and compare the incidence of dentinal defects caused during root canal filling removal using conventional, rotary, and reciprocating retreatment file systems. A detailed protocol explaining purpose and procedures of the study was submitted to the Institutional Ethics Committee and ethical clearance obtained. Sixty human maxillary permanent central incisors were collected and decoronated to 12-mm standardized length. The canals prepared up to a master apical file size F3 with Protaper hand files, obturated using AH plus sealer, examined under the stereomicroscope (×40 magnification): Group I: Control (n = 15), Group II: Conventional (n = 15), Group III: Protaper Universal Retreatment Files (n = 15), and Group IV: Reciproc Blue (n = 15). After instrumentation, teeth were sectioned at 3, 6, and 9 mm from the apex to evaluate the presence of dentinal defects under the stereomicroscope. Statistics were performed using the SPSS, version, 25 (SPSS Inc., Chicago, IL, USA). Initially, normality test was done using the Shapiro-Wilk test and data were not normally distributed followed by Kruskal-Wallis test. P < 0.05 is considered statistically significant. Maximum percentage increase in dentinal defects was observed in Protaper Universal Retreatment Files followed by Conventional method and Reciproc Blue. Significantly Reciproc Blue reduced the incidence of dentinal defects after root canal preparation.

ProTaper universal retreatment retreatment potential in oval-shaped canals filled with different obturation techniques-A micro-computed tomography study.

The objective of this in vitro micro-computed tomography investigation is to assess the efficacy of the ProTaper Universal Retreatment System in retreating oval-shaped root canals filled with three obturation procedures. Thirty-six lower incisors with a single oval root canal were prepared using XP-Endo Shaper up to size 30/0.04, and allocated into three equal groups based on the filling technique: Group 1: Warm vertical condensation technique; Group 2: GuttaCore obturators; Group 3: Cold lateral condensation technique. All samples were further retreated using the ProTaper Universal Retreatment system. Micro-CT analysis was performed before and after the retreatment procedure. Statistical analysis was performed with a significance level of 0.05. Data analysis was conducted using the Kolmogorov-Smirnov and Kruskal-Wallis H tests. The best performance of the files was achieved when the removal of the filling in the entire canal was considered. However, this outcome was not statistically significant when compared with the other observed root canal levels. The retreatment procedure could not ensure thorough cleanliness of the canal walls from filling remnants, regardless of the obturation technique and observational level. The ProTaper Universal Retreatment system used for the removal of gutta-percha and sealer in oval-shaped root canals demonstrated equal effectiveness, regardless of the obturation technique used.

The efficacy of XP endo retreatment system in removing bioceramic sealer from dentinal walls: An in vitro micro computed tomography study

Objectives: This study compared the efficacy of the XP endo retreatment (XPER) system in removing Total Fill Hi Flow BC (Bio ceramic) and Total Fill BC sealers from dentinal walls to that of the Pro Taper Universal retreatment (PTUR) system using micro-computed tomography (micro CT) analysis.

An in vitro evaluation of the removed dentin thickness of different retreatment systems using with and without solvent in the danger zone of mandibular molar teeth

An in vitro evaluation of the removed dentin thickness of different retreatment systems using with and without solvent in the danger zone of mandibular molar teeth

Comparative analysis of novel heat-treated retreatment file system on the removal of obturating material using nano-computed tomography.

The aim of nonsurgical retreatment is to remove the previous filling material followed by chemo-mechanical preparation of the canal to achieve proper disinfection of the root canal system. This is then followed by re-obturation. This study evaluates the time taken to retrieve the gutta-percha and the quantity of remaining filling material after retreatment with two different file systems. The quantity of remaining filling material was assessed using nano-computed tomography (CT) due to its increased accuracy. Forty extracted single-rooted teeth were split into two groups at random and decoronated and obturated at a standard root length of 16 mm. Solite RS3 (SRS-3) Retreatment and ProTaper Universal Retreatment (PTUR) systems were used to retrieve the gutta-percha after a preoperative nano-CT scan. Postoperative nano-CT scan was taken and both the scans were superimposed to quantify the remaining filling material. The time taken to remove gutta-percha was measured using a stopwatch. The statistical analysis comparing the two groups was conducted using the independent t-test. The quantitative analysis of remaining filling material using nano-CT showed no statistical difference between both the file systems used (P > 0.05). However, SRS-3 took significantly less time in the removal of gutta-percha (P < 0.05). Hence, we can conclude that there is no significant difference in the amount of remaining filling material between both the file systems. However, time taken to remove the gutta-percha was lesser in SRS-3 compared to PTUR file system.

Comparative Evaluation of Three Rotary Retreatment Systems for Apical Extrusion of Root Canals Obturated with Different Techniques

The aim of this study was to evaluate the quantitative amount of apically extruded debris after endodontic retreatment using three retreatment rotary systems D-RaCe, R-Endo, and EdgefileXR in the teeth obturated by two techniques (single cone and continuous wave compaction). Sixty human mandibular premolars with single straight root canals were prepared by 2Shape endodontic rotary system with file size (25/0.04). After that, samples were divided into two groups according to the technique of obturation used (n=30/group): A: single cone and B: continuous wave compaction. Then, further random subdivision for each group into three sub groups according to the system used for retreatment (n=10/group) as follow: A1,B1:D-RaCe, A2,B2:R-Endo, and A3,B3: EdgefileXR. Preweighed Eppendorf tubes were used to collect the apical extruded material during endodontic retreatment. Then, Eppendorf tubes were stored in an incubator at 68C for 5 days. The weight of extruded debris was calculated by subtracting the weight of the empty tube from the weight of the tube containing the extruded debris. Data were analyzed statistically using one way ANOVA analysis of variance and post hoc Duncan test. EdgeFileXR and R-Endo were significantly not different, but significantly different from D-race in two obturation technique. Also, result showed that the same system exhibited no difference in both obturation techniques. All retreatment techniques resulted in apical extrusion debris. Also, it was concluded that the techniques of obturation had no significant effect in the amount of apical extruded debris by different retreatment systems used in this study.

Measurement of Residual Material Remained in the Root Canals that Retreated by Different Rotary System

Aims: This study was aimed to measure the quantity of residual material remained in root canals after root canal system being retreated by rotary instruments of three types: EdgefileXR, D-RaCe, and R-Endo in teeth that their canals filled by either single cone method or the continuous wave compaction method. Methods: human mandibular cuspid teeth (n=60) had only one non curve canal were instrumented with file (25/0.04). Then, the teeth classified into two main groups depending on the technique that they were obturated with (thirty teeth for each group): A: single cone method and B: continuous wave compaction method. After that, other subcategories, for each of the groups subdivided into three subgroups depending on the retreatment system that used (n=10/group) as following: A1, B1: D-RaCe, A2, B2: R-Endo, and A3, B3: EdgefileXR. The teeth were analyzed by using cone beam, computed tomography with aid of AutoCAD software to evaluate the percentage of residual obturating material. We used both tests one, way ANOVA; and post hoc, Duncan to analyze the data statically. Results: the results were found there was significant; difference between D-race and other two rotary systems, while no significant difference between EdgefileXR and R-Endo in both technique of obturation. Also, this study reported there was no difference statically in the same rotary system in both0 techniques of obturation. Conclusions: All rotary retreatment systems left residual obturating material. EdgeFileXRl rotary system is more effective, among systems.

Effectiveness of Two Endodontic Instruments in Calcium Silicate-Based Sealer Retreatment.

The objective of the present in vitro work was to investigate the effectiveness and time required for the removal of calcium silicate-based sealer using two rotary retreatment systems. Sixty extracted, single-canal, lower premolars were used. After obturation using the single-cone technique with calcium silicate-based sealer, samples were divided into four groups according to the technique of desobturation: Group 1 (G1): D-Race; Group 2 (G2): D-Race followed by the use of XP-Endo Finisher R; Group 3 (G3): Protaper Universal Retreatment; and Group 4 (G4): Protaper Universal Retreatment followed by the use of XP-Endo Finisher R. Cone beam computed tomography (CBCT) images were used to calculate the remaining filling materials at the middle and apical thirds. Times required to perform each method were recorded. Scanning electron microscopy (SEM) and digital microscopy were used to evaluate the remaining filling materials. Data were statistically analyzed using the t-test and one way ANOVA on ranks tests. No statistically significant difference was found between G1 and G3 after CBCT observations (p > 0.05). Xp-Endo Finisher R significantly increased the ability to remove materials regardless of the initially used retreatment system (p < 0.05). Statistically significant longer time was found in G3 and G4 compared to G1 and G2, respectively (p < 0.05), to reach the full working length. No retreatment system was able to totally remove the calcium silicate-based sealer from the root canal at the middle and apical thirds (p > 0.05). Digital microscopy demonstrated that the residual materials were the remaining sealers on the canal walls. SEM showed the mineral depositions of calcium silicate materials onto the canal walls and into the dentinal tubules. However, that calcium silicate materials provide mineral deposition into the dentinal tubules might indicate that the traditional irrigants could not be sufficient to remove calcium silicate-based materials from the root canal, and other agents should be used to make retreatment considerably easier.

Effect of Two Retreatment Systems on the Bond Strength of TotalFill Bioceramic sealer: An in vitro study

Effect of Two Retreatment Systems on the Bond Strength of TotalFill Bioceramic sealer: An in vitro study

The effect of different retreatment systems and root canal sealers on the fracture resistance of endodontically retreated samples: A laboratory study

The effect of different retreatment systems and root canal sealers on the fracture resistance of endodontically retreated samples: A laboratory 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 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.

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.