Influence of retreatment in the formation of dentinal microcracks in mandibular molars filled with a calcium silicate based sealer

Introduction: In endodontically treated teeth, dentinal defects such as microcracks can progress to a vertical root fracture and lead to tooth loss. Objective: The present study aimed to evaluate, by micro-computed tomography analysis, the formation of dentinal microcracks during filling removal in endodontic retreatment of root canals filled with gutta-percha and Total Fill BC bioceramic sealer. Methods: Twenty mesial roots of mandibular molars were instrumented and obturated with gutta-percha and Total Fill BC sealer and then the filling material was removed with rotary Protaper Retreatment files. The specimens were scanned before instrumentation, after filling and after retreatment. The transversal images obtained after filling were compared with the images obtained after removal of the filling material. A descriptive statistical analysis was performed. Results: Among the 24.444 cross-sections analyzed, 5.67% presented some type of dentinal defect, with 0.51% in the initial images, 2.58% in the post-filling images and 2.58% in the post-retreatment images. All the dentinal defects identified in the images obtained after the retreatment were already present in the corresponding images after the filling. New dentinal microcracks were not observed after removal of the filling material. Conclusion: Retreatment of mesial roots of mandibular molars filled with a silicate-based root canal filling material do not influence the formation of dentinal microcracks.

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Evaluation of Two Shaping Systems and Two Ultrasonic Irrigation Devices in Removing Root Canal Filling Material from Mesial Roots of Mandibular Molars: A Micro CT Study

Dentistry Journal ◽

10.3390/dj7010002 ◽

2019 ◽

Vol 7 (1) ◽

pp. 2 ◽

Cited By ~ 1

Author(s):

Marc Krikor Kaloustian ◽

Walid Nehme ◽

Claire El Hachem ◽

Carla Zogheib ◽

Nabil Ghosn ◽

...

Keyword(s):

Ct Scan ◽

Filling Material ◽

Micro Ct ◽

Micro Computed Tomography ◽

Root Canal Filling ◽

Mandibular Molars ◽

Group A ◽

Ultrasonic Irrigation ◽

Group B ◽

Group D

We assessed the efficiency of two shaping file systems and two passive ultrasonic irrigation (PUI) devices for removing filling material during retreatment. The mesial canals from 44 extracted mandibular molars were prepared and obturated. The teeth were randomly divided into two groups, and then one group was retreated with Reciproc R25 (VDW, Munich, Germany) (n = 44) and the other group was retreated with 2Shape (TS, Micro Mega, Besançon, France) (n = 44). A micro-computed tomography (CT) scan was taken before and after the retreatment to assess the volume of the filling material remnants. The teeth were then randomly divided into four groups to test two different PUI devices: Irrisafe (Satelec Acteon Group, Merignac, France) and Endo Ultra (Vista Dental Products, Racine, WI, USA). The teeth in Group A were retreated with 2Shape to test the Endo Ultra (n = 22) device, the teeth in Group B were retreated with 2Shape in order to test the Irrisafe (n = 22) device, the teeth in Group C were retreated with Reciproc to test the Endo Ultra (n = 22) device, and Group D was retreated with Reciproc to test the Irrisafe (n = 22) device. A third micro-CT scan was taken after the retreatment to test the PUIs. The percentage of Gutta-Percha (GP) and sealer removed was 94.75% for TS2 (p < 0.001) and 89.3% for R25 (p < 0.001). The PUI significantly enhanced the removal of the filling material by 0.76% for Group A (p < 0.001), 1.47% for Group B (p < 0.001), 2.61% for Group C (p < 0.001), and by 1.66% for Group D (p < 0.001). 2Shape was more effective at removing the GP and sealer during retreatment (p = 0.018). The supplementary approach with PUI significantly improved filling material removal, with no statistical difference between the four groups (p = 0.106).

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Radiographic and scanning electron microscopic assessment of root canal filling remnants after endodontic re-instrumentation

Brazilian Dental Science ◽

10.14295/bds.2017.v20i1.1325 ◽

2017 ◽

Vol 20 (1) ◽

pp. 80 ◽

Cited By ~ 1

Author(s):

Luciane Geanini Pena Santos ◽

Wilson Tadeu Felippe ◽

Beatriz Dulcineia Mendes Souza ◽

Andrea Cristina Konrath ◽

Mabel Mariela Rodríguez Cordeiro ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Root Canal ◽

Filling Material ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Ah Plus ◽

Endodontic Retreatment ◽

Scanning Electron

Objective: Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic re-instrumentation. Material and Methods: Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were re-instrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P < 0.05). Results: Radiographic and SEM analysis showed that material from the MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. Conclusion: After re-instrumentation, MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third.Keywords Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.

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The Effect of Ultrasonic Agitation on the Porosity Distribution in Apically Perforated Root Canals Filled with Different Bioceramic Materials and Techniques: A Micro-CT Assessment

Journal of Clinical Medicine ◽

10.3390/jcm10214977 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4977

Author(s):

Saulius Drukteinis ◽

Goda Bilvinaite ◽

Hagay Shemesh ◽

Paulius Tusas ◽

Vytaute Peciuliene

Keyword(s):

Root Canal ◽

Micro Computed Tomography ◽

Root Canal Filling ◽

Porosity Distribution ◽

Significance Level ◽

Ultrasonic Agitation ◽

Root Canals ◽

Gutta Percha ◽

Before And After ◽

Rotary Instrument

The present study evaluated the effect of ultrasonic agitation on the porosity distribution of BioRoot RCS/single gutta-percha cone (BR/SC) and MTA Flow (MF) root canals fillings used as apical plugs in moderately curved and apically perforated roots. Eighty mesial root canals of mandibular first molars were enlarged up to ProTaper NEXT X5 rotary instrument 2 mm beyond the apical foramen, simulating apical perforations. Specimens were randomly divided into four experimental groups (20 canals per group) according to the material and technique used for root canal obturation: BR/SC, BR/SC with ultrasonic agitation (BR/SC-UA), MF and MF with ultrasonic agitation (MF-UA). The ultrasonic tip was passively inserted into the root canal after the injection of flowable cement and activated for 10 s. The specimens were scanned before and after obturation with a high-resolution micro-computed tomography scanner, and the porosity of the apical plugs was assessed. The differences between groups were analyzed using the Kruskal-Wallis and Mann-Whitney tests, with the significance level set at 5%. None of the obturation materials and techniques used in this study was able to provide a pore-free root canal filling in the apical 5 mm. Considerably higher percentages of open and closed pores were observed in the MF and MF-UA groups, with the highest porosity being in the MF-UA group (p < 0.05). No significant differences were observed between the BR/SC and BR/SC-UA groups, where the quantity of open and closed pores remained similar (p > 0.05).

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Verification of remaining filling materials in flattened/oval-shaped root canals after use of several endodontic retreatment protocols

RSBO ◽

10.21726/rsbo.v17i2.29 ◽

2021 ◽

Vol 17 (2) ◽

pp. 72-78

Author(s):

Fábio Carmona Tirintan ◽

Álvaro Henrique Borges ◽

Jesus Djalma Pécora ◽

Manoel dos Santos da Silva Neto ◽

Matheus Gehrke Barbosa ◽

...

Keyword(s):

Complete Removal ◽

Lower Amount ◽

Control Group ◽

Filling Material ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Level Of Significance ◽

Relative Differences ◽

Endodontic Retreatment

This study verified of remaining filling materials in flattened/oval-shaped root canals after use of several endodontic retreatment protocols. Material and methods: Seventy human mandibular incisors were selected. Sixty specimens received crown-apex preparation performed by ProTaper Next® system andwere filled with hybrid Tagger technique with gutta-percha and AH Plus®. Ten specimens were left unprepared (Control Group). The specimens were randomly distributed in six groups, according the different retreatment protocols: G1 – Clearsonic® + ProTaper Universal Retreatment® + Reciproc®; G2 – Reciproc®; G3 – Clearsonic® + ProTaper Universal Retreatment®; G4 – Clearsonic® + Reciproc®; G5 – Oscillatory EndoEze® + Manual files; G6 – ProTaper Universal Retreatment®. Presence of root canal filling material residual were evaluated using Scanning Electron Microscopy. The relative differences of remaining filling materials between the groups and root thirds were determined by Kolmogorov-Smirnov and Levene tests followed by Tukey post hoc test. The level of significance was set at α = 5%. Results: Regarding the presence residual, G1 (Clearsonic® + ProTaper Universal Retreatment® + Reciproc®), G2 (Reciproc®), G3(Clearsonic® + ProTaper Universal Retreatment®) and G6 (ProTaper Universal Retreatment®) protocols presented a lower amount (p<0.05). The highest values (p<0.05) of remaining filling materials were presented in the G5 (Oscillatory EndoEze® + Manual files) protocol. Intermediate values (p<0.05) were presented by G4 (Clearsonic® + Reciproc®) protocol. Conclusion: The endodontic retreatment protocols no showed effectiveness for complete removal of remaining sealing material from flattened/oval-shaped root canals.

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Comparative Evaluation of Efficacy of Three Different Rotary Retreatment Systems with Manual Instrumentation in Removing Gutta-Percha from Root Canals – An In Vitro Study

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/219 ◽

2021 ◽

Vol 10 (14) ◽

pp. 1025-1029

Author(s):

Aparna V. Muraleedhar ◽

Sarvapelli Venkata Satish ◽

Ashwini M. Patil ◽

Suresh Kumar Kovvuru ◽

Snehalatha Patil

Keyword(s):

In Vitro Study ◽

Lower Amount ◽

Filling Material ◽

Root Canals ◽

Gutta Percha ◽

Residual Material ◽

Group 2 ◽

Post Hoc ◽

Endodontic Retreatment

BACKGROUND The primary goal of endodontic retreatment is to take out the root filling completely to ensure that the canal is completely cleaned. Gutta percha removal using hand instruments is a time-consuming procedure and tedious for the operator. Therefore, various nickel titanium instruments have been introduced for the effective retrieval of gutta percha. This study was done to compare the efficacy of three different rotary systems compared with manual instrumentation for gutta percha removal during retreatment. METHODS Forty-eight single rooted premolars were prepared and obturated using gutta percha and AH Plus sealer using lateral compaction technique. Samples were randomly divided into four groups of 12 specimens each. Group 1 was retreated with Hedstrom Files (H-Files), group 2 was retreated with pro taper universal retreatment files (PTUR), group 3 with R-Endo retreatment files and group 4 with Neoendo retreatment files. Time taken for the retreatment was recorded for each tooth using a stopwatch. The samples were sectioned longitudinally and observed under a stereomicroscope. Digital images were taken and analysed using digital image analysing software. The data was statistically analysed using Kruskal-Wallis and Post-hoc Mann-Whitney test. RESULTS The Neoendo group showed significantly lower amount of residual material compared to PTUR, R-Endo and the H-Files (P = 0.00). The maximum residual material was observed in the H file group. The time taken for gutta percha removal was least for the Neoendo group followed by PTUR, R-Endo and H-Files. CONCLUSIONS None of the instruments were able to remove the filling material completely. Gutta percha removal using Neoendo and protaper universal retreatment files were faster and more efficient compared to REndo and H files. KEY WORDS Endodontic Retreatment, Protaper Universal Retreatment Files, R-Endo, Neoendo, HFiles

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Filling Ability and Flow of Root Canal Sealers: A Micro-Computed Tomographic Study

Brazilian Dental Journal ◽

10.1590/0103-6440202003328 ◽

2020 ◽

Vol 31 (5) ◽

pp. 499-504

Author(s):

Jáder Camilo Pinto ◽

Fernanda Ferrari Esteves Torres ◽

Mariana Mena Barreto Pivoto-João ◽

Joni Augusto Cirelli ◽

Juliane Maria Guerreiro-Tanomaru ◽

...

Keyword(s):

Root Canal ◽

Continuous Wave ◽

Glass Plate ◽

Filling Material ◽

Micro Computed Tomography ◽

Central Cavity ◽

Root Canals ◽

Mandibular Molars ◽

Filling Ability ◽

Cavity Filling

Abstract This study evaluated by micro-computed tomography (μCT) the filling ability in curved root canals, besides the flow of AH Plus (AHP) and Neo MTA Plus (NMTAP) sealers using different methodologies. Mandibular molars mesial roots with two root canals and degree of curvature between 20° and 40° were selected. The specimens were prepared with the ProDesign R system up to size 35.05 and were filled with the sealers by a continuous wave of condensation technique, Thermo Pack II (n=12). The teeth were scanned using μCT after root canal preparation and obturation. The volumetric percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 (n=10). Flow and filling were also evaluated in μCT using a glass plate with a central cavity and four grooves from the central cavity (n=6). Flow was linearly calculated into the grooves. The central cavity filling (CCF) and lateral cavity filling (LCF) were calculated in mm³. Data were submitted to non-paired t test with a significance threshold at 5%. The percentage of filling and voids between the root canals filled with AHP or NMTAP was similar (p>0.05). NMTAP presented the lowest flow in conventional test (p<0.05). Using μCT, sealers had similar CCF, LCF and linear flow (p>0.05). In conclusion, NMTAP and AHP had similar filling ability in curved mesial root canals of mandibular molars without presence of isthmus. Although AHP presented better flow than NMTAP using ISO methodology, there was no difference between these materials regarding volumetric filling when evaluated by μCT.

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Efficacy of A Novel File in Removing Root Canal Filling Material from Root Canals of Endodontically Treated Teeth - An In Vitro Study

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2020.12.03.451 ◽

2020 ◽

Vol 12 (03) ◽

Keyword(s):

Root Canal ◽

In Vitro Study ◽

Vitro Study ◽

Filling Material ◽

Endodontically Treated Teeth ◽

Root Canal Filling ◽

Root Canals

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Comparison of Two Techniques for Selection of Master Gutta-Percha Cone Using Micro-Computed Tomography

Brazilian Dental Journal ◽

10.1590/0103-6440201302330 ◽

2013 ◽

Vol 24 (4) ◽

pp. 367-370 ◽

Cited By ~ 2

Author(s):

Joao Manoel Silva-Filho ◽

Aline Evangelista Souza-Gabriel ◽

Graziela Bianchi Leoni ◽

Samuel Henrique Camara De-Bem ◽

Edson Alfredo ◽

...

Keyword(s):

Computed Tomography ◽

Conventional Technique ◽

Filling Material ◽

Micro Ct ◽

Micro Computed Tomography ◽

Root Canals ◽

Gutta Percha ◽

Working Length ◽

Significant Difference ◽

Material Volume

This study used micro-computed tomography (micro-CT) to evaluate the fit of the master gutta-percha cone at time of cone fit, gutta-percha volume in the filling material, and the filling material volume in relation to the canal at the apical limit of the working length. Root canals of 20 maxillary central incisors were prepared with rotary instruments and distributed into two groups (n=10). The gutta-percha cone tip was either plasticized (apical thermal impression technique - ATI) or not (conventional technique - CT), and its apical fit was checked. The apical 1 mm of working length was examined with a micro-CT, canals were filled with gutta-percha and sealer, and new micro-CT scans were obtained. In CT, gutta-percha filled 35.83 ± 15.05% of the canal at cone selection and 38.72 ± 11.64% after filling. In ATI, these values were 23.14 ± 7.74% and 26.98 ± 20.40%, respectively. Gutta-percha volume in the filling material, and filling material volume in relation to the canal were, respectively, 61.28 ± 11.64% and 87.76 ± 9.98% for CT, and 73.00 ± 20.41% and 89.96 ± 9.08% for ATI. No significant difference was found between cone selection and after canal filling, for either CT (p=0.593) or ATI (p=0.4975). The techniques did not differ significantly with respect to gutta-percha volume in the filling material (p=0.132) and filling material volume in relation to the canal (p=0.612). An ideal fit of the master gutta-percha cone at working length was not achieved regardless of the cone selection technique, and the material-filled area was similar for both techniques.

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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

Journal of Clinical Medicine ◽

10.3390/jcm9061989 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1989 ◽

Cited By ~ 1

Author(s):

Tarek-Fahed Alakabani ◽

Vicente Faus-Llácer ◽

Ignacio Faus-Matoses ◽

Celia Ruiz-Sánchez ◽

Álvaro Zubizarreta-Macho ◽

...

Keyword(s):

Computed Tomography ◽

Root Canal ◽

Material Removal ◽

Filling Material ◽

Micro Computed Tomography ◽

Root Canal Filling ◽

Root Canal Retreatment ◽

Before And After ◽

Canal Systems ◽

Endodontic Retreatment

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.

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Efficacy of Removing Thermafil and GuttaCore from Straight Root Canal Systems Using a Novel Non-Surgical Root Canal Re-Treatment System: A Micro-Computed Tomography Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10061266 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1266

Author(s):

Vicente Faus-Llácer ◽

Rubén Pérez ◽

Ignacio Faus-Matoses ◽

Celia Ruiz-Sánchez ◽

Álvaro Zubizarreta-Macho ◽

...

Keyword(s):

Root Canal ◽

Treatment System ◽

Filling Material ◽

Micro Computed Tomography ◽

Root Canal Filling ◽

Filling Materials ◽

Gutta Percha ◽

Ct Analysis ◽

Canal Systems ◽

Ah Plus

The present study aims to evaluate the effectiveness of an XP-endo non-surgical root canal re-treatment system in removing both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems using micro-computed tomography (micro-CT) analysis. The study was performed on 20 single-rooted upper teeth, which were randomly allocated into the following study groups: Group A, Thermafil and AH Plus sealer (n = 10); Group B, GuttaCore and AH Plus sealer (n = 10). Before and after the non-surgical root canal re-treatment procedure, the samples were submitted for a micro-CT analysis. The volume of the root canal filling material (mm3), the volume of the remaining root canal filling material (mm3) and the time (minutes) needed to remove the root canal filling material were also recorded. Student’s t-test was used to analyze the results. No statistically significant differences were found between the volume of the remaining root canal filling material in the GuttaCore and Thermafil root canal filling systems at the coronal third (p = 0.782), middle third (p = 0.838) or apical third (p = 0.882) of the straight root canal systems; however, the GuttaCore required a statistically significant (p = 0.037) shorter amount of time (4.72 ± 0.76 min) to be removed than the Thermafil carrier-based root canal filling material (5.92 ± 1.42 min). The XP-endo Finisher non-surgical endodontic re-treatment system removes both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems, although removal of the GuttaCore gutta-percha carrier-based root canal filling material required less time.

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