Secondary Root Canal Treatment with Reciproc Blue and K-File: Radiographic and ESEM-EDX Analysis of Dentin and Root Canal Filling Remnants

Secondary root canal treatment requires the complete removal of filling materials with different chemical-physical properties. A newly developed single-use NiTi instrument (Reciproc Blue, RB) may be more effective in root canal retreatment. The aim of the present study was to evaluate morphology and composition of remnants after retreatment with RB compared to traditional K-File technique, in canals obturated with Thermafil/AH Plus. Twenty-four single-rooted human teeth were shaped with NiTi obturated with AH-Plus/Thermafil and retreated using RB NiTi instruments or manual K-Files. Radiographs were taken to evaluate endodontic space and radiopacity of residual filling-material before/after procedures. After retreatment, samples were longitudinally split and observed by environmental scanning electron microscopy connected to energy dispersive X-Ray spectroscopy (ESEM-EDX) to analyze the debris/remnant position, microchemistry, and dentinal surface morphology. Time for retreatments was recorded and compared using one-way ANOVA (p-value = 0.05). Radiopaque filling residuals were found in both groups. RB system resulted statistically faster than manual K-File in retreatment procedure (p < 0.001). Root canal space radiographic appearance obtained after retreatment with RB was wider than K-File (p < 0.05). ESEM-EDX revealed 4 different morphological dentin area. Area-1: debris-free with typical Ca, P, and N composition of dentin and detected in 70% of the surface. Area-2: presence of deproteinized smear layer free from N and debris in 15% of the surface. Area-3: a thick packed smear layer N-free and with fine debris consisting of trace elements from sealer in 10% of the surface. Area-4: packed with debris and trace elements. No difference was observed between both instruments regarding root canal space appearance and ESEM-EDX analysis. Both systems were able to remove filling material but created a dentine morphology composed of packed debris and filling materials embedded into the smear layer. Dentin surface composition resulted in collagen depleted by irrigation procedures. The reciprocating system required less time to complete retreatment.

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Micro-CT Evaluation of Root Filling Removal after Three Stages of Retreatment Procedure

Brazilian Dental Journal ◽

10.1590/0103-6440201300061 ◽

2015 ◽

Vol 26 (6) ◽

pp. 612-618 ◽

Cited By ~ 11

Author(s):

Ricardo Abreu da Rosa ◽

Manuela Favarin Santini ◽

Bruno Cavalini Cavenago ◽

Jefferson Ricardo Pereira ◽

Marco Antônio Húngaro Duarte ◽

...

Keyword(s):

Root Canal ◽

Filling Material ◽

Micro Ct ◽

Micro Computed Tomography ◽

Root Canal Filling ◽

Tomography System ◽

Filling Materials ◽

Ct Evaluation ◽

Ah Plus ◽

Post Hoc

The aim of this study was to quantify the residual filling material after filling removal, re-preparation with rotary or reciprocating files and passive ultrasonic irrigation (PUI). Twenty maxillary molars were prepared using ProTaper instruments up to F1. The teeth were filled with AH Plus and ProTaper gutta-percha points using the single-cone technique. Thereafter, the specimens were scanned using a micro-computed tomography system (Micro-CT #1). Then, the root canal filling was removed using ProTaper Retreatment files, and a new scan was performed (Micro-CT #2). The specimens were divided into two groups according to the instrument used for re-preparation: ProTaper rotary or WaveOne reciprocating files (Micro-CT #3). Finally, PUI was performed, and a new micro-CT scan was performed (Micro-CT #4). Intragroup and intergroup analyses were performed using Friedman and Dunn's post hoc test and the Kruskal-Wallis and Dunn post hoc tests, respectively. Palatal canal presented the highest volume of residual filling material in all stages of endodontic retreatment (p<0.05). The main reduction of filling volume was achieved after using ProTaper Retreament (p<0.05). The amount of remaining filling material after using ProTaper Retreatment was similar to that achieved with rotary and reciprocating files and after PUI (p>0.05). Rotary and reciprocating files achieved similar removal of the root canal filling (p>0.05). The greatest reduction in filling material was achieved after using ProTaper Retreatment files. Rotary and reciprocating instruments and PUI did not improve the removal of root canal filling materials.

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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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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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Correction to: A 12-month follow-up of primary and secondary root canal treatment in teeth obturated with a hydraulic sealer

Clinical Oral Investigations ◽

10.1007/s00784-021-04026-z ◽

2021 ◽

Author(s):

Giulia Bardini ◽

Laura Casula ◽

Emanuele Ambu ◽

Davide Musu ◽

Montse Mercadè ◽

...

Keyword(s):

Root Canal ◽

Root Canal Treatment ◽

Secondary Root

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Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study

Materials ◽

10.3390/ma14102661 ◽

2021 ◽

Vol 14 (10) ◽

pp. 2661

Author(s):

Kiche Shim ◽

Young-Eun Jang ◽

Yemi Kim

Keyword(s):

Postoperative Pain ◽

Postoperative Period ◽

Root Canal ◽

Continuous Wave ◽

Root Canal Treatment ◽

Root Canals ◽

Anterior Teeth ◽

Significant Difference ◽

Ah Plus ◽

Group 2

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.

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Management of Severe Curvatures in Root Canal Treatment with the New Generation of Rotating Files Using a Safe and Predictable Protocol

The Open Dentistry Journal ◽

10.2174/1874210602014010421 ◽

2020 ◽

Vol 14 (1) ◽

pp. 421-425

Author(s):

Alfredo Iandolo ◽

Alessandra Amato ◽

Stefano Martina ◽

Dina Abdel latif ◽

Giuseppe Pantaleo

Keyword(s):

Surface Area ◽

Root Canal ◽

Root Canal Treatment ◽

Complex Root ◽

Root Canals ◽

New Generation ◽

Area And Volume ◽

Clinical Cases

Objective: The aim of this work was to show the management of severe curvatures done with the new generation of rotating files through a safe and predictable protocol. Methods: Three clinical cases were described. A safe protocol was explained using the latest generation of rotating files for the shaping of the anatomy of complex root canals. All the cases presented 90°, 45° curvatures and/or double curvatures. Results: The instrumentation of canals increased their surface area and volume. All the cases with 90° and 45° curvatures were optimally shaped. Conclusion: With the help of rotating files in the martensitic alloy, it is possible to work safely, while avoiding the risk of file separation, even in root canals with severe curvatures, thus achieving success even in complex clinical cases.

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GuttaFlow Bioseal as Monocone Obturation Technique in Curved Root Canals: A Scanning Electron Microscopy Study

Science Letters ◽

10.24191/sl.v15i2.13824 ◽

2021 ◽

Vol 15 (2) ◽

pp. 42-59

Author(s):

Musliana Mustaffa ◽

◽

Hajar Ar Rahmah Nasri ◽

Insyirah Kamarulzaman ◽

Mohamad Shafiq Mohd Ibrahim ◽

...

Keyword(s):

Surface Area ◽

Root Canal ◽

Current Approach ◽

Filling Material ◽

Sem Images ◽

Root Canals ◽

Gutta Percha ◽

Curved Root Canals ◽

Scanning Electron ◽

Group 1

The obturation quality of GuttaFlow Bioseal in curved root canals is not commonly investigated although there has been a current approach toward utilizing this material in extracted molars in recent years. This study assessed the obturated surface area, extrusion of root filling material beyond the apical foramen and duration of obturation procedure in curved root canals using monocone obturation technique. Access cavity was prepared in 20 human mandibular molars. Root canals with curvature of more than 10 as determined according to Schneider’s method were included. Samples were prepared using Hyflex CM rotary files and divided into two groups (n=10): Group 1 [gutta-percha cone and GuttaFlow Bioseal] and Group 2 [gutta-percha cone and RoekoSeal Automix root canal sealer]. The duration of obturation procedure was recorded and obturation radiographs were taken. Samples were bisected and the mesial roots were sectioned horizontally to obtain 3 root segments; apical, middle and coronal. All resected roots were mounted on brass stubs, sputter-coated with thin platinum coating and observed under scanning electron microscope (SEM) at 70x magnification. The SEM images were transferred to the SketchAndCalc Area Calculator software. No statistically significant differences in the obturated surface area and extrusion of root filling material were observed between Group 1 and 2, irrespective of the status of root canal curvature. Duration for obturation in severe root canal curvatures between Group 1 and 2 were statistically significant. Obturated surface area and extrusion of root filling material were not affected by the root canal curvature, however duration for obturation using GuttaFlow Bioseal in severe root canal curvatures was slightly longer.

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Sealing Ability of AH Plus and GuttaFlow Bioseal

Bioinorganic Chemistry and Applications ◽

10.1155/2020/8892561 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Soo-Hyuk Lee ◽

Soram Oh ◽

Adel Saeed Al-Ghamdi ◽

Ayman Omar Mandorah ◽

Kee-Yeon Kum ◽

...

Keyword(s):

Fluid Flow ◽

Root Canal ◽

Glass Ceramics ◽

Filling Material ◽

Root Canal Filling ◽

Measuring Device ◽

Gutta Percha ◽

Sealing Ability ◽

Ah Plus ◽

The Mean

The objective of root canal obturation is to achieve a fluid-tight seal. Recently, GuttaFlow bioseal (GB), a root canal sealer composed of polydimethylsiloxane, gutta-percha particles, and bioactive glass ceramics, has been developed, to enhance the sealing ability of root canal filling material. The objective of this study was to assess the sealing ability of GB using a subnanoliter-scaled fluid-flow measuring device and to compare with that of AH Plus (AH). The fluid flow in root canal-filled teeth using either gutta-percha cone (GP) with AH (GAR; n = 10) or GP with GB (GBR; n = 10) and in GP inserted in AH blocks (GA; n = 10) or GP inserted in GB blocks (GB; n = 10) was measured. In addition, fluid flow in sealer blocks of AH (A; n = 10) and GB (B; n = 10), which served as negative controls, was measured. Root canal-filled teeth using GP without any sealer (GR) acted as positive controls (n = 10). The leakage was obtained by calculating the volume of moved water by time (s), after stabilization of the fluid flow was achieved. Statistical analysis was performed using the Kruskal–Wallis test and Mann–Whitney U-test with Bonferroni correction. A p value less than 0.00238 (0.05/21) was considered significantly different. The mean leakages (nL/s) in the groups are as follows: GAR, 0.0958 ± 0.0543; GBR, 0.0223 ± 0.0246; GA, 0.0644 ± 0.0803; GB, 0.0267 ± 0.0182; A, 0.0055 ± 0.0057; B, 0.0052 ± 0.005; and GR, 0.2892 ± 0.3018. The mean leakage in the GBR group was lower than that in the GAR group (p = 0.001), while the mean leakages in the GA and GB groups were not significantly different. GuttaFlow bioseal can be useful in single-cone obturation technique.

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