scholarly journals Endodontic retreatment: significance and a systematic review of te major protocols

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Larissa Gabriele Pereira Santana ◽  
Fábio Pereira Linhares de Castro
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Patient Comfort ◽  
Filling Material ◽  
Treatment Scenario ◽  
Cement Pastes ◽  
Root Canals ◽  
Review Model ◽  
High Degree ◽  
Endodontic Retreatment

Introduction: In the endodontic treatment scenario, despite the emergence of techniques and instruments that facilitate the treatment, there are still cases that require retreatment of the treated root canals. Non-surgical endodontic retreatment (NSER) can be performed in one or several visits. Endodontic pain has been the main reason for patient consultations after therapy and affects patient comfort. A condition for successful endodontic retreatment is proper cleaning of the root canals, therefore, special attention must be given to the technique used to remove the filling material, with the most commonly used cement, pastes, and gutta-percha cones. Objective: This systematic review aimed to evaluate the main protocols and techniques for endodontic retreatment. Methods: The present study was followed by a systematic literature review model. Clinical studies were included as case reports, retrospective, prospective and randomized trials with qualitative and/or quantitative analysis. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The results showed that cleaning and the presence of debris at a speed of 1500 rpm provided greater agility with a smaller number of fractured instruments. Furthermore, the dynamic navigation system enabled the minimally invasive removal of the fiber post with a high degree of precision, without unnecessary removal of the root structure. One visit NSER had lower postoperative pain than multiple visits only for 1 and 30 days. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for cases of bioceramics. Finally, there is a predominance of E. faecalis and P. gingivalis in all phases of endodontic retreatment.

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

2017 ◽  
Vol 20 (1) ◽  
pp. 80 ◽  
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

<p><strong>Objective: </strong>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. <strong>Material and Methods:</strong> 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 &lt; 0.05). <strong>Results: </strong>Radiographic and SEM analysis showed that material from the<strong> </strong>MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. <strong>Conclusion: </strong>After re-instrumentation<strong>, </strong>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.</p><p><strong>Keywords </strong></p><p>Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.</p>

Guided Endodontics in Root Canals with Complex Access: Two Case Reports

2021 ◽  
Vol 32 (6) ◽  
pp. 115-123
Author(s):  
Wesley Fernandes Gonçalves ◽  
Lucas da Fonseca Roberti Garcia ◽  
Daniela Peressoni Vieira-Schuldt ◽  
Eduardo Antunes Bortoluzzi ◽  
Luiz Carlos de Lima Dias-Júnior ◽  
...  
Keyword(s):  
Root Canal ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Radiographic Examination ◽  
Free Access ◽  
Filling Material ◽  
Radiographic Images ◽  
Root Canals ◽  
First Case ◽  
The Right

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.

scholarly journals Analysis of the presence of filling material in oval root canals using computed microtomography after endodontic retreatment performed by different techniques

2017 ◽  
Vol 16 ◽  
pp. 1-8
Author(s):  
Maria Antonieta Veloso Carvalho Oliveira ◽  
Jady Karine Borelli ◽  
Kellen Cristina Mendes Azevedo ◽  
Luís Henrique Araújo Raposo ◽  
Lúcio Borges de Araújo ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Data Analysis ◽  
Root Canal ◽  
Filling Material ◽  
Central Incisor ◽  
Cross Sectional ◽  
Root Canals ◽  
Root Canal Anatomy ◽  
Computed Microtomography ◽  
Endodontic Retreatment

Aim: The aim of this study was to evaluate the presence of filling material in oval root canals after endodontic retreatment performed by different techniques, considering the area (mm2), location and root third using computed microtomography (µ-CT). Methods: Thirty human lower central incisor underwent biomechanical preparation, root filling and filling removal using two techniques (n=15): MN- manual retreatment technique (Gates Glidden burs and stainless steel manual files); and RT- rotary retreatment technique (ProTaper Universal and ProTaper Retreatment Systems). Cross-sectional images of the teeth were made using µ-CT to identify the presence of remaining filling in all root thirds of the canal walls. The remaining material detected in 150 µ-CT sections was identified and its area quantified (mm2) for each root third individually. Results: Data analysis showed no difference in the remaining area of filling material (p=0.8611) for the both techniques. Higher frequency of remaining material was verified in the lingual wall of the root canals. Regardless of the retreatment technique, the apical third showed lager areas of remaining filling material. More areas of remaining material were detected in the cervical third of the RT group, whereas for the MN group, most areas were observed in the middle and apical thirds. Conclusion: According to our results, no significant differences were verified between the efficiency of the rotary and manual techniques for removing filling material due to the interferences caused by the root canal anatomy.

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

RSBO ◽  
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. 

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

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

scholarly journals Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Jojo Kottoor ◽  
Denzil Albuquerque ◽  
Natanasabapathy Velmurugan ◽  
Jacob Kuruvilla
Keyword(s):  
Systematic Review ◽  
Anatomic Variation ◽  
Case Reports ◽  
Statistical Significance ◽  
Middle Eastern ◽  
Root Anatomy ◽  
Chi Square ◽  
Root Canals ◽  
Pubmed Database ◽  
Chi Square Test

Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24%) while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

scholarly journals The effect of retrograde material type and surgical techniques on the success rate of surgical endodontic retreatment: systematic review of prospective randomized clinical trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ashraf Abou ElReash ◽  
Hamdi Hamama ◽  
John C. Comisi ◽  
Ahmed Zaeneldin ◽  
Xie Xiaoli
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Success Rate ◽  
Randomized Clinical Trials ◽  
Surgical Techniques ◽  
Filling Material ◽  
Material Type ◽  
Filling Materials ◽  
Retrograde Filling ◽  
Endodontic Retreatment

Abstract Background Endodontic surgical procedures, when performed, require retrograde filling materials that are biocompatible, non-toxic, non-irritant, dimensionally stable, and ideally promote bone formation. Precise evaluation of retrograde filling materials in clinical trials is necessary to give holistic view for properties of material and potential outcome from its use. The purpose of this review is to evaluate the effect of retrograde material type and surgical techniques on the success rate of surgical endodontic retreatment. Methods An electronic search was performed in the time frame between 1st of January 2000 to 1st of September 2020 using database. Sources Web of Science, PubMed and redundant hand searches through their references. Seven inclusion–exclusion criteria were set for the selection and identification of relevant articles. Risk of bias was conducted for the included studies. Results Nine randomized clinical trials (RCTs) fulfilled the inclusion criteria for this systematic review. The outcome of this review revealed that none of the reviewed trials totally-fulfilled CONSORT 2010 criteria. Conclusions In light of the outcome of this review, there is no enough evidence to support the superiority of certain retrograde filling material or surgical technique over another in the success rate of surgical endodontics retreatment. The variety of methodologies and strategies, such as patient selection, the method of treatment and study analysis, led to doubtful credibility of the obtained clinical evidence. Further prospective randomized controlled clinical trials evaluating the specific effect of the various used materials are needed.

scholarly journals Efficacy of passive ultrasonic irrigation in removing root filling material during endodontic retreatment

2016 ◽  
Vol 45 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Carina MICHELON ◽  
Marina FRIGHETTO ◽  
Pauline Mastella LANG ◽  
Mariana De Carlo BELLO ◽  
Rafael PILLAR ◽  
...  
Keyword(s):  
Filling Material ◽  
Root Canal Filling ◽  
Passive Ultrasonic Irrigation ◽  
Root Canals ◽  
Filling Materials ◽  
Complex Anatomy ◽  
Ultrasonic Irrigation ◽  
Canal Shaping ◽  
Student’S T ◽  
Endodontic Retreatment

Abstract Introduction The aim of endodontic retreatment is to remove the previous root filling materials completely to allow for the subsequent steps of cleaning, canal shaping and filling replacement. Objective To evaluate the efficacy of passive ultrasonic irrigation (PUI) in the removal of residual root filling material after removing the bulk of the root filling with nickel-titanium rotary instruments. Material and method Eighteen mesial isthmus-containing roots of human mandibular molars were prepared and filled. The root canal filling was removed with the ProTaper Retreatment system and K-files. The specimens were randomized into 2 groups (n = 9), both irrigated with 2.5% NaOCl and 17% EDTA. In the conventional group, an irrigation syringe was used. In the PUI group, the PUI technique was used. The roots were sectioned longitudinally and evaluated under stereomicroscopy. Student’s t test was used to compare groups and the general linear model was used to compare the apical, cervical, and middle root thirds within each group, in regard to the percentages of remaining residual filling material. Result There was no statistically significant intergroup difference, irrespective of which root third was evaluated (P > 0.05). In the PUI group, the apical third showed a significantly higher percentage of residual filling material, in comparison with the cervical (P = 0.038) and middle (P = 0.029) thirds. Conclusion The PUI technique was not more effective than the conventional irrigation technique in removing residual root filling material during endodontic retreatment in root canals with a complex anatomy.

scholarly journals Monitoring nociception and awareness during palliative sedation: A systematic review

2021 ◽  
pp. 026921632110229
Author(s):  
Nathalie Dieudonné Rahm ◽  
Ghizlaine Morawska ◽  
Sophie Pautex ◽  
Nadia Elia
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Palliative Sedation ◽  
Patient Comfort ◽  
Cochrane Library ◽  
Poor Correlation ◽  
Level Of Consciousness ◽  
Core Elements ◽  
The Cochrane Library

Background: Providing unawareness and pain relief are core elements of palliative sedation. In addition to clinical scales, nociception and electroencephalogram-based depth of sedation monitoring are used to assess the level of consciousness and analgesia during sedation in intensive care units and during procedures. Aim: To determine whether reported devices impact the outcomes of palliative sedation. Design: Systematic review and narrative synthesis of research published between January 2000 and December 2020. Data sources: Embase, Google Scholar, PubMed, CENTRAL, and the Cochrane Library. All reports describing the use of any monitoring device to assess the level of consciousness or analgesia during palliative sedation were screened for inclusion. Data concerning safety and efficacy were extracted. Patient comfort was the primary outcome of interest. Articles reporting sedation but that did not meet guidelines of the European Association for Palliative Care were excluded. Results: Six reports of five studies were identified. Four of these were case series and two were case reports. Together, these six reports involved a total of 67 sedated adults. Methodological quality was assessed fair to good. Medication regimens were adjusted to bispectral index monitoring values in two studies, which found poor correlation between monitoring values and observational scores. In another study, high nociception index values, representing absence of pain, were used to detect opioid overdosing. Relatives and caregivers found the procedures feasible and acceptable.

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