Citation Information :
Patil A, Aggarwal S, Pol T, Bhor S, Shenoy V, Sumanthini M. Retreatment Efficacy of Hand vs Rotary Instrumentation in Oval-shaped Root Canals: An In Vitro Study. World J Dent 2022; 13 (5):454-459.
Aim: To evaluate and compare the efficacy of the ProTaper Universal Retreatment system (PTUS) and R-Endo rotary instruments with Hedström files (H-files) for the removal of gutta-percha (GP) in Retreatment of oval-shaped root canals.
Methods: Sixty mandibular premolars with one single straight canal were selected. These were instrumented with K-type files and filled using cold lateral compaction and sealer. Further, they were randomly divided into three groups of 20 each. Specimens were retreated with GP solvent and were split longitudinally. Root canal walls were examined using a stereomicroscope attached to Image Analyzer Software (MVIG 2005, Chroma Systems, India) to evaluate the cleanliness of root canal walls. Moreover, separated instruments during Retreatment and time required to remove obturating material were noted.
Results: Residue percentage was lesser (Tukey's test, p < 0.01) when the PTUS was used than when the R-Endo and H-files were used. Most of the residue in all specimens was in the apical one-third [analysis of variance (ANOVA), p < 0.01]. However, the time for removal of the root canal filling was lower with rotary files as compared with H-files. There was one fractured instrument in the PTUS group.
Conclusion: In this in vitro study, leftover residual filling material was found inside the root canal system, mainly in the apical third. The PTUS proved to be an efficient method of removing GP and sealer from mandibular premolars. More studies should be carried out using another endodontic Retreatment system to evaluate the efficacy in oval-shaped canals.
Clinical significance: For the success of endodontic Retreatment complete removal of previous endodontic material is required for the elimination of endodontic microflora from the root canal system. Many techniques and instruments have been advocated in endodontic Retreatment to remove obturating materials. However, residues of filling materials and iatrogenic errors have been observed. Removal of GP is always challenging in oval-shaped root canals. The findings of this study will enable clinicians to select the endodontic file system to provide optimal patient care.
Siqueira JF. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001;34(1):1–10. DOI: 10.1046/j.1365-2591.2001.00396.x
Nguyen TA, Kim Y, Kim E, et al. Comparison of the efficacy of different techniques for the removal of root canal filling material in artificial teeth: a micro-computed tomography study. J Clin Med 2019;8(7):984. DOI: 10.3390/jcm8070984
Kvist T, Reit C. The perceived benefit of endodontic retreatment. Int Endod J 2002;35(4):359–365. DOI: 10.1046/j.1365-2591.2002.00486.x
Torabinejad M, Corr R, Handysides R, et al. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod 2009;35(7):930–937. DOI: 10.1016/j.joen.2009.04.023
Sundqvist G, Figdor D, Persson S, et al. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative Retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85(1):86–93. DOI: 10.1016/s1079-2104(98)90404-8
Nasiri K, Wrbas KT. The efficacy of retreatment rotary and reciprocating files in the removal of filling material from root canals: a systematic review. Dent Oral Maxillofac Res 2020;6(1):1–5. DOI: 10.15761/domr.1000329
Prasad A, Nair R, Angelo J, et al. A comparative evaluation of retrievability of Guttapercha, Resilon and CPoints for retreatment, using two different rotary retrieval systems—an ex vivo study. Saudi Endod J 2018;8(2):87–92. DOI: 10.4103/sej.sej_29_17
Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper Universal retreatment files in removing filling materials during root canal retreatment. J Endod 2008;34(11):1381–1384. DOI: 10.1016/j.joen.2008.08.002
Purba R, Sonarkar S, Podar R, et al. Comparative evaluation of retreatment techniques by using different file systems from oval-shaped canals. J Conserv Dent 2020;23(1):91–96. DOI: 10.4103/JCD.JCD_167_20
Jou YT, Karabucak B, Levin J, et al. Endodontic working width: current concepts and techniques. Dent Clin North Am 2004;48(1):323–335. DOI: 10.1016/j.cden.2003.12.006
Mollo A, Botti G, Prinicipi Goldoni N, et al. Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals. Int Endod J 2012;45(1):1–6. DOI: 10.1111/j.1365-2591.2011.01932.x
Wu MK, R'oris A, Barkis D, et al. Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89(6):739–743. DOI: 10.1067/moe.2000.106344
Zmener O, Pameijer CH, Banegas G. Retreatment efficacy of hand versus automated instrumentation in oval-shaped root canals: an ex vivo study. Int Endod J 2006;39(7):521–526. DOI: 10.1111/j.1365-2591.2006.01100.x
Brooks JK, Kleinman JW. Retrieval of extensive gutta-percha extruded into the maxillary sinus: use of 3-dimensional cone-beam computed tomography. J Endod 2013;39(9):1189–1193. DOI: 10.1016/j.joen.2013.04.006
Pirani C, Pelliccioni GA, Marchionni S, et al. Effectiveness of three different retreatment techniques in canals filled with compacted gutta-percha or Thermafil: a scanning electron microscope study. J Endod 2009;35(10):1433–1440. DOI: 10.1016/j.joen.2009.06.002
Colaco AS, Pai VAR. Comparative evaluation of the efficiency of manual and rotary gutta-percha removal techniques. J Endod 2015;41(11):1871–1874. DOI: 10.1016/j.joen.2015.07.012
Schirrmeister JF, Wrbas KT, Meyer KM, et al. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod 2006;32(5):469–472. DOI: 10.1016/j.joen.2005.10.052
De Azevêdo Rios M, Villela AM, Cunha RS, et al. Efficacy of 2 reciprocating systems compared with a rotary retreatment system for gutta-percha removal. J Endod 2014;40(4):543–546. DOI: 10.1016/j.joen.2013.11.013
Kfir A, Tsesis I, Yakirevich E, et al. The efficacy of five techniques for removing root filling material: microscopic versus radiographic evaluation. Int Endod J 2012;45(1):35–41. DOI: 10.1111/j.1365-2591.2011.01944.x
Bernardes RA, de Amorim Campelo A, Junior DSS, et al. Evaluation of the flow rate of 3 endodontic sealers: Sealer 26, AH Plus, and MTA Obtura. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(1):e47–e49. DOI: 10.1016/j.tripleo.2009.08.038
World Health Organization, International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 82, Some Traditional Herbal Medicines, Some Mycotoxins, Naphthalene and Styrene. Lyon, France: IARC Press; 2002.
Wilcox LR. Endodontic retreatment with halothane versus chloroform solvent. J Endod 1995;21(6):305–307. DOI: 10.1016/S0099-2399(06)81006-X
Martos J, Gastal MT, Sommer L, et al. Dissolving efficacy of organic solvents on root canal sealers. Clin Oral Investig 2006;10(1):50–54. DOI: 10.1007/s00784-005-0023-2
Hülsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J 2004;37(7):468–476. DOI: 10.1111/j.1365-2591.2004.00823.x
Gu LS, Ling JQ, Wei X, et al. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J 2008;41(4):288–295. DOI: 10.1111/j.1365-2591.2007.01350.x
Chakravarthy Y, Divya V. Efficacy of a new retreatment system (R ENDO) in root canals obturated with gutta-percha using two different eugenol free sealers—an in vitro comparitive study. MedPulse Int Med J 2016;3(11):933–938.
Takahashi CM, Cunha RS, De Martin AS, et al. In vitro evaluation of the effectiveness of ProTaper Universal rotary retreatment system for gutta-percha removal with or without a solvent. J Endod 2009;35(11):1580–1583. DOI: 10.1016/j.joen.2009.07.015
Reddy N, Reddy Admala S, Dinapadu S, et al. Comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal in root canal retreatment: an in vitro study. J Contemp Dent Pract 14(4):635–643. DOI: 10.5005/jp-journals-10024-1377
Haïkel Y, Serfaty R, Bateman G, et al. Dynamic and cyclic fatigue of engine-driven rotary nickel-titanium endodontic instruments. J Endod 1999;25(6):434–440. DOI: 10.1016/S0099-2399(99)80274-X
Wolcott S, Wolcott J, Ishley D, et al. Separation Incidence of Protaper rotary instruments: a large cohort clinical evaluation. J Endod 2006;32(12):1139–1141. DOI: 10.1016/j.joen.2006.05.015