Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment

  • Received : 2020.03.09
  • Accepted : 2020.05.15
  • Published : 2021.02.28
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Abstract

Objectives: The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated. Materials and Methods: Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level. Results: Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05). Conclusions: All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.

Keywords

Acknowledgement

The authors thank Professor Dr. Pelin Guneri and Associate Professor Timur Kose for their valuable suggestions.

References

  1. Machtou P, Reit C. Non-surgical retreatment. In: Bergenholtz G, Horsted-Bindslev P, Reit C. Textbook of endodontology. 1st ed. Oxford: Blackwell Munksgaard; 2003. p300-310. 
  2. Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjo B, Engstrom B. Retreatment of endodontic fillings. Scand J Dent Res 1979;87:217-224. 
  3. Caliskan MK. Nonsurgical retreatment of teeth with periapical lesions previously managed by either endodontic or surgical intervention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:242-248.  https://doi.org/10.1016/j.tripleo.2004.09.014
  4. Hulsmann M, Drebenstedt S, Holscher C. Shaping and filling root canals during root canal re-treatment. Endod Topics 2008;19:74-124.  https://doi.org/10.1111/j.1601-1546.2011.00264.x
  5. Betti LV, Bramante CM. Quantec SC rotary instruments versus hand files for gutta-percha removal in root canal retreatment. Int Endod J 2001;34:514-519.  https://doi.org/10.1046/j.1365-2591.2001.00424.x
  6. Bernardes RA, Duarte MA, Vivan RR, Alcalde MP, Vasconcelos BC, Bramante CM. Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. Int Endod J 2016;49:890-897.  https://doi.org/10.1111/iej.12522
  7. Hulsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J 2004;37:468-476.  https://doi.org/10.1111/j.1365-2591.2004.00823.x
  8. Siqueira JF Jr, Rocas IN, Ricucci D, Hulsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J 2014;216:305-312.  https://doi.org/10.1038/sj.bdj.2014.200
  9. Huang X, Ling J, Wei X, Gu L. Quantitative evaluation of debris extruded apically by using ProTaper Universal Tulsa rotary system in endodontic retreatment. J Endod 2007;33:1102-1105.  https://doi.org/10.1016/j.joen.2007.05.019
  10. Topcuoglu HS, Akti A, Tuncay O, Dincer AN, Duzgun S, Topcuoglu G. Evaluation of debris extruded apically during the removal of root canal filling material using ProTaper, D-RaCe, and R-Endo rotary nickel-titanium retreatment instruments and hand files. J Endod 2014;40:2066-2069.  https://doi.org/10.1016/j.joen.2014.09.004
  11. Sae-Lim V, Rajamanickam I, Lim BK, Lee HL. Effectiveness of ProFile. 04 taper rotary instruments in endodontic retreatment. J Endod 2000;26:100-104.  https://doi.org/10.1097/00004770-200002000-00010
  12. Kasikci Bilgi I, Koseler I, Guneri P, Hulsmann M, Caliskan MK. Efficiency and apical extrusion of debris: a comparative ex vivo study of four retreatment techniques in severely curved root canals. Int Endod J 2017;50:910-918.  https://doi.org/10.1111/iej.12708
  13. Schirrmeister JF, Wrbas KT, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod 2006;32:469-472.  https://doi.org/10.1016/j.joen.2005.10.052
  14. Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod 1997;23:77-85.  https://doi.org/10.1016/S0099-2399(97)80250-6
  15. Myers GL, Montgomery S. A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques. J Endod 1991;17:275-279.  https://doi.org/10.1016/S0099-2399(06)81866-2
  16. Ruiz-Hubard EE, Gutmann JL, Wagner MJ. A quantitative assessment of canal debris forced periapically during root canal instrumentation using two different techniques. J Endod 1987;13:554-558.  https://doi.org/10.1016/S0099-2399(87)80004-3
  17. Fukushima H, Yamamoto K, Hirohata K, Sagawa H, Leung KP, Walker CB. Localization and identification of root canal bacteria in clinically asymptomatic periapical pathosis. J Endod 1990;16:534-538.  https://doi.org/10.1016/S0099-2399(07)80216-0
  18. Burklein S, Schafer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 2012;38:850-852.  https://doi.org/10.1016/j.joen.2012.02.017
  19. Canakci BC, Ustun Y, Er O, Genc Sen O. Evaluation of apically extruded debris from curved root canal filling removal using 5 nickel-titanium systems. J Endod 2016;42:1101-1104.  https://doi.org/10.1016/j.joen.2016.03.012
  20. Delai D, Boijink D, Hoppe CB, Grecca AS, Kopper PM. Apically extruded debris in filling removal of curved canals using 3 NiTi systems and hand files. Braz Dent J 2018;29:54-59.  https://doi.org/10.1590/0103-6440201801760
  21. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3. Retreatment techniques. J Endod 1990;16:543-549.  https://doi.org/10.1016/S0099-2399(07)80219-6
  22. Hinrichs RE, Walker WA 3rd, Schindler WG. A comparison of amounts of apically extruded debris using handpiece-driven nickel-titanium instrument systems. J Endod 1998;24:102-106.  https://doi.org/10.1016/S0099-2399(98)80086-1
  23. Leonardi LE, Atlas DM, Raiden G. Apical extrusion of debris by manual and mechanical instrumentation. Braz Dent J 2007;18:16-19.  https://doi.org/10.1590/S0103-64402007000100004
  24. Karataslioglu E, Arslan H, Er G, Avci E. Influence of canal curvature on the amount of apically extruded debris determined by using three-dimensional determination method. Aust Endod J 2019;45:216-224.  https://doi.org/10.1111/aej.12311
  25. Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod 2015;41:237-241.  https://doi.org/10.1016/j.joen.2014.09.023
  26. Arslan H, Doganay E, Alsancak M, Capar ID, Karatas E, Gunduz HA. Comparison of apically extruded debris after root canal instrumentation using Reciproc® instruments with various kinematics. Int Endod J 2016;49:307-310.  https://doi.org/10.1111/iej.12449
  27. Toyoglu M, Altunbas D. Influence of different kinematics on apical extrusion of irrigant and debris during canal preparation using K3XF instruments. J Endod 2017;43:1565-1568.  https://doi.org/10.1016/j.joen.2017.05.001
  28. ustun Y, Canakci BC, Dincer AN, Er O, Duzgun S. Evaluation of apically extruded debris associated with several Ni-Ti systems. Int Endod J 2015;48:701-704.  https://doi.org/10.1111/iej.12369
  29. Silva EJ, Carapia MF, Lopes RM, Belladonna FG, Senna PM, Souza EM, De-Deus G. Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems. Int Endod J 2016;49:700-705.  https://doi.org/10.1111/iej.12503
  30. Burklein S, Benten S, Schafer E. Quantitative evaluation of apically extruded debris with different singlefile systems: Reciproc, F360 and One Shape versus Mtwo. Int Endod J 2014;47:405-409.  https://doi.org/10.1111/iej.12161
  31. Hassanloo A, Watson P, Finer Y, Friedman S. Retreatment efficacy of the Epiphany soft resin obturation system. Int Endod J 2007;40:633-643.  https://doi.org/10.1111/j.1365-2591.2007.01261.x
  32. Azim AA, Wang HH, Tarrosh M, Azim KA, Piasecki L. Comparison between single-file rotary systems: part 1-efficiency, effectiveness, and adverse effects in endodontic retreatment. J Endod 2018;44:1720-1724.  https://doi.org/10.1016/j.joen.2018.07.022
  33. Tasdemir T, Er K, Yildirim T, Celik D. Efficacy of three rotary NiTi instruments in removing gutta-percha from root canals. Int Endod J 2008;41:191-196.  https://doi.org/10.1111/j.1365-2591.2007.01335.x
  34. Abramovitz I, Relles-Bonar S, Baransi B, Kfir A. The effectiveness of a self-adjusting file to remove residual gutta-percha after retreatment with rotary files. Int Endod J 2012;45:386-392.  https://doi.org/10.1111/j.1365-2591.2011.01988.x
  35. Akbulut MB, Akman M, Terlemez A, Magat G, Sener S, Shetty H. Efficacy of Twisted File Adaptive, Reciproc and ProTaper Universal Retreatment instruments for root-canal-filling removal: a cone-beam computed tomography study. Dent Mater J 2016;35:126-131.  https://doi.org/10.4012/dmj.2015-214
  36. Rodig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hulsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J 2014;47:942-948.  https://doi.org/10.1111/iej.12239
  37. Keles A, Alcin H, Kamalak A, Versiani MA. Oval-shaped canal retreatment with self-adjusting file: a micro-computed tomography study. Clin Oral Investig 2014;18:1147-1153.  https://doi.org/10.1007/s00784-013-1086-0
  38. Monguilhott Crozeta B, Damiao de Sousa-Neto M, Bianchi Leoni G, Francisco Mazzi-Chaves J, Terezinha Correa Silva-Sousa Y, Baratto-Filho F. A micro-computed tomography assessment of the efficacy of rotary and reciprocating techniques for filling material removal in root canal retreatment. Clin Oral Investig 2016;20:2235-2240.  https://doi.org/10.1007/s00784-016-1728-0
  39. Hulsmann M. Research that matters - canal preparation, retreatment and working length studies. Int Endod J 2013;46:293-295. 
  40. Gergi R, Sabbagh C. Effectiveness of two nickel-titanium rotary instruments and a hand file for removing gutta-percha in severely curved root canals during retreatment: an ex vivo study. Int Endod J 2007;40:532-537.  https://doi.org/10.1111/j.1365-2591.2007.01254.x
  41. Takahashi CM, Cunha RS, de Martin AS, Fontana CE, Silveira CF, da Silveira Bueno CE. In vitro evaluation of the effectiveness of ProTaper universal rotary retreatment system for gutta-percha removal with or without a solvent. J Endod 2009;35:1580-1583.  https://doi.org/10.1016/j.joen.2009.07.015
  42. Gogulnath D, Rajan RM, Arathy G, Kandaswamy D. A comparative evaluation of the canal centering ability of three rotary nickel-titanium retreatment systems in the mesio-buccal canals of mandibular first molars using computed tomography. J Conserv Dent 2015;18:310-314.  https://doi.org/10.4103/0972-0707.159735
  43. Topcuoglu HS, Zan R, Akpek F, Topcuoglu G, Ulusan O, Akti A, Duzgun S, Agirnasligil M. Apically extruded debris during root canal preparation using Vortex Blue, K3XF, ProTaper Next and Reciproc instruments. Int Endod J 2016;49:1183-1187.  https://doi.org/10.1111/iej.12572
  44. Dincer AN, Er O, Canakci BC. Evaluation of apically extruded debris during root canal retreatment with several NiTi systems. Int Endod J 2015;48:1194-1198.  https://doi.org/10.1111/iej.12425