Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques

Emmanuel João Nogueira Leal Silva; Felipe Gonçalves Belladonna; Marianna Fernandes Carapiá; Brenda Leite Muniz; Mariana Santoro Rocha; Edson Jorge Lima Moreira

doi:10.5395/rde.2018.43.e5

Journal List > Restor Dent Endod > v.43(1) > 1094272

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Silva, Belladonna, Carapiá, Muniz, Rocha, and Moreira: Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques

Research Article

Restor Dent Endod 2018;43(1):e5.

Published online: 4 February 2018

DOI: https://doi.org/10.5395/rde.2018.43.e5

Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques

Emmanuel João Nogueira Leal Silva^1,^*, Felipe Gonçalves Belladonna², Marianna Fernandes Carapiá¹, Brenda Leite Muniz¹, Mariana Santoro Rocha¹, Edson Jorge Lima Moreira¹

¹Department of Endodontics, School of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil

²Department of Endodontics, Fluminense Federal University, Niterói, RJ, Brazil

^*Correspondence to Emmanuel João Nogueira Leal Silva, DDS, MSc, PhD Associate Professor, Department of Endodontics, School of Dentistry, Grande Rio University, Rua Herotides de Oliveira, 61/902 Icaraí – Niterói, RJ 24230-230, Brazil. E-mail: nogueiraemmanuel@hotmail.com

Received 9 October 2017 Accepted 14 December 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated.

Materials and Methods

Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded.

Results

Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups.

Conclusions

Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

Keywords: Endodontics, Retreatment, X-ray microtomography

References

1. Imura N, Pinheiro ET, Gomes BP, Zaia AA, Ferraz CC, Souza-Filho FJ. The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod. 2007; 33:1278–1282.

2. Siqueira JF Jr, Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J. 2014; 216:305–312.

3. Taş demir 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.

4. Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J. 2008; 41:288–295.

5. Duncan HF, Chong BS. Removal of root filling materials. Endod Topics. 2008; 19:33–57.

6. Ricucci D, Siqueira JF Jr, Bate AL, Pitt Ford TR. Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients. J Endod. 2009; 35:493–502.

7. Ma J, Al-Ashaw AJ, Shen Y, Gao Y, Yang Y, Zhang C, Haapasalo M. Efficacy of ProTaper Universal Rotary Retreatment system for gutta-percha removal from oval root canals: a microcomputed tomography study. J Endod. 2012; 38:1516–1520.

8. Bernardes RA, Duarte MA, Vivan RR, Alcalde MP, Vasconcelos BC, Bramante CM. Comparison of three retreatment techniques with ultrasonic activation in flattened canals using microcomputed tomography and scanning electron microscopy. Int Endod J. 2016; 49:890–897.

9. Zuolo AS, Mello JE Jr, Cunha RS, Zuolo ML, Bueno CE. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J. 2013; 46:947–953.

10. Silva EJ, Sá L, Belladonna FG, Neves AA, Accorsi-Mendonça T, Vieira VT, De-Deus G, Moreira EJ. Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material. J Endod. 2014; 40:2077–2080.

11. De-Deus G, Moreira EJ, Lopes HP, Elias CN. Extended cyclic fatigue life of F2 ProTaper instruments used in reciprocating movement. Int Endod J. 2010; 43:1063–1068.

12. Steffen H, Löw A, Rosin M, Welk A. Comparison of K hand files and ProFiles 0.06/0.04 in simulated curved root canals prepared by students. Quintessence Int. 2006; 37:811–817.

13. Abu-Tahun I, Al-Rabab'ah MA, Hammad M, Khraisat A. Technical quality of root canal treatment of posterior teeth after rotary or hand preparation by fifth year undergraduate students, The University of Jordan. Aust Endod J. 2014; 40:123–130.

14. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971; 32:271–275.

15. Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006; 39:249–281.

16. Stabholz A, Friedman S. Endodontic retreatment–case selection and technique. Part 2: treatment planning for retreatment. J Endod. 1988; 14:607–614.

17. Saad AY, Al-Hadlaq SM, Al-Katheeri NH. Efficacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod. 2007; 33:38–41.

18. Solomonov M, Paqué F, Kaya S, Adigüzel O, Kfir A, Yiğ it-Özer S. Self-adjusting files in retreatment: a high-resolution microcomputed tomography study. J Endod. 2012; 38:1283–1287.

19. Gluskin AH, Brown DC, Buchanan LS. A reconstructed computerized tomographic comparison of Ni-Ti rotary GT files versus traditional instruments in canals shaped by novice operators. Int Endod J. 2001; 34:476–484.

20. Abu-Tahun I, Al-Rabab'ah MA, Hammad M, Khraisat A. Technical quality of root canal treatment of posterior teeth after rotary or hand preparation by fifth year undergraduate students, The University of Jordan. Aust Endod J. 2014; 40:123–130.

21. Marending M, Biel P, Attin T, Zehnder M. Comparison of two contemporary rotary systems in a pre-clinical student course setting. Int Endod J. 2016; 49:591–598.

22. Alves FR, Marceliano-Alves MF, Sousa JC, Silveira SB, Provenzano JC, Siqueira JF Jr. Removal of root canal fillings in curved canals using either reciprocating single- or rotary multi-instrument systems and a supplementary step with the XP-Endo Finisher. J Endod. 2016; 42:1114–1119.

23. 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.

24. 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.

25. Hülsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J. 2004; 37:468–476.

26. Barrieshi-Nusair KM. Gutta-percha retreatment: effectiveness of nickel-titanium rotary instruments versus stainless steel hand files. J Endod. 2002; 28:454–456.

27. Wilcox LR. Endodontic retreatment with halothane versus chloroform solvent. J Endod. 1995; 21:305–307.

28. Tagger M, Tamse A, Katz A, Korzen BH. Evaluation of the apical seal produced by a hybrid root canal filling method, combining lateral condensation and thermatic compaction. J Endod. 1984; 10:299–303.

Figure 1.

Reconstructed 3-dimensional micro-computed tomographic (micro-CT) images of a given specimen of each group showing the presence of remaining root canal fillings in (A) bucco-lingual and (B) mesio-distal views. (C) Cross-sections at the (c) cervical, (m) middle, and (a) apical thirds showing the presence of remaining root canal fillings.

Table 1.

Remaining filling material (%) and the time required to complete endodontic retreatments (minutes)

Group	Remaining filling material (%)	Time (min)
Manual K-file	13.86 ± 17.83 ^a	23.33 ± 15.70 ^a
Mtwo retreatment file	16.21 ± 17.08 ^a	10.11 ± 6.15 ^b
Reciproc file	3.62 ± 5.52 ^b	10.11 ± 5.51 ^b

The values are shown as mean ± standard deviation. Different superscript letters demonstrate significant differences in the column (p < 0.05).

TOOLS

Similar articles