Comparative evaluation of the effectiveness of different rotary systems in removal of root canal filling materials
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Aim: The aim of this study was to compare the remaining root canal filling materials after instrumentation using ProTaper Universal Retreatment (PTUR) system alone or combined with Neoniti, One Curve, and using hand Hedstrom files and Gates Glidden drills using cone beam computed tomography (CBCT) images.
Methodology: Fifty-two mandibular premolars with single and straight canals were used. The canals were instrumented with ProTaper rotary instruments up to F3 and filled with gutta-percha and AH26 sealer. All the samples were placed into silicone models. Samples were scanned with CBCT and assigned into four groups (n = 13): the PTUR system group, the PTUR system plus Neoniti group, the PTUR system plus One Curve group, and the hand Hedstrom files plus Gates Glidden group. The specimens were scanned once again after retreatment procedures, and the volume of the remaining filling materials was determined. Data were analyzed using Kruskal-Wallis and Dunn tests (α=0.05).
Results: None of the retreatment procedures provided complete removal of the filling materials. Hedstrom files plus Gates Glidden removed more residual obturation materials than the other groups. The additional use of the Neoniti or One Curve systems significantly improved the removal of filling materials when compared with the PTUR system alone (P<0.05). The differences between the PTUR plus Neoniti group and the PTUR plus One Curve group were not statistically significant (P>0.05).
Conclusions: Using Gates Glidden and Hedstrom files was the most effective way for retrieval of endodontic material from the root canals, while PTUR alone was the least effective method. Re-instrumenting with rotary files significantly improved the removal of root filling materials.
Araghi S, Mirzaee SS, Soltani P, Miri S, Miri M. The effect of calcium hydroxide on the apical microleakage of canals filled with bioceramic and resin sealers. G Ital Endod. 2020;34.
Nair P. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006;39:249-81.
Schirrmeister JF, Wrbas K-T, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod. 2006;32:469-72.
Pontoriero DIK, Grandini S, Spagnuolo G, Discepoli N, Benedicenti S, Maccagnola V, et al. Clinical Outcomes of Endodontic Treatments and Restorations with and without Posts Up to 18 Years. J Clin Med. 2021;10:908.
Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study. Phases I and II: Orthograde retreatment. J Endod. 2004;30:627-33.
Fenoul G, Meless G, Pérez F. The efficacy of R‐Endo® rotary NiTi and stainless‐steel hand instruments to remove gutta‐percha and Resilon. Int Endod J. 2010;43:135-41.
Colaco AS, Pai VA. Comparative evaluation of the efficiency of manual and rotary gutta-percha removal techniques. J Endod. 2015;41:1871-4.
de Oliveira DP, Barbizam JVB, Trope M, Teixeira FB. Comparison between gutta-percha and resilon removal using two different techniques in endodontic retreatment. J Endod. 2006;32:362-4.
Rödig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of reciprocating and rotary N i T i instruments for retreatment of curved root canals assessed by micro‐CT. Int Endod J. 2014;47:942-8.
Rödig T, Hausdörfer T, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of D‐RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta‐percha from curved root canals–a micro‐computed tomography study. Int Endod J. 2012;45:580-9.
Zuolo A, Mello Jr J, Cunha R, Zuolo M, Bueno C. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J. 2013;46:947-53.
Bago I, Suk M, Katić M, Gabrić D, Anić I. Comparison of the effectiveness of various rotary and reciprocating systems with different surface treatments to remove gutta‐percha and an epoxy resin‐based sealer from straight root canals. Int Endod J. 2019;52:105-13.
Çanakçi BC, Ustun Y, Er O, Sen OG. Evaluation of apically extruded debris from curved root canal filling removal using 5 nickel-titanium systems. J Endod. 2016;42:1101-4.
Khedmat S, Azari A, Shamshiri AR, Fadae M, Fakhar HB. Efficacy of ProTaper and Mtwo retreatment files in removal of gutta-percha and GuttaFlow from root canals. Iran Endod J. 2016;11:184.
Khoshbin E, Donyavi Z, Atibeh EA, Roshanaei G, Amani F. The effect of canal preparation with four different rotary systems on formation of dentinal cracks: an in vitro evaluation. Iran Endod J. 2018;13:163.
Fatima K, Nair R, Khasnis S, Vallabhaneni S, Patil JD. Efficacy of rotary and reciprocating single-file systems on different access outlines for gutta-percha removal in retreatment: An in vitro study. J Conserv Dent. 2018;21:354.
Zinge PR, Patil J. Comparative evaluation of effect of rotary and reciprocating single-file systems on pericervical dentin: A cone-beam computed tomography study. J Conserv Dent. 2017;20:424.
Ertuğrul İF. Effect of sodium hypochlorite on the cyclic fatigue resistance: a scanning electron microscopy evaluation. Microsc Res Tech. 2019;82:2089-94.
Staffoli S, Grande NM, Plotino G, Özyürek T, Gündoğar M, Fortunato L, et al. Influence of environmental temperature, heat-treatment and design on the cyclic fatigue resistance of three generations of a single-file nickel–titanium rotary instrument. Odontology. 2019;107:301-7.
Eid BM, Maksoud HBA, Elsewify TM. Efficacy of XP-endo Finisher-R in enhancing removal of bioceramic sealer from oval root canal: a micro CT study. G Ital Endod. 2021;35.
Özyürek T, Demiryürek EÖ. Efficacy of different nickel-titanium instruments in removing gutta-percha during root canal retreatment. J Endod. 2016;42:646-9.
de Azevêdo Rios M, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, et al. Efficacy of 2 reciprocating systems compared with a rotary retreatment system for gutta-percha removal. J Endod. 2014;40:543-6.
Moazzami F, Khojastepour L, Nabavizadeh M, Habashi MS. Cone-beam computed tomography assessment of root canal transportation by neoniti and reciproc single-file systems. Iran Endod J. 2016;11:96.
Yürüker S, Görduysus M, Küçükkaya S, Uzunoğlu E, Ilgın C, Gülen O, et al. Efficacy of combined use of different nickel-titanium files on removing root canal filling materials. J Endod. 2016;42:487-92.
Silva EJNL, Orlowsky NB, Herrera DR, Machado R, Krebs RL, Coutinho-Filho TdS. Effectiveness of rotatory and reciprocating movements in root canal filling material removal. Braz Oral Res. 2015;29:01-6.
Gomes NN, De Carvalho GM, Sponchiado Júnior EC, Garcia LDFR, Marques AAF, De Carvalho FMA. Filling Material Removal with Reciprocating and Rotary Systems Associated with Passive Ultrasonic Irrigation. Eur Endod J. 2017;2:6-.
Limoeiro AG, Braitt AH, Machado AS, Bueno CE, Fontana CE, Freire LG, et al. Micro-computed tomography evaluation of filling material removal by three reciprocating systems with different thermal treatments. G Ital Endod. 2021.
Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment. J Endod. 2008;34:1381-4.
de Campos Fruchi L, Ordinola-Zapata R, Cavenago BC, Duarte MAH, da Silveira Bueno CE, De Martin AS. Efficacy of reciprocating instruments for removing filling material in curved canals obturated with a single-cone technique: a micro–computed tomographic analysis. J Endod. 2014;40:1000-4.
Nevares G, Diana S, Freire LG, Romeiro K, Fogel HM, Dos Santos M, et al. Efficacy of ProTaper NEXT compared with Reciproc in removing obturation material from severely curved root canals: a micro–computed tomography study. J Endod. 2016;42:803-8.
Mollo A, Botti G, Prinicipi Goldoni N, Randellini E, Paragliola R, Chazine M, et al. Efficacy of two Ni‐Ti systems and hand files for removing gutta‐percha from root canals. Int Endod J. 2012;45:1-6.
Hammad M, Qualtrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentation for retreatment of canals filled with different materials. J Endod. 2008;34:1370-3.
Bueno CEdS, Delboni MG, Araújo RAd, Carrara HJ, Cunha RS. Effectiveness of rotary and hand files in gutta-percha and sealer removal using chloroform or chlorhexidine gel. Braz Dent J. 2006;17:139-43.
Aksel H, Küçükkaya Eren S, Askerbeyli Örs S, Serper A, Ocak M, Çelik H. Micro‐CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP‐Endo Finisher file. Int Endod J. 2019;52:1070-6.
Ealla KR, Raj PT, Mudrakola DP, Baby D, Govindankutty RK, Davis D, et al. Evaluation of effectiveness of two different endodontic retreatment systems in removal of gutta-percha: an in vitro study. J Contemp Dent Pract. 2018;19:726-31.
Copyright (c) 2022 Neda Shekarchizade, Masoume Shahpouri, Mohammadreza Avalin Charsooghi, Gianrico Spagnuolo, Parisa Soltani
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Giornale Italiano di Endodonzia has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.