Effectiveness of Two Endodontic Instruments in Calcium Silicate-Based Sealer Retreatment

The objective of the present in vitro work was to investigate the effectiveness and time required for the removal of calcium silicate-based sealer using two rotary retreatment systems. Sixty extracted, single-canal, lower premolars were used. After obturation using the single-cone technique with calcium silicate-based sealer, samples were divided into four groups according to the technique of desobturation: Group 1 (G1): D-Race; Group 2 (G2): D-Race followed by the use of XP–Endo Finisher R; Group 3 (G3): Protaper Universal Retreatment; and Group 4 (G4): Protaper Universal Retreatment followed by the use of XP–Endo Finisher R. Cone beam computed tomography (CBCT) images were used to calculate the remaining filling materials at the middle and apical thirds. Times required to perform each method were recorded. Scanning electron microscopy (SEM) and digital microscopy were used to evaluate the remaining filling materials. Data were statistically analyzed using the t-test and one way ANOVA on ranks tests. No statistically significant difference was found between G1 and G3 after CBCT observations (p > 0.05). Xp-Endo Finisher R significantly increased the ability to remove materials regardless of the initially used retreatment system (p < 0.05). Statistically significant longer time was found in G3 and G4 compared to G1 and G2, respectively (p < 0.05), to reach the full working length. No retreatment system was able to totally remove the calcium silicate-based sealer from the root canal at the middle and apical thirds (p > 0.05). Digital microscopy demonstrated that the residual materials were the remaining sealers on the canal walls. SEM showed the mineral depositions of calcium silicate materials onto the canal walls and into the dentinal tubules. However, that calcium silicate materials provide mineral deposition into the dentinal tubules might indicate that the traditional irrigants could not be sufficient to remove calcium silicate-based materials from the root canal, and other agents should be used to make retreatment considerably easier.

[1]  R. Mhanna,et al.  The Effectiveness of Different Irrigation Techniques on Debris and Smear Layer Removal in Primary Mandibular Second Molars: An In Vitro Study , 2023, The Journal of Contemporary Dental Practice.

[2]  Recent Advances in Biomaterials and Dental Disease , 2023 .

[3]  A. Mandorah,et al.  Retreatment of XP-endo Shaper and R-Endo files in curved root canals , 2023, BMC Oral Health.

[4]  Y. Haikel,et al.  Special Issue “Recent Advances in Biomaterials and Dental Disease” Part I , 2023, Bioengineering.

[5]  C. Affolter-Zbaraszczuk,et al.  Physicochemical and Mechanical Properties of Premixed Calcium Silicate and Resin Sealers , 2022, Journal of functional biomaterials.

[6]  Y. Haikel,et al.  Physicochemical and Antibacterial Properties of Bioactive Retrograde Filling Materials , 2022, Bioengineering.

[7]  Y. Haikel,et al.  Physicochemical and Antibacterial Properties of Conventional and Two Premixed Root Canal Filling Materials in Primary Teeth , 2022, Journal of functional biomaterials.

[8]  Y. Haikel,et al.  Effectiveness of the REvision System and Sonic Irrigation in the Removal of Root Canal Filling Material from Oval Canals: An In Vitro Study , 2022, Bioengineering.

[9]  Reham Hassan,et al.  Cleaning Efficiency of XP Finisher, XP Finisher R and Passive Ultrasonic Irrigation Following Retreatment of Teeth Obturated with TotalFill HiFlow Bioceramic Sealer , 2022, European endodontic journal.

[10]  V. Fontanella,et al.  XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals. , 2022, Brazilian oral research.

[11]  Aswathi Varghese,et al.  Retrievability of bioceramic-based sealers in comparison with epoxy resin-based sealer assessed using microcomputed tomography: A systematic review of laboratory-based studies , 2021, Journal of conservative dentistry : JCD.

[12]  S. Karahan,et al.  Contribution of XP-Endo files to the root canal filling removal: A systematic review and meta-analysis of in vitro studies. , 2021, Australian endodontic journal : the journal of the Australian Society of Endodontology Inc.

[13]  V. Ball,et al.  Tannic acid speeds up the setting of mineral trioxide aggregate cements and improves its surface and bulk properties. , 2021, Journal of colloid and interface science.

[14]  N. Mittal,et al.  Comparative evaluation of retreatability of bioceramic sealer (BioRoot RCS) and epoxy resin (AH Plus) sealer with two different retreatment files: An in vitro study , 2021, Journal of conservative dentistry : JCD.

[15]  Y. Haïkel,et al.  Microscopic and chemical evaluation of the filling quality of five obturation techniques in oval-shaped root canals , 2020, Clinical Oral Investigations.

[16]  Y. Haikel,et al.  In Vitro Evaluation of Different Irrigation Protocols on Intracanal Smear Layer Removal in Teeth with or without Pre-Endodontic Proximal Wall Restoration , 2020, Journal of clinical medicine.

[17]  Y. Arntz,et al.  Physicochemical and Antibacterial Properties of Novel, Premixed Calcium Silicate-Based Sealer Compared to Powder–Liquid Bioceramic Sealer , 2020, Journal of clinical medicine.

[18]  R. Lopes,et al.  Micro-computed tomographic assessment of supplementary cleaning techniques for removing bioceramic sealer and gutta-percha in oval canals. , 2020, Journal of endodontics.

[19]  K. Wrbas,et al.  Comparison of the efficacy of different Ni-Ti instruments in the removal of gutta-percha and sealer in root canal retreatment , 2020, Indian journal of dental research : official publication of Indian Society for Dental Research.

[20]  V. Stefanova,et al.  Retreatability of Bioceramic Endodontic Sealers: a Review. , 2020, Folia medica.

[21]  M. Sousa-Neto,et al.  Retreatability of BC Sealer and AH Plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment , 2020, Clinical Oral Investigations.

[22]  J. Camilleri,et al.  Retreatment efficacy of hydraulic calcium silicate sealers used in single cone obturation. , 2020, Journal of dentistry.

[23]  Deepu Patil,et al.  In vitro comparative evaluation of efficiency of XP-endo shaper, XP-endo finisher, and XP-endo finisher-R files in terms of residual root filling material, preservation of root dentin, and time during retreatment procedures in oval canals – A cone-beam computed tomography analysis , 2020, Journal of conservative dentistry : JCD.

[24]  A. Tripathi,et al.  Biomechanical preparation in primary molars using manual and three NiTi instruments: a cone-beam-computed tomographic in vitro study , 2020, European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry.

[25]  C. Llena,et al.  Cytocompatibility, bioactivity potential, and ion release of three premixed calcium silicate-based sealers , 2019, Clinical Oral Investigations.

[26]  Euiseong Kim,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 , 2019, Journal of clinical medicine.

[27]  D. M. Cavalcante,et al.  XP‐endo Finisher R instrument optimizes the removal of root filling remnants in oval‐shaped canals , 2019, International endodontic journal.

[28]  L. Tapak,et al.  Comparative Evaluation of Retreatability of Endodontically Treated Teeth using AH 26, Fluoride Varnish and Mineral Trioxide Aggregate-based Endodontic Sealers , 2019, The Open Dentistry Journal.

[29]  K. Kozyrakis,et al.  Removal ability of MTA-, bioceramic-, and resin-based sealers from obturated root canals, following XP-endo® Finisher R file: An ex vivo study , 2019 .

[30]  Amit Patil,et al.  Efficacy of Rotary and Hand Instrument in removing Gutta-percha and Sealer from Root Canals of Endodontically Treated Teeth. , 2018, The journal of contemporary dental practice.

[31]  Jayaprakash D. Patil,et al.  Efficacy of rotary and reciprocating single-file systems on different access outlines for gutta-percha removal in retreatment: An in vitro study , 2018, Journal of conservative dentistry : JCD.

[32]  G. De-Deus,et al.  Effectiveness of XP-endo Finisher and XP-endo Finisher R in removing root filling remnants: a micro-CT study. , 2018, International endodontic journal.

[33]  T. Dammaschke,et al.  Retreatability of three calcium silicate-containing sealers and one epoxy resin-based root canal sealer with four different root canal instruments , 2018, Clinical Oral Investigations.

[34]  A. S. Kato,et al.  Effectiveness of the ProTaper Next and Reciproc Systems in Removing Root Canal Filling Material with Sonic or Ultrasonic Irrigation: A Micro–computed Tomographic Study , 2017, Journal of endodontics.

[35]  S. Pasha,et al.  Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative in vitro study , 2017, Journal of conservative dentistry : JCD.

[36]  T. Cox,et al.  Retreatability of two endodontic sealers, EndoSequence BC Sealer and AH Plus: a micro-computed tomographic comparison , 2016, Restorative dentistry & endodontics.

[37]  R. A. Bernardes,et al.  Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. , 2016, International endodontic journal.

[38]  Chengfei Zhang,et al.  Effectiveness of Sonic, Ultrasonic, and Photon-Induced Photoacoustic Streaming Activation of NaOCl on Filling Material Removal Following Retreatment in Oval Canal Anatomy. , 2016, Photomedicine and laser surgery.

[39]  H. Arslan,et al.  Removal of filling materials from oval-shaped canals using laser irradiation: a micro-computed tomographic study. , 2015, Journal of endodontics.

[40]  Ali Bijani,et al.  CBCT Evaluation of the Root Canal Filling Removal Using D-RaCe, ProTaper Retreatment Kit and Hand Files in curved canals , 2014, Iranian endodontic journal.

[41]  J. Yoo,et al.  Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: a scanning electron microscopy study , 2014, International Journal of Oral Science.

[42]  D. Hess,et al.  Retreatability of a bioceramic root canal sealing material. , 2011, Journal of endodontics.

[43]  K. Hargreaves,et al.  Cohen's Pathways of the Pulp Expert Consult, 10th Edition , 2010 .

[44]  I. N. Rôças,et al.  Clinical implications and microbiology of bacterial persistence after treatment procedures. , 2008, Journal of endodontics.

[45]  P. Nair On the causes of persistent apical periodontitis: a review. , 2006, International endodontic journal.

[46]  J F Siqueira,et al.  Aetiology of root canal treatment failure: why well-treated teeth can fail. , 2001, International endodontic journal.