Comparative Evaluation of Time Taken to Retrieve Gutta Percha Using Two Different Solvents and A Novel Heat Treated Retreatment File System In Root Canal Treated Teeth - An In Vitro Study
Main Article Content
Keywords
Gutta-percha, Protaper Retreatment files, Retreatment, Retrieval, Root canal, Solite RS3, Medical, Conservation
Abstract
Background: Non-surgical retreatment is a conservative alternative to periapical surgery for the treatment of persistent infections. It is essential to perform the retreatment procedure efficiently using appropriate instruments and solvents to achieve successful outcomes.
Objective: The objective of this study was to compare the efficiency of a novel heat treated retreatment file Solite RS3, in terms of time required for gutta-percha removal using two different solvents.
Methods: Sixty single-rooted teeth were selected and prepared using the Step Back technique. The canals were filled with AH Plus sealer using matched single cone taper technique. The teeth were divided into three groups, and the time taken to remove gutta-percha was recorded using a stopwatch.Statistical analysis was performed using the One way ANOVA.
Results: The solvent GP Solv took longer to remove gutta-percha compared to the Xylene and EDTA (Contro). The difference between time taken for GP retrieval between Xylene and GP Solv was statistically significant (p<0.05).
Conclusion: While the sample size and in vitro setting are limitations of this study, it can be inferred that Solite RS3 files were faster in removing gutta-percha using Xylene as a solvent. Within the limitations of the study, it can be concluded that there was a significant difference between Xylene and GP Solv in terms of time taken to retrieve the Gutta-percha
References
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10. Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res
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13. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3. Retreatment techniques. J Endod 1990;16:543–9.
14. Schirrmeister JF, Strohl C, Altenburger MJ, Wrbas K-T, Hellwig E. Shaping ability and safety of five different rotary nickel-titanium
instruments compared with stainless steel hand instrumentation in simulated curved root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:807–13.
15. Ferreira JJ, Rhodes JS, Ford TR. The efficacy of gutta-percha removal using ProFiles. Int Endod J 2001;34:267–74.
16. Sae-Lim V, Rajamanickam I, Lim BK, Lee HL.Effectiveness of ProFile .04 taper rotary instruments in endodontic retreatment. J Endod
2000;26:100–4.
17. Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent 2019;22:114–22.
18. Arumugam P, George R, Jayaseelan VP. Aberrations of m6A regulators are associated with tumorigenesis and metastasis in head and neck squamous cell carcinoma. Arch Oral Biol 2021;122:105030.
19. Balachander K, Paramasivam A. Cell-free mitochondrial DNA as a novel non-invasive biomarker for oral cancer. Oral Oncol
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20. Bijai LK, Muthukrishnan A. Potential role of fibroblast senescence in malignant transformation of oral submucous fibrosis. Oral Oncol 2022;127:105810.
21. Ezhilarasan D, Lakshmi T, Subha M, Deepak Nallasamy V, Raghunandhakumar S. The ambiguous role of sirtuins in head and neck
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22. Pandiar D, Ramani P, Krishnan RP, Monica K. Multifaceted multinucleated giant cells in oral squamous cell carcinoma. Oral Oncol
2021;121:105400.
23. Sekar D. Circulatory microRNAs inhibition and its signaling pathways in the treatment of oral squamous cell carcinoma (OSCC). Oral Oncol 2022;126:105763.
24. Murugesan A, Sivakumar A. Comparison of accuracy of mesiodistal tooth measurements made in conventional study models and digital models obtained from intraoral scan and desktop scan of study models. J Orthod 2020;47:149–55.
25. Sekar D. The Role of microRNAs as a predictive biomarker and therapeutic molecule in the treatment of Oral Potentially Malignant Disorder(OPMD). Oral Oncol 2022;127:105786.
26. Sekar D, Murthykumar K, Ganapathy D. miR206 and its mimics: A predictive biomarker and therapeutic molecule in the treatment of oral cancer. Oral Oncol 2022;128:105849.
27. Kurniawan A, Chusida A ’nisaa, Atika N, Gianosa TK, Solikhin MD, Margaretha MS, et al. The Applicable Dental Age Estimation Methods for Children and Adolescents in Indonesia. Int J Dent 2022;2022:6761476.
28. Jeevanandan G, Ravindran V, Subramanian EM, Kumar AS. Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation
Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13:21–6.
29. Preethy NA, Jeevanandan G, Govindaraju L, Subramanian E. Comparison of Shear Bond Strength of Three Commercially Available
Esthetic Restorative Composite Materials: An Study. Int J Clin Pediatr Dent 2020;13:635–9.
30. Govindaraju L, Jeevanandan G, Subramanian EMG. ABO blood grouping: A potential risk factor for early childhood caries - A crosssectional study. Indian J Dent Res 2018;29:313–6.
31. Poornima P, Krithikadatta J, Ponraj RR, Velmurugan N, Kishen A. Biofilm formation following chitosan-based varnish or chlorhexidine-fluoride varnish application in patients undergoing fixed orthodontic treatment: a double blinded randomised controlled trial.BMC Oral Health 2021;21:465.
32. Simon S, Pertot W-J. Clinical Success in Endodontic Retreatment. Quintessence International Editeur; 2019.
33. Rodrigues CT, Duarte MAH, de Almeida MM, de Andrade FB, Bernardineli N. Efficacy of CMWire, M-Wire, and Nickel-Titanium Instruments for Removing Filling Material from Curved Root Canals: A Micro-Computed Tomography Study.J Endod 2016;42:1651–5.
34. Taşdemir T, Er K, Yildirim T, Celik D. Efficacy of three rotary NiTi instruments in removing gutta-percha from root canals. Int Endod J
2008;41:191–6.
35. Schirrmeister JF, Hermanns P, Meyer KM, Goetz F, Hellwig E. Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study. Int Endod J 2006;39:558–65.
36. 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.
37. Horvath SD, Altenburger MJ, Naumann M, Wolkewitz M, Schirrmeister JF. Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: a scanning electron microscopic study. Int Endod J 2009;42:1032–8.
38. Sharma Y, Kumar SP, A GS, Pandey D, Ahmed M, Ahmed S. Comparative Evaluation of Solubility of Gutta-Percha in Three Different
Solvents: A Cone-Beam Computed Tomography (CBCT) Study. Cureus 2022;14:e26788.
39. Sağlam BC, Koçak MM, Türker SA, Koçak S. Efficacy of different solvents in removing guttapercha from curved root canals: a microcomputed tomography study. Aust Endod J 2014;40:76–80.
40. Schuur AHB, Moorer WR, Wesselink PR.[Solvents for the removal of gutta-percha from root canals. 2. Side effects of chloroform,
halothane and xylene]. Ned Tijdschr Tandheelkd 2004;111:303–6.
41. George T, Brady MF. Ethylenediaminetetraacetic Acid (EDTA). StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
42. Jagzap JB, Patil SS, Gade VJ, Chandhok DJ, Upagade MA, Thakur DA. Effectiveness of Three Different Irrigants - 17%
Ethylenediaminetetraacetic Acid, Q-MIX, and Phytic Acid in Smear Layer Removal: A Comparative Scanning Electron Microscope
Study. Contemp Clin Dent 2017;8:459–63.
43. Babgi W, Alhajaji M, Al-Mehmadi L, Elbaqli R, Khayat N, Aldahlawi S, et al. Effect of root conditioning agents hyaluronic acid, EDTA and chlorhexidine on the attachment of human gingival fibroblasts to healthy root surface. Saudi Dent J 2021;33:342–7.
44. Uemura M, Hata G, Toda T, Weine FS. Effectiveness of eucalyptol and d-limonene as gutta-percha solvents. J Endod 1997;23:739–41.
45. Vajrabhaya L-O, Suwannawong SK, Kamolroongwarakul R, Pewklieng L. Cytotoxicity evaluation of gutta-percha solvents:
Chloroform and GP-Solvent (limonene). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:756–9.
46. Sun J. D-Limonene: safety and clinical applications. Altern Med Rev 2007;12:259–64.
47. Maria R, Dutta SD, Thete SG, AlAttas MH. Evaluation of Antibacterial Properties of Organic Gutta-percha Solvents and Synthetic Solvents Against. J Int Soc Prev Community Dent 2021;11:179–83.
48. Ferreira I, Braga AC, Lopes MA, Pina-Vaz I. Improvement of the efficacy of endodontic solvents by ultrasonic agitation. Saudi Dent J
2021;33:39–43.
2. Só MVR, Saran C, Magro ML, Vier-Pelisser FV, Munhoz M. Efficacy of ProTaper retreatment system in root canals filled with gutta-percha and two endodontic sealers. J Endod 2008;34:1223–5.
3. 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 guttapercha from curved root canals - a microcomputed tomography study. Int Endod J
2012;45:580–9.
4. Jorgensen B, Williamson A, Chu R, Qian F. The Efficacy of the WaveOne Reciprocating File System versus the ProTaper Retreatment System in Endodontic Retreatment of Two Different Obturating Techniques. J Endod 2017;43:1011–3.
5. Shivanand S, Patil CR, Thangala V, Kumar PR, Sachdeva J, Krishna A. To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment. J Contemp Dent Pract 2013;14:440–4.
6. Panchal V, Jeevanandan G, Subramanian E. Comparison of instrumentation time and obturation quality between hand K-file, H-files,
and rotary Kedo-S in root canal treatment of primary teeth: A randomized controlled trial. J Indian Soc Pedod Prev Dent 2019;37:75–9.
7. Divya S, Jeevanandan G, Sujatha S, Subramanian EMG, Ravindran V. Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial. Indian J Dent Res 2019;30:904–8.
8. Fuks A, Peretz B. Pediatric Endodontics: Current Concepts in Pulp Therapy for Primary and Young Permanent Teeth. Springer; 2016.
9. Jeevanandan G, Govindaraju L, Subramanian EMG, Priyadarshini P. Comparative Evaluation of Quality of Obturation and Its Effect on
Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent
2021;14:88–96.
10. Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res
1979;87:217–24.
11. Sadat Shojaee N, Vakilinezhad E, Shokouhi MM. In Vitro Comparison of Efficacy of Neolix and ProTaper Universal Retreatment Rotary Systems in Removal of Gutta-Percha Combined with Two Different Sealers. J Dent 2019;20:285–91.
12. Wilcox LR. Endodontic retreatment: ultrasonics and chloroform as the final step in reinstrumentation. J Endod 1989;15:125–8.
13. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3. Retreatment techniques. J Endod 1990;16:543–9.
14. Schirrmeister JF, Strohl C, Altenburger MJ, Wrbas K-T, Hellwig E. Shaping ability and safety of five different rotary nickel-titanium
instruments compared with stainless steel hand instrumentation in simulated curved root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:807–13.
15. Ferreira JJ, Rhodes JS, Ford TR. The efficacy of gutta-percha removal using ProFiles. Int Endod J 2001;34:267–74.
16. Sae-Lim V, Rajamanickam I, Lim BK, Lee HL.Effectiveness of ProFile .04 taper rotary instruments in endodontic retreatment. J Endod
2000;26:100–4.
17. Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent 2019;22:114–22.
18. Arumugam P, George R, Jayaseelan VP. Aberrations of m6A regulators are associated with tumorigenesis and metastasis in head and neck squamous cell carcinoma. Arch Oral Biol 2021;122:105030.
19. Balachander K, Paramasivam A. Cell-free mitochondrial DNA as a novel non-invasive biomarker for oral cancer. Oral Oncol
2022;127:105825.
20. Bijai LK, Muthukrishnan A. Potential role of fibroblast senescence in malignant transformation of oral submucous fibrosis. Oral Oncol 2022;127:105810.
21. Ezhilarasan D, Lakshmi T, Subha M, Deepak Nallasamy V, Raghunandhakumar S. The ambiguous role of sirtuins in head and neck
squamous cell carcinoma. Oral Dis 2022;28:559–67.
22. Pandiar D, Ramani P, Krishnan RP, Monica K. Multifaceted multinucleated giant cells in oral squamous cell carcinoma. Oral Oncol
2021;121:105400.
23. Sekar D. Circulatory microRNAs inhibition and its signaling pathways in the treatment of oral squamous cell carcinoma (OSCC). Oral Oncol 2022;126:105763.
24. Murugesan A, Sivakumar A. Comparison of accuracy of mesiodistal tooth measurements made in conventional study models and digital models obtained from intraoral scan and desktop scan of study models. J Orthod 2020;47:149–55.
25. Sekar D. The Role of microRNAs as a predictive biomarker and therapeutic molecule in the treatment of Oral Potentially Malignant Disorder(OPMD). Oral Oncol 2022;127:105786.
26. Sekar D, Murthykumar K, Ganapathy D. miR206 and its mimics: A predictive biomarker and therapeutic molecule in the treatment of oral cancer. Oral Oncol 2022;128:105849.
27. Kurniawan A, Chusida A ’nisaa, Atika N, Gianosa TK, Solikhin MD, Margaretha MS, et al. The Applicable Dental Age Estimation Methods for Children and Adolescents in Indonesia. Int J Dent 2022;2022:6761476.
28. Jeevanandan G, Ravindran V, Subramanian EM, Kumar AS. Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation
Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13:21–6.
29. Preethy NA, Jeevanandan G, Govindaraju L, Subramanian E. Comparison of Shear Bond Strength of Three Commercially Available
Esthetic Restorative Composite Materials: An Study. Int J Clin Pediatr Dent 2020;13:635–9.
30. Govindaraju L, Jeevanandan G, Subramanian EMG. ABO blood grouping: A potential risk factor for early childhood caries - A crosssectional study. Indian J Dent Res 2018;29:313–6.
31. Poornima P, Krithikadatta J, Ponraj RR, Velmurugan N, Kishen A. Biofilm formation following chitosan-based varnish or chlorhexidine-fluoride varnish application in patients undergoing fixed orthodontic treatment: a double blinded randomised controlled trial.BMC Oral Health 2021;21:465.
32. Simon S, Pertot W-J. Clinical Success in Endodontic Retreatment. Quintessence International Editeur; 2019.
33. Rodrigues CT, Duarte MAH, de Almeida MM, de Andrade FB, Bernardineli N. Efficacy of CMWire, M-Wire, and Nickel-Titanium Instruments for Removing Filling Material from Curved Root Canals: A Micro-Computed Tomography Study.J Endod 2016;42:1651–5.
34. Taşdemir T, Er K, Yildirim T, Celik D. Efficacy of three rotary NiTi instruments in removing gutta-percha from root canals. Int Endod J
2008;41:191–6.
35. Schirrmeister JF, Hermanns P, Meyer KM, Goetz F, Hellwig E. Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study. Int Endod J 2006;39:558–65.
36. 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.
37. Horvath SD, Altenburger MJ, Naumann M, Wolkewitz M, Schirrmeister JF. Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: a scanning electron microscopic study. Int Endod J 2009;42:1032–8.
38. Sharma Y, Kumar SP, A GS, Pandey D, Ahmed M, Ahmed S. Comparative Evaluation of Solubility of Gutta-Percha in Three Different
Solvents: A Cone-Beam Computed Tomography (CBCT) Study. Cureus 2022;14:e26788.
39. Sağlam BC, Koçak MM, Türker SA, Koçak S. Efficacy of different solvents in removing guttapercha from curved root canals: a microcomputed tomography study. Aust Endod J 2014;40:76–80.
40. Schuur AHB, Moorer WR, Wesselink PR.[Solvents for the removal of gutta-percha from root canals. 2. Side effects of chloroform,
halothane and xylene]. Ned Tijdschr Tandheelkd 2004;111:303–6.
41. George T, Brady MF. Ethylenediaminetetraacetic Acid (EDTA). StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
42. Jagzap JB, Patil SS, Gade VJ, Chandhok DJ, Upagade MA, Thakur DA. Effectiveness of Three Different Irrigants - 17%
Ethylenediaminetetraacetic Acid, Q-MIX, and Phytic Acid in Smear Layer Removal: A Comparative Scanning Electron Microscope
Study. Contemp Clin Dent 2017;8:459–63.
43. Babgi W, Alhajaji M, Al-Mehmadi L, Elbaqli R, Khayat N, Aldahlawi S, et al. Effect of root conditioning agents hyaluronic acid, EDTA and chlorhexidine on the attachment of human gingival fibroblasts to healthy root surface. Saudi Dent J 2021;33:342–7.
44. Uemura M, Hata G, Toda T, Weine FS. Effectiveness of eucalyptol and d-limonene as gutta-percha solvents. J Endod 1997;23:739–41.
45. Vajrabhaya L-O, Suwannawong SK, Kamolroongwarakul R, Pewklieng L. Cytotoxicity evaluation of gutta-percha solvents:
Chloroform and GP-Solvent (limonene). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:756–9.
46. Sun J. D-Limonene: safety and clinical applications. Altern Med Rev 2007;12:259–64.
47. Maria R, Dutta SD, Thete SG, AlAttas MH. Evaluation of Antibacterial Properties of Organic Gutta-percha Solvents and Synthetic Solvents Against. J Int Soc Prev Community Dent 2021;11:179–83.
48. Ferreira I, Braga AC, Lopes MA, Pina-Vaz I. Improvement of the efficacy of endodontic solvents by ultrasonic agitation. Saudi Dent J
2021;33:39–43.
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Published
Jun 6, 2023
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Harish Selvaraj, Pradeep Solete, Ganesh Jeevanandan, Delphine Priscilla Antony S, & Adimulapu Hima Sandeep. (2023). Comparative Evaluation of Time Taken to Retrieve Gutta Percha Using Two Different Solvents and A Novel Heat Treated Retreatment File System In Root Canal Treated Teeth - An In Vitro Study . Journal of Population Therapeutics and Clinical Pharmacology, 30(14), 116–122. https://doi.org/10.47750/jptcp.2023.30.14.015
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