Efficacy Of Novel Heat Treated Retreatment File System In Removing Gutta-Percha And Sealer From The Root Canal Walls- A Scanning Electron Microscope Analysis
Main Article Content
Keywords
Dentinal tubules, d-Limonene, endodontic retreatment, gutta-percha removal, scanning electron microscopy
Abstract
Objective: This study aimed to investigate the impact of solvents on the presence of gutta-percha and sealer remnants on root canal walls and inside dentinal tubules.
Methods: A total of 30 teeth were chemo mechanically prepared with an apical size of 30. In groups 1-3 (n = 10 each), the canals were filled with gutta-percha and sealer using matched single cone technique. The removal of root fillings was performed after 2 weeks using Solite RS3 endodontic retreatment files with three different solvents: group 1 (EDTA), group 2 (Xylene), and group 3 (GP Solv). After additional irrigation, the roots were split and subjected to scanning electron microscopy (SEM). The number of filled dentinal tubules (SEM) and the surface covered by root filling remnants were evaluated in the coronal, middle, and apical thirds of each root half. Statistical analysis was conducted using mixed models for clustered data, followed by Tukey's test.
Results: The control group A (EDTA) exhibited the lowest value of remnant GP followed by the Group B (Xylene) group and Group C (GP Solv) (P < 0.05 for all group comparisons). Moreover, the EDTA control group had fewer remnants than all other groups (P < 0.05).
Conclusion: The use of solvents resulted in higher remnants of gutta-percha and sealer on root canal walls and inside dentinal tubules.
References
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19. 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.
20. 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.
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22. 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.
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25. Govindaraju L, Jeevanandam G, Subramanian EMG. ABO blood grouping: A potential risk factor for early childhood caries - A cross-sectional study. Indian J Dent Res 2018;29:313–6.
26. Divya S, Jeevanandam 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 randomized clinical trial. Indian J Dent Res 2019;30:904–8.
27. Poornima P, Krithika Datta 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 randomized controlled trial. BMC Oral Health 2021;21:465.
28. Baratto Filho F, Ferreira EL, Fariniuk LF. Efficiency of the 0.04 taper ProFile during the re-treatment of gutta-percha-filled root canals. Int Endod J 2002;35:651–4.
29. Schirrmeister JF, Wrbas K-T, Schneider FH, Altenburger MJ, Hellwig E. Effectiveness of a hand file and three nickel-titanium rotary instruments for removing gutta-percha in curved root canals during retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:542–7.
30. Scelza MFZ, Coil JM, Maciel AC de C, Oliveira LRL, Scelza P. Comparative SEM evaluation of three solvents used in endodontic retreatment: an ex vivo study. J Appl Oral Sci 2008;16:24–9.
31. Hunter KR, Doblecki W, Pelleu GB Jr. Halothane and eucalyptol as alternatives to chloroform for softening gutta-percha. J Endod 1991;17:310–1.
32. Haikel Y, Allemann C. Effectiveness of four methods for preparing root canals: a scanning electron microscopic evaluation. J Endod 1988;14:340–5.
33. Prati C, Selighini M, Ferrieri P, Mongiorgi R. Scanning electron microscopic evaluation of different endodontic procedures on dentin morphology of human teeth. J Endod 1994;20:174–9.
34. Das S, De Ida A, Das S, Nair V, Saha N, Chattopadhyay S. Comparative evaluation of three different rotary instrumentation systems for removal of gutta-percha from root canal during endodontic retreatment: An study. J Conserv Dent 2017;20:311–6.
35. 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.
36. Schirrmeister JF, Meyer KM, Hermanns P, Altenburger MJ, Wrbas K-T. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J 2006;39:150–6.
37. Agrawal P, Ramanna PK, Arora S, Sivarajan S, Jayan A, Sangeetha KM. Evaluation of Efficacy of Different Instrumentation for Removal of Gutta-percha and Sealers in Endodontic Retreatment: An Study. J Contemp Dent Pract 2019;20:1269–73.
38. Wourms DJ, Campbell AD, Hicks ML, Pelleu GB Jr. Alternative solvents to chloroform for gutta-percha removal. J Endod 1990;16:224–6.
39. Pecora G, Andreana S. Use of dental operating microscope in endodontic surgery. Oral Surg Oral Med Oral Pathol 1993;75:751–8.
40. 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.
41. Gaffoor FMA, Chintu S, Thota L, Kumar A, Thota G, Dwivedi V, et al. An Study of Gutta Percha Removal Commencing from the Root Canal Undergoing Endodontic Retreatment using Different Rotary Instrumentation Systems. J Pharm Bioallied Sci 2022;14:S522–5.
2. 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.
3. Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res 1979;87:217–24.
4. Sadat Shojaee N, Valinezhad 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.
5. Wilcox LR. Endodontic retreatment: ultrasonics and chloroform as the final step in reinstrumentation. J Endod 1989;15:125–8.
6. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3. Retreatment techniques. J Endod 1990;16:543–9.
7. 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.
8. Ferreira JJ, Rhodes JS, Ford TR. The efficacy of gutta-percha removal using ProFiles. Int Endod J 2001;34:267–74.
9. 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.
10. Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent 2019;22:114–22.
11. Love RM, Jenkinson HF. Invasion of dentinal tubules by oral bacteria. Crit Rev Oral Biol Med 2002;13:171–83.
12. Zanettini PR, Barletta FB, de Mello Rahden. In vitro comparison of different reciprocating systems used during endodontic retreatment. Aust Endod J 2008;34:80–5.
13. 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.
14. Balachander K, Paramasivam A. Cell-free mitochondrial DNA as a novel non-invasive biomarker for oral cancer. Oral Oncol 2022;127:105825.
15. Bijai LK, Muthukrishnan A. Potential role of fibroblast senescence in malignant transformation of oral submucous fibrosis. Oral Oncol 2022;127:105810.
16. Ezhilarasan D, Lakshmi T, Subha M, Deepak Nallasamy V, Raghunandan Kumar S. The ambiguous role of sirtuins in head and neck squamous cell carcinoma. Oral Dis 2022;28:559–67.
17. Pandiar D, Ramani P, Krishnan RP, Monica K. Multifaceted multinucleated giant cells in oral squamous cell carcinoma. Oral Oncol 2021;121:105400.
18. Sekar D. Circulatory microRNAs inhibition and its signaling pathways in the treatment of oral squamous cell carcinoma (OSCC). Oral Oncol 2022;126:105763.
19. 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.
20. 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.
21. Sekar D, Murthy Kumar K, Ganapathy D. miR-206 and its mimics: A predictive biomarker and therapeutic molecule in the treatment of oral cancer. Oral Oncol 2022;128:105849.
22. 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.
23. Jeevanandam 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.
24. Preethy NA, Jeevanandam G, Govindaraju L, Subramanian E. Comparison of Shear Bond Strength of Three Commercially Available Esthetic Restorative Composite Materials: A Study. Int J Clin Pediatr Dent 2020;13:635–9.
25. Govindaraju L, Jeevanandam G, Subramanian EMG. ABO blood grouping: A potential risk factor for early childhood caries - A cross-sectional study. Indian J Dent Res 2018;29:313–6.
26. Divya S, Jeevanandam 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 randomized clinical trial. Indian J Dent Res 2019;30:904–8.
27. Poornima P, Krithika Datta 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 randomized controlled trial. BMC Oral Health 2021;21:465.
28. Baratto Filho F, Ferreira EL, Fariniuk LF. Efficiency of the 0.04 taper ProFile during the re-treatment of gutta-percha-filled root canals. Int Endod J 2002;35:651–4.
29. Schirrmeister JF, Wrbas K-T, Schneider FH, Altenburger MJ, Hellwig E. Effectiveness of a hand file and three nickel-titanium rotary instruments for removing gutta-percha in curved root canals during retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:542–7.
30. Scelza MFZ, Coil JM, Maciel AC de C, Oliveira LRL, Scelza P. Comparative SEM evaluation of three solvents used in endodontic retreatment: an ex vivo study. J Appl Oral Sci 2008;16:24–9.
31. Hunter KR, Doblecki W, Pelleu GB Jr. Halothane and eucalyptol as alternatives to chloroform for softening gutta-percha. J Endod 1991;17:310–1.
32. Haikel Y, Allemann C. Effectiveness of four methods for preparing root canals: a scanning electron microscopic evaluation. J Endod 1988;14:340–5.
33. Prati C, Selighini M, Ferrieri P, Mongiorgi R. Scanning electron microscopic evaluation of different endodontic procedures on dentin morphology of human teeth. J Endod 1994;20:174–9.
34. Das S, De Ida A, Das S, Nair V, Saha N, Chattopadhyay S. Comparative evaluation of three different rotary instrumentation systems for removal of gutta-percha from root canal during endodontic retreatment: An study. J Conserv Dent 2017;20:311–6.
35. 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.
36. Schirrmeister JF, Meyer KM, Hermanns P, Altenburger MJ, Wrbas K-T. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J 2006;39:150–6.
37. Agrawal P, Ramanna PK, Arora S, Sivarajan S, Jayan A, Sangeetha KM. Evaluation of Efficacy of Different Instrumentation for Removal of Gutta-percha and Sealers in Endodontic Retreatment: An Study. J Contemp Dent Pract 2019;20:1269–73.
38. Wourms DJ, Campbell AD, Hicks ML, Pelleu GB Jr. Alternative solvents to chloroform for gutta-percha removal. J Endod 1990;16:224–6.
39. Pecora G, Andreana S. Use of dental operating microscope in endodontic surgery. Oral Surg Oral Med Oral Pathol 1993;75:751–8.
40. 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.
41. Gaffoor FMA, Chintu S, Thota L, Kumar A, Thota G, Dwivedi V, et al. An Study of Gutta Percha Removal Commencing from the Root Canal Undergoing Endodontic Retreatment using Different Rotary Instrumentation Systems. J Pharm Bioallied Sci 2022;14:S522–5.
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Published
Jun 6, 2023
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Harish Selvaraj, Pradeep Solete, Ganesh Jeevanandan, Delphine Priscilla Antony S, Sowmya K, & Adimulapu Hima Sandeep. (2023). Efficacy Of Novel Heat Treated Retreatment File System In Removing Gutta-Percha And Sealer From The Root Canal Walls- A Scanning Electron Microscope Analysis. Journal of Population Therapeutics and Clinical Pharmacology, 30(14), 123–129. https://doi.org/10.47750/jptcp.2023.30.14.016
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