Assessment of apical extrusion of debris during endodontic retreatment with 3 rotary nickel-titanium retreatment systems and hand files

Abstract

SummaryAim: to evaluate the amount of debris extruded apically as well as the time needed for removal of root canal filling material using ProTaper, MTwo, REndo NiTi rotary retreatment systems and hand files.Materials and methods: 60 freshly extracted human single-rooted teeth were instrumented with Protaper files and obturated with gutta-percha and MTA Fillapex sealer with the cold lateral compaction technique. Teeth were then randomly assigned to 4 groups. ProTaper, MTwo, REndo rotary retreatment systems and Hedstroem hand files were utilized for root canal filling removal. Debris extruded apically was collected into pre-weighed vials. The weight of the dry extruded debris was established by subtracting the pre-retreatment and post-retreatment weight of vials. Time needed for reaching WL, complete removal of gutta-percha and total retreatment time were also recorded with a stopwatch. The data obtained were analyzed using One-way ANOVA (the level of significance was set at P=0.05).Results: Hand instrumentation caused significantly more debris extrusion compared with rotary systems (P<0.001). There was no significant difference among the other groups (P>0.05). Hedstroem hand files needed significantly more time for the completion of the retreatment procedure than rotary systems (P<0.001). Among rotary retreatment files, ProTaper completed the procedure significantly quicker than MTwo and REndo (P<0.001).Conclusion: Rotary retreatment files caused less apical extrusion of debris and needed less time for the completion of the retreatment procedure compared to hand files.

Evaluation of apical extrusion during conventional retreatment with three endodontic systems

“…Apical extrusion of debris during endodontic treatment and retreatment can lead to postoperative pain and discomfort 10 . Apical extrusion of debris and solvents from various instrumentation techniques during endodontic treatment has been studied in detail in the literature 13 .…”

“…Because NiTi rotary systems function using the crown down technique, it was also performed with Hedstroem files in this study, in order to avoid differences between groups. Apical debris extrusion during endodontic treatment and retreatment can lead to postoperative pain and discomfort 10 . Several studies have investigated the amount of extruded material periapical during endodontic treatment of root canal irradiation using root canal surgery [20][21][22] .…”

“…In this study, the instrumentation was followed by abundant irrigation. It has been concluded that instrumentation in combination with irrigation leads to more extrusion of debris compared to instrumentation without irrigation 10 . The distilled water we used in our research was recommended as a solvent to avoid the possible effect of crystallization of sodium hypochlorite on the results 11 .…”

“…Some rotating NiTi systems are specially designed for the retreatment of the root canal system. Studies for clinical use and efficiency of rotary retreatment instruments have concluded that, they are more appropriate in terms of the efficiency and speed of removal of the filling material at endodontic retreatment versus hand instruments 10 . The filling material, pulp necrotic tissue, dentine residues, bacteria and their products and/or irrigation can be extruded in periapical tissues during endodontic retreatment 11 .…”

Influence of endodontic procedure on postoperative pain: Evidence from systematic reviews

“…According to number of files used for instrumentations, engine driven instruments can be divided in single-and multiple-file systems. Different root canal instruments may produce different amounts of extruded debris 13,14 , affecting the postoperative pain incidence. Two recent systematic reviews and meta-analysis assessed influence of type of instruments on postoperative pain.…”