Evaluation of apical extrusion during conventional retreatment with three endodontic systems

Abstract

SummaryBackground/Aim: The aim of this study was to compare the apical extrusion during endodontic retreatment using three different endodontic systems.Material and Methods: 120 extracted human teeth were ex vivo endodontically treated and retreatment was performed using three different endodontic systems. Samples were divided into 3 groups, A-retreatment with Hedstroem hand files, B-retreatment with Pro Taper Retreatment files and C-retreatment with Pro Taper Gold files. Apically extruded material was collected in pre-measured Eppendorfs on a laboratory scale (10−5g). The amount of the extruded material was measured after the retreatment. The data were analysed using the the statistical software: STATISTICA 7.1 and SPSS for Windows 20.Results: The statistical analysis of the data revealed significant differences between the three endodontic retreatment systems (P< 0.05). Apical extrusion in the A endodontic system is significantly greater than the rotary (B and C) endodontic systems.Conclusions: In ex vivo conditions the results of this study showed significant statistical difference between three investigated endodontic retreatment systems concerning the amount of apically exuded material. The largest amount of material suppressed periapically was proven for Hedstroem hand instruments.

Effect of treatment variables on apical extrusion of debris during root canal retreatment: A systematic review and meta-analysis of laboratory studies

“…32,39 In most of the studies, NSRCRT was performed without solvents. 4,8,[23][24][25][29][30][31][32][34][35][36][37][38][39][40][41]94,95,[98][99][100][101][102]105,106,109,111,114 Eucalyptol was the most commonly used solvent among the studies. 7,[26][27][28]107,112 The most preferred solution during NSRCRT was distilled water 4,7,8,[10][11][12]23,[25][26][27][28][29][30]32,…”

“…Among the included studies, PTUR was the most selected retreatment system. 4,[8][9][10][11][12]23,24,28,30,31,34,37,38,41,[96][97][98][99][100][101]103,104,107,109,110,[112][113][114] Comparative findings on the effect of PTUR and other retreatment systems on the amount of AED are as follows: PTUR and Mtwo retreatment systems were compared in seven studies. 10,23,24,31,38,100,101 One study with a high risk of bias reported that PTUR increased the amount of AED compared to the Mtwo retreatment system, 10 while one study with a medium risk of bias reported the opposite.…”

“…8,28,30,106 Furthermore, 78% of the studies reported that manual instrumentation extruded more debris apically compared to engine-driven instrumentation. [8][9][10][27][28][29][30]34,38,96,97,[101][102][103]106,109,113,114 Therefore, strong evidence indicated the increased debris extrusion potential of manual instrumentation compared to enginedriven instrumentation. = : No significant difference, > : Significantly higher, amount of extruded debris sequenced from the most to the least…”

“…Since there was at least one rotary group in the 23 studies above, the same studies were also evaluated in this section. 4,[7][8][9][10][27][28][29][30][31]34,38,[96][97][98][101][102][103]106,107,109,113,114 Overall, 15 studies reported manual instrumentation during NSRCRT extruded more debris apically compared to rotary instrumentation, 9,10,[27][28][29][30]96,97,[101][102][103]106,109,113,114 and three of them presented a low risk of bias. 28,30,106 Eight studies reported no difference between the amount of AED with both instrumentation types.…”

“…Eighteen studies were included in this analysis. 4,[7][8][9][10][27][28][29][30][31]96,98,101,103,106,107,109,114 A random-effects model was used (I 2 = 96.90%, P < 0.0001), which revealed no significant difference in the amount of AED between manual and engine-driven instrumentation techniques [SMD: 0.74, 95% confidence interval (CI): -0.086-1.573, P > 0.05] (Figure 2a).…”