Reciprocating System for Secondary Root Canal Treatment of Oval Canals: CBCT, X-rays for Remnant Detection and Their Identification with ESEM and EDX

Abstract

Aim of the study: to evaluate root filling remnants after secondary root canal treatments (SRCTs) of oval-shaped canals with X-rays and cone beam computed tomography (CBCT). The SRCTs were performed using reciprocating NiTi instruments. Methods: Single-rooted teeth (N = 64) were randomly treated with Reciproc Blue (RB) and filled with AH Plus/single cone (SC group) or AH Plus/Guttafusion (GF group). After seven days of storage in HBSS (Hanks balanced salt solution), Gates Glidden burs #2/3 and RB #25 and #40 were used for the SRCTs. The time to complete the procedure was measured. X-rays and CBCT were used to calculate, respectively, the area and the volume occupied by the remnants in the coronal, middle, and apical thirds of each canal. Environmental scanning electron microscopy (ESEM) and energy dispersive X-ray spectroscopy (EDX) were used for qualitative evaluation and morphology composition of the remnants in sectioned roots. A statistical analysis was performed using Sigma Plot (version 13, IBM, Armonk, NY, USA). The study was designed according to PRILE guidelines. Results: After the SRCTs, the middle thirds of the root canals showed the presence of remnants in both groups, as demonstrated by X-rays and CBCT. The GF group showed a statistically significant higher volume of remnants than the SC Group only in the middle third. The ESEM supported by the EDX revealed the remnant composition by the detection of trace elements of sealer and gutta-percha in all root canals. Conclusion: The study demonstrated that the middle third of root canals is a critical region where remnants were packed and spread in the buccal-lingual sides of canals. ESEM-EDX detected a fine layer of filling remnants in all root thirds, suggesting a larger canal contamination than the X-rays and CBCT examinations revealed.

De la Radiografía Convencional a la Tomografía Computarizada de Haz Cónico: Una Comparación de los Métodos de Imagen en la Localización Precisa de los Conductos Radiculares, Revisión Bibliográfica

“…Aunque evidentemente hay consistencia sobre las virtudes de la tomografía computarizada o CBTC, cabe destacar sus antecedentes y vacíos de investigación, pues la radiografía convencional continúa siendo usada ampliamente a través de los años por sus costos y disponibilidad; esto es señalado por autores como (Spinelli et al, 2022), pues entre sus resultados figuran datos similares al compararlos en específicos casos clínicos, esto implica que se debería realizar siempre una valoración de recursos individual, según las características del caso que se esté tratando. Es de gran importancia notar que los estudios citados no cubren todos los cuadros clínicos que pudieran presentarse, pero la evidencia científica actual sí respalda el uso de la CBTC en situaciones clínicas de mayor complejidad.…”

Analysis of the Root Canal Apical Third Obturation Quality Depending on the Tooth Root Individual Anatomy

“…4 The frequently used lateral compaction method reliably obstructs the root canal and allows the use of less sealer. 5,6 However, it may require more appointment time compared to other methods. The vertical compaction technique requires the use of special equipment and makes it possible to obtain gutta-percha in the form of a homogeneous and size-stable mass facilitating the penetration of the material into the branches of the root canal system.…”