|Year : 2017 | Volume
| Issue : 2 | Page : 115-117
Comparative evaluation of efficacy and effectiveness of profile rotary instruments in conjugation with solvent for retreatment of resilon and gutta-percha: An In vitro study
Manoj Chandak1, Avinash Salgar2, Pradhnya Nikhade1, Shilpa Shrivastava1, Aditi Sahni1, Rakhi Chandak3
1 Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Sawangi, India
2 Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, India
3 Department of Oral Medicine and Radiology, Swargiya Dadasaheb Kalmegh Smruti Dental College, Nagpur, Maharashtra, India
|Date of Web Publication||8-Sep-2017|
Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Sawangi, Maharashtra
Source of Support: None, Conflict of Interest: None
Aim: The aim is to determine the effectiveness of rotary instrumentation (ProFile 0.06 tapered rotary NiTi instruments) in conjugation with solvent (chloroform) in the removal of resilon compared to gutta-percha during root canal retreatment. Materials and Methods: Sixty recently extracted human mandibular permanent premolars with straight roots with single canals were used. Decoronation of samples done at cementoenamel junction using the diamond disk. The length of each canal was determined with a size 15 K file and canals were instrumented using a crown down technique with ProFile 0.06 tapered NiTi rotary instruments. Irrigation done followed by obturation. Result and Conclusion: Statistical evaluation was done using paired t-test (P < 0.05) which showed that the samples obturated with resilon showed significantly better results at the apical third when compared to samples obturated with gutta-percha and the time required for Group 2 is significantly less than Group 1.
Keywords: Gutta-percha, resilon, retreatment
|How to cite this article:|
Chandak M, Salgar A, Nikhade P, Shrivastava S, Sahni A, Chandak R. Comparative evaluation of efficacy and effectiveness of profile rotary instruments in conjugation with solvent for retreatment of resilon and gutta-percha: An In vitro study. J Datta Meghe Inst Med Sci Univ 2017;12:115-7
|How to cite this URL:|
Chandak M, Salgar A, Nikhade P, Shrivastava S, Sahni A, Chandak R. Comparative evaluation of efficacy and effectiveness of profile rotary instruments in conjugation with solvent for retreatment of resilon and gutta-percha: An In vitro study. J Datta Meghe Inst Med Sci Univ [serial online] 2017 [cited 2019 Oct 18];12:115-7. Available from: http://www.journaldmims.com/text.asp?2017/12/2/115/214194
| Introduction|| |
Technologic advancements in dentistry have vastly improved the quality of care provided to the general population. A survey performed by the American Dental Association survey system, Chicago and estimated that the number of endodontic cases treated annually ranges from 24 to 50 million. This vast dramatic increase was described in endodontics as the “good news-bad news” dilemma. The good news is that hundreds of millions of teeth are salvaged through the combination of endodontics, periodontics, and restorative dentistry. The bad news is that 10 of millions of endodontically treated teeth are failing each year for a variety of reasons., For example, the success rate for conventionally treated teeth is 85% to 90%; this still leaves a failure rate of 10% to 15%. A 10% failure rate would result in the failure of at least 2.4 million cases. Therefore, the future of endodontics will include dealing with the retreatment of its failures. N on the surgical endodontic treatment of previously filled root canals is the initial treatment of choice for management of endodontic failures. Lin et al. (1991) and Siqueira et al. (1997) have demonstrated that part of root canal space often remains untouched during chemomechanical preparation, regardless of technique, and instruments employed. The primary objective of root canal filling includes sealing of root canal system completely to prevent penetration of tissue liquid, bacteria, and their products into the canal to avoid re-infection. Gutta-percha was popularized by Bowman in 1867, in its pure molecular structure, gutta-percha is the trans-isomer of poly-isoprene and has an approximately 60% crystalline form. Despite proximity, it does not chemically adhere to the dentinal walls and complete the dentinal seal. Consequently, a sealing agent is required. Sealers are binding agents used to fill up the gap between root canal wall and obturating material. It also fills up the irregularities, discrepancies, lateral canals, and accessory canals. AH, plus is an epoxy-based resin sealer available in two paste system, i.e., epoxy paste and amine paste with the working time of 4 h and setting time of 9–15 h.
Resilon broadens the dimensions of endodontic adhesion. Recently, a new root canal filling material, Epiphany obturating system (Resilon research LLC, Madison, CT, USA) consisting of three items as follows the core material (Resilon), the sealer, and its bonding agent (Primer) are introduced to obtain a better seal. The aim of this study was to determine the effectiveness of rotary instrumentation (ProFile 0.06 tapered rotary NiTi instruments) in conjugation with heat (E and Q Plus system) in the removal of resilon compared to gutta-percha during root canal retreatment [Table 1], [Table 2], [Table 3] and [Graph 1].
| Materials and Methods|| |
Sixty recently extracted human mandibular permanent premolars with straight roots with single canals were used in this study. Examination of all teeth was done under 8X magnification with a stereomicroscope (Carl Zeiss) to rule out any teeth with preexisting root fractures, resorptive defects, caries, hypercementosis, cracks, open apices, and previous restorations or root canal treatments. All samples were decoronated at the cementoenamel junction to get root length of 16 ± 2 mm. All the samples were instrumented using a crown down technique with ProFile 0.06 tapered NiTi rotary instruments (Dentsply Tulsa Dental, OK) in an EndoMoT model C-105 electric motor with an NSK F20R 20:1 reduction contra angled handpiece (NSK Nakanishi inc., Tochigi, Japan). The canals were then dried with sterile paper points (Dentsply, Maillefer, Ballaigues, Switzerland). Roots were then randomly divided into two groups of 30 roots each.
All the specimens were stored at 37°C in 100% humidity for 3 weeks.
Each sample from both the groups was evaluated at three different anatomical areas, i.e., apical, middle, and coronal.
Group 1: Retreatment of thirty gutta-percha filled roots using rotary instruments with solvent (chloroform)
A reservoir for chloroform was created with gutta-percha using a size thirty ProFile 0.06 rotary file rotating at 1300 rpm. Three to five drops of the chloroform were introduced into the reservoir at a time. This sequence was repeated and was followed by Crown down technique of instrumentation using ProFile 0.06 rotary file system at 350 rpm with Glyde File Prep (Dentsply Maillefer, France) endodontic lubricant. The instrumentation was done at working length until all the gutta-percha material was removed from each canal. The canal was irrigated using 5% NaOCl.
Group 2: Retreatment of thirty resilon filled roots using rotary instruments with solvent (chloroform)
Resilon was removed from the canal using solvent similar to the technique used in Group 1.
A final irrigation with 5 ml of 5% NaOCl followed by 5 ml of 17% ethylenediaminetetraacetic acid delivered from 24 gauge needle was used in all samples. The endpoint of instrumentation during gutta-percha and resilon removal was determined when ProFile size 40, 0.06 rotary file went to the working length and the canal walls were free of visible debris as depicted by radiograph. The time required for retreatment of each group was measured in minutes and expressed as mean ± standard deviation.
The roots were sectioned longitudinally in half with fracture line passing through the root canals. Both the halves were visualized using stereomicroscope (Carl Ziess, Germany) at ×20 magnification.
A grading system was used with respect to the amount of residual obturating material and debris at the coronal, middle, and apical portions of each root canal according to the following criteria.
Representative specimens were fixed with 10% formalin solution for 24 h and rinsed 3 times with a phosphate buffered solution then dehydrated with ascending concentrations of ethanol (30%–100%) and air-dried. Each specimen was sputter coated with gold and examined under scanning electron microscope (Coslab laboratory equipments, India) at 15 kV.
| Results|| |
The cleanliness of the root canals obturated using gutta-percha and resilon after their removal using solvent was evaluated and statistical analysis was performed using paired t-test (P< 0.05) at coronal, middle, and apical thirds. Results show statistical difference at apical third whereas no significant difference was observed at the coronal and middle third.
| Discussion|| |
The prerequisites for successful retreatment comprises re-entry into the cana system and removal of the existing root filling throughout the canal length to allow chemo-mechanical reinstrumentation and complete disinfection of the root canal system and the creation of favorable conditions for peri-radicular healing.
The presentin vitro study was carried out with the aim to determine the effectiveness of NiTi 0.06 taper rotary (ProFile) instrumentation in conjugation with solvent (chloroform) in the removal of resilon compared to gutta-percha during root canal retreatment. NiTi instruments make enlarging and removal of filing material from the root canals easier and faster than stainless steel files with less tendency of straightening, zipping, ledging, or perforation of curved canals.,
For over 100 years, gutta-percha has been the most commonly used material to obdurate the canal system as it fulfils many ideal requirements of root filing materials.,,,,
The significant improvement in resilon when compared to gutta-percha is claimed to form “A monoblock” within the canals, resulting in strengthening the root to some extent reducing the bacterial ingress by bonding to the dentinal walls when used in conjunction with its sealer.
Chloroform effectively dissolves gutta-percha as well as resilon and allows quicker access to working length furthermore eliminates the need for excessive force during the negotiation of obturated canals. The samples obturated with resilon had shown cleaner and faster removal as it forms a monoblock with a significant difference at the apical third which may be attributed to the inaccessibility of the solvent to reach the apical area.
This is anin vitro study, therefore, the interferences might not correlate completely in clinical situations which need to be evaluated in future studies.
| Conclusion|| |
No significant difference was observed in cleanliness at the coronal and middle third of all the samples, whereas the apical third showed better results in samples obturated with resilon. The time required is significantly less for removal of resilon.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ruddle CJ. Non surgical endodontic retreatment. In: Cohen S, Burns RC, editors. Pathways of Pulp. 8th
ed. St. Louis: Mosby-Year Book; 2002.
Ruddle CJ. Micro-endodontic nonsurgical retreatment. Dent Clin North Am 1997;41:429-54.
Wong R. Conventional endodontic failure and retreatment. Dent Clin North Am 2004;48:265-89.
Ingle JI, Bakland LK, Beveridge BE, Glick DH, Hoskin AE. Modern.
de Oliveira DP, Barbizam JV, Trope M, Teixeira FB. Comparison between gutta-percha and resilon removal using two different techniques in endodontic retreatment. J Endod 2006;32:362-4.
Stabholz A, Friedman S. Endodontic retreatment – Case selection and technique. Part 2: Treatment planning for retreatment. J Endod 1988;14:607-14.
Saad AY, Al-Hadlaq SM, Al-Katheeri NH. Efficacy of two rotary NiTi instruments in the removal of Gutta-Percha during root canal retreatment. J Endod 2007;33:38-41.
Tasdemir T, Yildirim T, Celik D. Comparative study of removal of current endodontic fillings. J Endod 2008;34:326-9.
Cohen S. Obturation of the cleaned & shaped root canal. In: Cohen S, Burns RC, editors. Pathways of Pulp. 8th
ed. St. Louis: Mosby-Year Book; 2002.
Tamse A, Unger U, Metzger Z, Rosenberg M. Gutta-percha solvents – A comparative study. J Endod 1986;12:337-9.
Wilcox LR. Endodontic retreatment with halothane versus chloroform solvent. J Endod 1995;21:305-7.
Hassanloo A, Watson P, Finer Y, Friedman S. Retreatment efficacy of the epiphany soft resin obturation system. Int Endod J 2007;40:633-43.
Teixeira FB, Teixeira EC, Thompson JY, Trope M. Fracture resistance of roots endodontically treated with a new resin filling material. J Am Dent Assoc 2004;135:646-52.
[Table 1], [Table 2], [Table 3]