Keleş Ali, Alcin Hatice, Kamalak Aliye, Versiani Marco A
Department of Endodontics, Faculty of Dentistry, İnönü University, Malatya, Turkey.
Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Clin Oral Investig. 2014 May;18(4):1147-1153. doi: 10.1007/s00784-013-1086-0.
The aim of this study was to assess the efficacy of removing the filling material from oval-shaped canals with rotary retreatment files, with or without the additional use of self-adjusting file (SAF), using micro-computed tomography.
Oval-shaped canals from 20 maxillary premolars were prepared and assigned to two groups (n = 10), according to the obturation technique: cold lateral condensation (CLC) or vertical condensation (VC). Then, retreatment procedure was performed with retreatment rotary instruments followed by SAF. The specimens were scanned after each procedure and the volume of the filling material calculated. Median and interquartile range (IQR) percentages of the remaining filling material after each retreatment technique were statistically compared by Wilcoxon and Mann–Whitney U tests with a significance level of 5 %.
The median percentage volume of the filling residue after rotary retreatment procedure was 1.59 (IQR = 1.26) and 0.42 (IQR = 0.86) in the CLC and VC groups, respectively (p < 0.05). After the use of SAF, the median percentage was 1.26 (IQR = 0.75) and 0.12 (IQR = 0.53) in the CLC and VC groups, respectively (p < 0.05). Statistically significant difference was also observed within the group after the additional use of SAF (p < 0.05).
None of the retreatment procedures completely removed the filling material. The additional use of the SAF improved the removal of filling material after the retreatment procedure with rotary instruments.
Filling material left after retreatment procedure may harbour necrotic tissue and bacteria, which could lead to a persistent disease and reinfection of the root canal system. The additional use of self-adjusting file after the conventional retreatment procedures may improve root canal cleanliness, allowing a better action of the irrigating solution.
本研究旨在使用微型计算机断层扫描技术，评估使用旋转再治疗锉去除椭圆形根管内充填材料的效果，无论是否额外使用自调式锉（SAF）。
选取20颗上颌前磨牙的椭圆形根管，根据充填技术分为两组（n = 10）：冷侧方加压充填（CLC）或垂直加压充填（VC）。然后，先用旋转再治疗器械进行再治疗，随后使用SAF。每次操作后对标本进行扫描，并计算充填材料的体积。采用Wilcoxon检验和Mann-Whitney U检验对每种再治疗技术后剩余充填材料的中位数和四分位数间距（IQR）百分比进行统计学比较，显著性水平为5%。
在CLC组和VC组中，旋转再治疗操作后充填残渣的体积百分比中位数分别为1.59（IQR = 1.26）和0.42（IQR = 0.86）（p < 0.05）。使用SAF后，CLC组和VC组的体积百分比中位数分别为1.26（IQR = 0.75）和0.12（IQR = 0.53）（p < 0.05）。在额外使用SAF后，组内也观察到统计学上的显著差异（p < 0.05）。
没有一种再治疗方法能完全去除充填材料。在使用旋转器械进行再治疗后额外使用SAF可改善充填材料的去除效果。
再治疗后残留的充填材料可能藏有坏死组织和细菌，这可能导致疾病持续存在和根管系统再次感染。在传统再治疗程序后额外使用自调式锉可能会提高根管清洁度，使冲洗液能更好地发挥作用。
