Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA.
Clin Oral Investig. 2021 Mar;25(3):891-899. doi: 10.1007/s00784-020-03376-4. Epub 2020 Jun 6.
The aim of this study was to evaluate the efficacy of supplementary techniques (ultrasonic tip/XP-endo Finisher R) in removing remaining filling materials (gutta-percha/AHPlus/BCSealer) from oval-shaped root canals during non-surgical endodontic retreatment.
Twenty-eight distal roots of human mandibular molars with single and oval-shaped canals were initially shaped with a R40 instrument and filled with gutta-percha points and AH Plus (n = 14) or BC Sealer (n = 14) followed by an initial micro-CT scanning. Initial filling material removal was performed in all 28 samples with an R50 instrument, and all samples submitted to a second micro-CT. Supplementary techniques with ultrasonic tips or XP-endo Finisher R instruments were performed in each sealer group, and all samples submitted to a third micro-CT. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed using T, ANOVA 3-way, and Tukey tests.
Lower values of remnant filling material were found for BC Sealer (16.06 ± 14.34) compared to AH Plus (28.30 ± 10.54) (P < 0.001), and considering the supplementary technique, lower values of remnant filling material were found for the ultrasonic tip (18.95 ± 11.05) compared to XP-endo Finisher R (25.41 ± 15.81) (P = 0.025). Ultrasonic instruments significantly reduced the percentage of remaining filling material for both AH Plus (P = 0.04) and BC Sealer (P = 0.02) while XP-endo Finisher R was effective for AHPlus only (P = 0.04). The remaining filling material was observed in all samples regardless the filling material or the supplementary technique employed.
Supplementary techniques increased filling material removal; however, none of them was able to render root canals completely free from root fillings. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for bioceramic cases.
Supplementary instrumentation techniques are effective tools to reduce the amount of filling materials during root canal retreatment.
本研究旨在评估辅助技术（超声尖端/XP-endo 锉 R）在非手术根管再治疗中从椭圆形根管中去除残留的充填材料（牙胶/AHPlus/BCSealer）的效果。
对 28 个人类下颌磨牙的远中根进行初始根管预备，使用 R40 器械，并用牙胶尖和 AHPlus（n=14）或 BCSealer（n=14）进行充填，随后进行初始微 CT 扫描。在所有 28 个样本中，使用 R50 器械进行初始充填材料去除，然后对所有样本进行第二次微 CT 扫描。在每个密封剂组中，使用超声尖端或 XP-endo 锉 R 器械进行辅助技术处理，并对所有样本进行第三次微 CT 扫描。计算整个根管以及冠、中、根尖三分之一的剩余充填材料体积。使用 T、ANOVA 三向和 Tukey 检验进行统计分析。
与 AHPlus（28.30±10.54）相比，BCSealer（16.06±14.34）的剩余充填材料值较低（P<0.001），并且考虑到辅助技术，与 XP-endo 锉 R（25.41±15.81）相比，超声尖端的剩余充填材料值较低（P=0.025）。超声器械显著降低了 AHPlus（P=0.04）和 BCSealer（P=0.02）的剩余充填材料百分比，而 XP-endo 锉 R 仅对 AHPlus 有效（P=0.04）。无论使用哪种充填材料或辅助技术，所有样本中均观察到剩余的充填材料。
辅助技术增加了充填材料的去除量；然而，没有一种技术能够使根管完全没有根充材料。超声尖端应被视为根管再治疗的一种良好选择，特别是对于生物陶瓷病例。
辅助器械技术是根管再治疗中减少充填材料量的有效工具。
