Department of Endodontics, Barretos University, Barretos, SP, Brazil.
Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas.
J Endod. 2020 Sep;46(9):1279-1285. doi: 10.1016/j.joen.2020.06.001. Epub 2020 Jun 15.
Nonsurgical endodontic retreatment continues to be a challenge in endodontics, particularly when dealing with a complex tooth anatomy. This study evaluated the efficacy of passive ultrasonic irrigation (PUI) and the GentleWave system as supplementary techniques to remove remaining filling materials from oval-shaped root canals.
Twenty distal roots of human mandibular molars with single and oval-shaped canals were shaped with R40 (40.06) instrument and filled with gutta-percha and AH Plus sealer using warm vertical obturation. Initial filling material removal was performed with R50 (50.05) instrument, followed by the use of PUI (n = 10) or GentleWave system (n = 10). Micro-computed tomographic images were obtained after obturation, initial material removal, and after the use of PUI and GentleWave. 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 by using analysis of variance, Kruskal-Wallis and Mann-Whitney tests. P ≤ .05 was considered significant.
The use of PUI and GentleWave as supplementary techniques significantly reduced the volume of remaining filling material after initial instrumentation (P < .05). However, none of these techniques was able to render canals free from filling materials. PUI showed better performance by removing 18% of the remaining filling material, whereas the GentleWave system was able to remove approximately 10% (P = .02).
The use of supplementary techniques optimized filling material removal after initial instrumentation. PUI enhanced the overall cleaning of the root canal system during endodontic retreatment in oval-shaped canals.
非手术性根管再治疗在根管治疗中仍然是一个挑战，尤其是在处理复杂的牙齿解剖结构时。本研究评估了被动超声冲洗（PUI）和 GentleWave 系统作为辅助技术，从椭圆形根管中去除剩余的填充材料的效果。
对 20 个人类下颌磨牙的远中根进行研究，这些牙齿具有单根管和椭圆形根管。使用 R40（40.06）器械进行根管预备，并用牙胶和 AH Plus 密封剂进行热垂直填充。先用 R50（50.05）器械进行初始填充材料去除，然后使用 PUI（n=10）或 GentleWave 系统（n=10）。在填充后、初始材料去除后以及使用 PUI 和 GentleWave 后，均获得微计算机断层扫描图像。计算整个根管以及冠部、中部和根尖部剩余填充材料的体积。采用方差分析、Kruskal-Wallis 和 Mann-Whitney 检验进行统计学分析。P≤0.05 被认为具有统计学意义。
作为辅助技术，使用 PUI 和 GentleWave 可显著减少初始器械处理后的剩余填充材料体积（P<0.05）。然而，这些技术都不能使根管内无填充材料。PUI 去除了 18%的剩余填充材料，表现更好，而 GentleWave 系统能够去除大约 10%（P=0.02）。
辅助技术的使用优化了初始器械处理后的填充材料去除效果。在椭圆形根管的根管再治疗中，PUI 增强了根管系统的整体清洁效果。
