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Retreatability of three calcium silicate-containing sealers and one epoxy resin-based root canal sealer with four different root canal instruments

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Abstract

Objectives

The objective of the study was to compare the retreatability of three calcium silicate-containing sealers (BioRoot RCS, MTA Fillapex, Endo C.P.M.) and an epoxy resin-based sealer (AH Plus) with different root canal instruments (Hedström files, Reciproc R40, Mtwo retreatment file R 25/.05 + Mtwo 40/.06, and F6 SkyTaper) concerning sealer remnants and retreatment time.

Materials and methods

Root canals of 192 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and one of the sealers (n = 48 per sealer). Two months later, retreatment was performed using one of the mentioned instruments (n = 12 per instrument and sealer). The roots were split longitudinally, and both halves were investigated using light microscopy. The percentage of sealer remnants covering the root canal wall was evaluated using the software ImageJ. The time required for retreatment was recorded. Statistical analysis was performed using two-way ANOVA and Student-Newman-Keuls post hoc test.

Results

Regarding the percentage of root canal filling remnants as well as retreatment time, two-way ANOVA indicated that the results were significantly affected by the sealer (p < 0.001) and by the instrument used (p < 0.05). Overall, the use of AH Plus was associated with significantly more remnants compared to all other sealers (p < 0.001) and F6 SkyTaper instruments allowed significantly faster retreatment than the other instruments (p < 0.05).

Conclusion

The retreatability of calcium silicate-containing sealers was better compared to AH Plus as less sealer remnants and shorter retreatment times were observed. Retreatment with engine-driven NiTi instruments was superior compared to hand instrumentation.

Clinical relevance

Engine-driven NiTi instruments are better suited to remove root canal fillings than stainless steel Hedström files.

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References

  1. De Cleen MJ, Schuurs AH, Wesselink PR, Wu MK (1993) Periapical status and prevalence of endodontic treatment in an adult Dutch population. Int Endod J 26:112–119

    Article  PubMed  Google Scholar 

  2. Weiger R, Hitzler S, Hermle G, Lost C (1997) Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. Endod Dent Traumatol 13:69–74

    Article  PubMed  Google Scholar 

  3. Pak JG, Fayazi S, White SN (2012) Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod 38:1170–1176. doi:10.1016/j.joen.2012.05.023

    Article  PubMed  Google Scholar 

  4. Lin LM, Skribner JE, Gängler P (1992) Factors associated with endodontic treatment failures. J Endod 18:625–627

    Article  PubMed  Google Scholar 

  5. Nair PNR (2006) On the causes of persistent apical periodontitis: a review. Int Endod J 39:249–281

    Article  PubMed  Google Scholar 

  6. Vârlan C, Dimitriu B, Vârlan V, Bodnar D, Suciu I (2009) Current opinions concerning the restoration of endodontically treated teeth: basic principles. J Med Life 2:165–172

    PubMed  PubMed Central  Google Scholar 

  7. Zehnder M, Paqué F (2011) Disinfection of the root canal system during root canal re-treatment. Endod Top 19:58–73

    Article  Google Scholar 

  8. Kang M, In Jung H, Song M, Kim SY, Kim HC, Kim E (2015) Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 19:569–582. doi:10.1007/s00784-015-1398-3

    Article  PubMed  Google Scholar 

  9. Nair PNR (2004) Pathogenesis of apical periodontitis and the causes of endodontic failure. Crit Rev Oral Biol Med 15:348–381

    Article  PubMed  Google Scholar 

  10. Grischke J, Müller-Heine A, Hülsmann M (2014) The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig 18:1845–1851. doi:10.1007/s00784-013-1161-6

    Article  PubMed  Google Scholar 

  11. Dammaschke T, Camp JH, Bogen G (2014) MTA in vital pulp therapy. In: Torabinejad M (ed) Mineral trioxide aggregate. Properties and clinical applications. Wiley Blackwell Ames, pp 71-110.

  12. Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I (2005) Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 31:97–100

    Article  PubMed  Google Scholar 

  13. Reyes-Carmona JF, Felippe MS, Felippe WT (2009) Biomineralization ability and interaction of mineral trioxide aggregate and white Portland cement with dentin in a phosphate-containing fluid. J Endod 35:731–736. doi:10.1016/j.joen.2009.02.011

    Article  PubMed  Google Scholar 

  14. Han L, Okiji T (2011) Uptake of calcium and silicon released from calcium silicate-based endodontic materials into root canal dentine. Int Endod J 44:1081–1087. doi:10.1111/j.1365-2591.2011.01924.x

    Article  PubMed  Google Scholar 

  15. Atmeh AR, Chong EZ, Richard G, Festy F, Watson TF (2012) Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res 91:454–459. doi:10.1177/0022034512443068

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kaup M, Dammann CH, Schäfer E, Dammaschke T (2015) Shear bond strength of Biodentine, ProRoot MTA, glass ionomer cement and composite resin on human dentine ex vivo. Head Face Med 11:14. doi:10.1186/s13005-015-0071-z

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wang Z, Shen Y, Haapasalo M (2014) Dentin extends the antibacterial effect of endodontic sealers against Enterococcus faecalis biofilms. J Endod 40:505–508. doi:10.1016/j.joen.2013.10.042

    Article  PubMed  Google Scholar 

  18. Gomes-Filho JE, Watanabe S, Gomes AC, Faria MD, Lodi CS, Penha Oliveira SH (2009) Evaluation of the effects of endodontic materials on fibroblast viability and cytokine production. J Endod 35:1577–1579. doi:10.1016/j.joen.2009.07.022

    Article  PubMed  Google Scholar 

  19. Scarparo RK, Haddad D, Acasigua GA, Fossati AC, Fachin EV, Grecca FS (2010) Mineral trioxide aggregate-based sealer: analysis of tissue reactions to a new endodontic material. J Endod 36:1174–1178. doi:10.1016/j.joen.2010.02.031

    Article  PubMed  Google Scholar 

  20. Camps J, Jeanneau C, El Ayachi I, Laurent P, About I (2015) Bioactivity of a calcium silicate-based endodontic cement (BioRoot RCS): interactions with human periodontal ligament cells in vitro. J Endod 41:1469–1473. doi:10.1016/j.joen.2015.04.011

    Article  PubMed  Google Scholar 

  21. Dimitrova-Nakov S, Uzunoglu E, Ardila-Osorio H, Baudry A, Richard G, Kellermann O, Goldberg M (2015) In vitro bioactivity of Bioroot™ RCS, via A4 mouse pulpal stem cells. Dent Mater 31:1290–1297. doi:10.1016/j.dental.2015.08.163

    Article  PubMed  Google Scholar 

  22. Eldeniz AU, Shehata M, Högg C, Reichl FX (2016) DNA double-strand breaks caused by new and contemporary endodontic sealers. Int Endod J 49:1141–1151. doi:10.1111/iej.12577

    Article  PubMed  Google Scholar 

  23. Cornélio AL, Rodrigues EM, Salles LP, Mestieri LB, Faria G, Guerreiro-Tanomaru JM, Tanomaru-Filho M (2017) Bioactivity of MTA Plus, Biodentine and experimental calcium silicate-based cements in human osteoblast-like cells. Int Endod J 50:39–47. doi:10.1111/iej.12589

    Article  Google Scholar 

  24. Zuolo AS, Mello JE Jr, Cunha RS, Zuolo ML, Bueno CE (2013) Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J 46:947–953. doi:10.1111/iej.12085

    Article  PubMed  Google Scholar 

  25. Rios MA, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, Bueno CE (2014) Efficacy of 2 reciprocating systems compared with a rotary retreatment system for gutta-percha removal. J Endod 40:543–546. doi:10.1016/j.joen.2013.11.013

    Article  Google Scholar 

  26. de Souza PF, Oliveira Goncalves LC, Franco Marques AA, Sponchiado Junior EC, Roberti Garcia LF, de Carvalho FM (2015) Root canal retreatment using reciprocating and continuous rotary nickel-titanium instruments. Eur J Dent 9:234–239. doi:10.4103/1305-7456.156834

    Article  PubMed  PubMed Central  Google Scholar 

  27. Koçak MM, Koçak S, Türker SA, Sağlam BC (2016) Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material. J Conserv Dent 19:184–188. doi:10.4103/0972-0707.178706

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hülsmann M, Bluhm V (2004) Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J 37:468–476

    Article  PubMed  Google Scholar 

  29. Iizuka N, Takenaka S, Shigetani Y, Okiji T (2008) Removal of resin-based root canal filling materials with K3 rotary instruments: relative efficacy for different combinations of filling materials. Dent Mater J 27:75–80

    Article  PubMed  Google Scholar 

  30. Neelakantan P, Grotra D, Sharma S (2013) Retreatability of 2 mineral trioxide aggregate-based root canal sealers: a cone-beam computed tomography analysis. J Endod 39:893–896. doi:10.1016/j.joen.2013.04.022

    Article  PubMed  Google Scholar 

  31. Rödig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hülsmann M (2014) Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J 47:942–948. doi:10.1111/iej.12239

    Article  PubMed  Google Scholar 

  32. Garg A, Nagpal A, Shetty S, Kumar S, Singh KK, Garg A (2015) Comparison of time required by D-RaCe, R-Endo and Mtwo instruments for retreatment: an in vitro study. J Clin Diagn Res 9:ZC47–ZC49. doi:10.7860/JCDR/2015/11100.5596

    PubMed  PubMed Central  Google Scholar 

  33. Uzunoglu E, Yilmaz Z, Sungur DD, Altundasar E (2015) Retreatability of root canals obturated using gutta-percha with bioceramic, MTA and resin-based sealers. Iran Endod J 10:93–98

    PubMed  PubMed Central  Google Scholar 

  34. Joseph M, Ahlawat J, Malhotra A, Rao M, Sharma A, Talwar S (2016) In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment. J Clin Exp Dent 8:e355–e360. doi:10.4317/jced.52488

    PubMed  PubMed Central  Google Scholar 

  35. Bramante CM, Fidelis NS, Assumpção TS, Bernardineli N, Garcia RB, Bramante AS, de Moraes IG (2010) Heat release, time required, and cleaning ability of Mtwo R and ProTaper universal retreatment systems in the removal of filling material. J Endod 36:1870–1873. doi:10.1016/j.joen.2010.08.013

    Article  PubMed  Google Scholar 

  36. Yadav P, Bharath MJ, Sahadev CK, Makonahalli Ramachandra PK, Rao Y, Ali A, Mohamed S (2013) An in vitro CT comparison of gutta-percha removal with two rotary systems and Hedstrom files. Iran Endod J 8:59–64

    PubMed  PubMed Central  Google Scholar 

  37. Zuolo AS, Zuolo ML, Bueno CES, Chu R, Cunha RS (2016) Evaluation of the efficacy of TRUShape and Reciproc file systems in the removal of root filling material: an ex vivo microcomputed tomographic study. J Endod 42:315–319. doi:10.1016/j.joen.2015.11.005

    Article  PubMed  Google Scholar 

  38. Nagas E, Uyanik MO, Eymirli A, Cehreli ZC, Vallittu PK, Lassila LVJ, Durmaz V (2012) Dentin moisture conditions after the adhesion of root canal sealers. J Endod 38:240–244. doi:10.1016/j.joen.2011.09.027

    Article  PubMed  Google Scholar 

  39. Ghoneim AG, Lutfy RA, Sabet NE, Fayyad DM (2011) Resistance to fracture of roots obturated with novel canal-filling systems. J Endod 37:1590–1592. doi:10.1016/j.joen.2011.08.008

    Article  PubMed  Google Scholar 

  40. Shokouhinejad N, Razmi H, Nekoofar MH, Sajadi S, Dummer PM, Khoshkhounejad M (2013) Push-out bond strength of bioceramic materials in a synthetic tissue fluid. J Dent (Tehran) 10:540–547

    Google Scholar 

  41. Hess D, Solomon E, Spears R, He J (2011) Retreatability of a bioceramic root canal sealing material. J Endod 37:1547–1549. doi:10.1016/j.joen.2011.08.016

    Article  PubMed  Google Scholar 

  42. Ersev H, Yilmaz B, Dinçol ME, Dağlaroğlu R (2012) The efficacy of ProTaper Universal rotary retreatment instrumentation to remove single gutta-percha cones cemented with several endodontic sealers. Int Endod J 45:756–762. doi:10.1111/j.1365-2591.2012.02032.x

    Article  PubMed  Google Scholar 

  43. Schirrmeister JF, Wrbas KT, Meyer KM, Altenburger MJ, Hellwig E (2006) Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod 32:469–472

    Article  PubMed  Google Scholar 

  44. Alves FR, Marceliano-Alves MF, Sousa JC, Silveira SB, Provenzano JC, Siqueira JF Jr (2016) Removal of root canal fillings in curved canals using either reciprocating single- or rotary multi-instrument systems and a supplementary step with the XP-Endo finisher. J Endod 42:1114–1119. doi:10.1016/j.joen.2016.04.007

    Article  PubMed  Google Scholar 

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Correspondence to Till Dammaschke.

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Donnermeyer, D., Bunne, C., Schäfer, E. et al. Retreatability of three calcium silicate-containing sealers and one epoxy resin-based root canal sealer with four different root canal instruments. Clin Oral Invest 22, 811–817 (2018). https://doi.org/10.1007/s00784-017-2156-5

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  • DOI: https://doi.org/10.1007/s00784-017-2156-5

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