Effectiveness of three different retreatment techniques in canals filled with compacted gutta-percha or Thermafil: a scanning electron microscope study.
BACKGROUND
This study evaluated the root canal wall morphology under scanning electron microscopy magnification after removal of 2 types of root canal fillings by using ultrasonic tips, nickel-titanium (NiTi) rotary instruments, and hand K-files.


METHODS
Thirty-six extracted roots were filled by using AH Plus (DeTrey-Dentsply, Konstanz, Germany) as a sealer with Thermafil (Tulsa Dental Products, Tulsa, OK) (18 roots) or warm vertically condensed gutta-percha (18 roots). All fillings were removed up to the middle third by using Gates Glidden drills. The retreatment was completed by using K-files (group 1), M-Two NiTi rotary instruments (group 2), or ESI ultrasonic tips (group 3) in 12 roots each. Root canals were irrigated by using 10% ethylenediaminetetraacetic acid and 2.5% NaOCl. The samples were split longitudinally and observed by scanning electron microscopy (100-2000x). The presence of smear layer, filling debris, and the surface profile was evaluated in each picture. Kruskal-Wallis (analysis of variance) and Mann-Whitney tests were used to evaluate the differences between the obturation techniques, the 3 retreatment methods, and the canal thirds (P < .05).


RESULTS
Resin sealer tags were observed inside dentinal tubules. No statistical differences (P > .05) were found among the 3 retreatment methods. No statistical differences were observed between Thermafil and vertically compacted warm gutta-percha for each group or between the coronal third used as control, middle, and apical thirds.


CONCLUSIONS
All retreatment techniques showed similar performances in terms of smear layer morphology, debris, and surface profile. None of them completely removed filling debris from dentinal tubules of apical third.
Endodontic Unit, Department of Dental Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. chiara.pirani4@unibo.it
Chiara
C
Pirani
Gian Andrea
GA
Pelliccioni
Silvia
S
Marchionni
Lucio
L
Montebugnoli
Gabriela
G
Piana
Carlo
C
Prati
D003722:Dental Alloys; D003786:Dental Pulp Cavity / Q000648:ultrastructure*; D003804:Dentin / Q000648:ultrastructure; D004492:Edetic Acid / Q000627:therapeutic use; D004853:Epoxy Resins / Q000627:therapeutic use; D004867:Equipment Design; D006171:Gutta-Percha / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D009532:Nickel; D019233:Retreatment; D012387:Root Canal Filling Materials / Q000737:chemistry / Q000627:therapeutic use*; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012389:Root Canal Obturation / Q000379:methods; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D012399:Rotation; D016369:Smear Layer; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D014025:Titanium; D019227:Tooth Apex / Q000648:ultrastructure; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation
D003722:Dental Alloys; D004853:Epoxy Resins; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; C534916:epoxy resin-based root canal sealer; C040654:titanium nickelide; D009532:Nickel; D006171:Gutta-Percha; D004492:Edetic Acid; D014025:Titanium; D012973:Sodium Hypochlorite