title: Assessment of Root Canal Filling Removal Effectiveness Using Micro-computed Tomography: A Systematic Review.
abstract: BACKGROUND
  The removal of obturation materials from the root canal system is a primary objective in root canal retreatment procedures. This systematic review aims to discuss the effectiveness of different instrumentation procedures in removing root-canal filling materials assessed by micro-computed tomography.
  
  
  METHODS
  An electronic search in PubMed and major endodontic journals was conducted using appropriate key words to identify investigations that examined the effectiveness of obturation material removal assessed by micro-computed tomography.
  
  
  RESULTS
  Among 345 studies, 22 satisfied the inclusion criteria. Seven studies compared hand instrumentation with Nickel-Titanium rotary or reciprocating systems. Three studies investigated rotary systems, and another three studies explored reciprocation. Eight studies compared rotary systems and reciprocation in removing filling materials from the root canal system. Other factors, such as the role of solvents and irrigant agitation, were discussed.
  
  
  CONCLUSIONS
  The application of different instrumentation protocols can effectively, but not completely, remove the filling materials from the root canal system. Only hand instrumentation was not associated with iatrogenic errors. Reciprocating and rotary systems exhibited similar abilities in removing root filling material. Retreatment files performed similarly to conventional ones. Solvents enhanced penetration of files but hindered cleaning of the root canal. The role of irrigant agitation was determined as controversial.
authors.affiliation: School of Dentistry, The University of Adelaide, Adelaide, Australia. Electronic address: giampiero.rossi-fedele@adelaide.edu.au.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Rossi-Fedele
authors.affiliation: School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Hany Mohamed Aly
authors.initials: HM
authors.lastname: Ahmed
mesh_terms: D006801:Humans; D015641:Radiography, Interventional / Q000379:methods; D019233:Retreatment / Q000379:methods; D012387:Root Canal Filling Materials; D012389:Root Canal Obturation / Q000379:methods*; D016896:Treatment Outcome; D055114:X-Ray Microtomography / Q000379:methods
chemical_list: D012387:Root Canal Filling Materials
keywords: Endodontics; instrumentation; micro–computed tomography; obturation materials; retreatment; root canal; solvents