Clinical Signicance.

The challenge Cshaped cross-sectional root anatomy presents to the clinician lies in the thickness, or lack thereof, of the canal walls that are considerably more thin than apparent, as suggested on x-ray. Perforation when ling or fracture during obturation is a potential threat.

Gao Y, Fan B, Cheung GSP, et al: C-shaped canal system in mandibular second molars part IV: 3-D morphological analysis and transverse measurement. J Endod 32:1062-1065, 2006 Reprints available from B Fan or M Fan, Key Lab for Oral Biomedical Engineering of Ministry of Education, School & Hosp of Stomatology, Wuhan Univ, 65 Luoyu Rd, Wuhan 430079, China; e-mail: bingfan8@hotmail.com

Removing gutta-percha in endodontic retreatment

Background.If root canal therapy fails, the preferred approach, being the most conservative choice, is retreatment. Retreatment is undertaken to regain access to the apical foramen by completely removing all root canal lling material, permitting sufcient cleaning and shaping of the system and nal appropriate obturation. The gutta-percha can be removed through several methods, including new exible rotary nickel-titanium (NiTi) les in a slow-speed handpiece. The efcacy of 2 rotary NiTi instruments in removing gutta-percha during root canal retreatment was evaluated in comparison with hand instruments using Hedstrom les. Methods.A total of 60 extracted human single-rooted anterior teeth and premolars were instrumented and obturated using the laterally condensed gutta-percha technique. Three groups of 20 teeth each were randomly formed. Two NiTi instruments, the ProTaper and K3, and hand instruments were used to remove the gutta-percha lling material. Roots underwent longitudinal splitting, then were digitally reproduced using a scanner. Areas where material remained were identied. In addition to efcacy, time required for removing the gutta-percha and amount of apically extruded debris were recorded. Results.The amount of lling material left by the 2 rotary NiTi instruments was signicantly less than that left by the hand instruments (Table 1). The NiTi instruments also required signicantly less time to remove the lling material than the hand instruments. The amount of debris removed was the same for each of the 3 techniques. Discussion.The removal of gutta-percha was achieved more quickly and more completely using the NiTi instruments than the hand instruments. All the instruments left some gutta-percha in the root canals.

Table 1.Remaining Filling Material in Each Third of the Canal (Expressed as Percentage of Area of Each Third) for Each Technique
Technique N Region Mean SD

Hand

20

ProTaper

20

K3

20

Apical Middle Coronal Apical Middle Coronal Apical Middle Coronal

15.89 10.29 11.32 5.94 4.50 3.51 7.81 5.03 5.53 3.51 2.78 1.79 8.07 5.14 5.73 3.92 3.10 2.24

Clinical Signicance.Retreatment of failing root canal treatments depends on gaining access to the apical foramen, totally debriding the canal, and adequately sealing it. In this study, automated instrumentation was faster and more effective than hand instruments in removing the old lling. No signicant difference was noted in the amount of debris extruded apically.

Saad AY, Al-Hadlaq SM, Al-Katheeri NH: Efcacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment. J Endod 33:39-41, 2007 Reprints available from SM Al-Hadlaq, Dept of Restorative Dental Sciences, Div of Endodontics, College of Dentistry, King Saud Univ, PO Box 60169, Riyadh 11545, Saudi Arabia; e-mail: smhadlaq@ksu.edu.sa

(This article was published in J Endod, 33, Saad AY, Al-Hadlaq SM, Al-Katheeri NH, Efcacy of two rotary NiTi instruments in the removal of gutta-percha during root canal retreatment, 39-41, Copyright American Association of Endodontics (2007).)

Volume 52

Issue 5

2007

287