Journal of Operative Dentistry & Endodontics

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VOLUME 4 , ISSUE 2 ( July-December, 2019 ) > List of Articles

Original Article

A Cone-beam Computed Tomographic Evaluation of Removing Root Canal Sealer Using a Novel Sonic Agitation Device

S Anitha Rao, Sunehra Sanam, Zaheer Ahmad, CS Soonu, Tummala Muralidhar

Keywords : Cone-beam computed tomography, Endodontic retreatment, Root filling materials, Ultrasonic irrigation, Waterpik power flosser

Citation Information : Rao SA, Sanam S, Ahmad Z, Soonu C, Muralidhar T. A Cone-beam Computed Tomographic Evaluation of Removing Root Canal Sealer Using a Novel Sonic Agitation Device. J Oper Dent Endod 2019; 4 (2):72-79.

DOI: 10.5005/jp-journals-10047-0084

License: CC BY-NC 4.0

Published Online: 01-02-2016

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: The aim of this in vitro study was to evaluate the efficacy of canal brush, Waterpik power flosser, and ultrasonic irrigation in removal of a sealer from the root canals using cone-beam computed tomography (CBCT). Materials and methods: Forty-five extracted mandibular premolars were prepared and obturated. The samples were divided into three groups (n = 15). In each group, the sealer was removed using canal brush, Waterpik power flosser, and ultrasonic irrigation. All the samples underwent CBCT imaging. The amount of sealer was evaluated in CBCT sagittal sections and was scored. The maximum concentration of residual sealer was recorded. Statistical analysis: Data were analyzed statistically using the IBM SPSS software version 20.0. Comparison of three groups with the amount of residual sealer was analyzed with the Kruskal–Wallis ANOVA and the Mann–Whitney U test and the level of significance is set at p < 0.05. Results: In comparison among canal brush (mean = 3.7), power flosser (mean = 2.7), and ultrasonic irrigation (mean = 2.3), with p value 0.0001, power flosser showed enhanced efficiency in removing the sealer in apical third when compared to ultrasonic irrigation. The removal of the sealer with power flosser and ultrasonic irrigation in coronal and middle third showed no significant difference. However, in the case of canal brush, there was significant difference in the sealer removal. The efficiency of canal brush is less when compared to power flosser and ultrasonic irrigation in all the thirds. Conclusion: The efficiency of sealer removal is more with both ultrasonic device and power flosser, but enhanced efficiency is seen with power flosser in apical third.

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  1. Sundqvist G, Figdor D, Persson S, et al. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol 1998;85(1):86–93. DOI: 10.1016/s1079-2104(98)90404-8.
  2. Ingle JI, Beveridge EE, GlicK DH, et al. Modern endodontic therapy. In: Ingle JI, Bakland LK. Endodontics. 4th ed., Philadelphia: Lee & Febiger; 1994. 33.
  3. Harty FJ, Parkins BJ, Wengraf AM. Success rate in root canal therapy: A retrospective study of conventional cases. Br Dent J 1970a;28(2): 65–70. DOI: 10.1038/sj.bdj.4802429.
  4. Zehnder M, Paque F. Disinfection of the root canal system during root canal re-treatment. Endod Top 2011;19(1):58–73. DOI: 10.1111/j.1601-1546.2011.00254.x.
  5. Schirrmeister JF, Meyer KM, Hermanns P, et al. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J 2006;39(2):150–156. DOI: 10.1111/j.1365-2591.2006.01066.x.
  6. Bergenholtz G, Lekholm U, Milthon R, et al. Retreatment of endodontic fillings. Scand J Dent Res 1979;87(3):217–224. DOI: 10.1111/j.1600-0722.1979.tb00675.x.
  7. Friedman S, Stabholz A. Endodontic retreatment case selection and technique. Part 2: Treatment planning for retreatment. J Endod 1988;14(12):607–614. DOI: 10.1016/S0099-2399(88)80058-X.
  8. Friedman S, Stabholz A, Tamse A. Endodontic retreatment case selection and technique. 3. Retreatment techniques. J Endod 1990;16(11):543–649. DOI: 10.1016/s0099-2399(07)80219-6.
  9. Kratchman SI. Obturation of the root canal system. Dent Clin North Am 2004;48(1):203–215. DOI: 10.1016/j.cden.2003.12.004.
  10. Reddy S, Neelakantan P, Saghiri MA, et al. Removal of guttapercha/zinc-oxide-eugenol sealer or gutta-percha/epoxy resin sealer from severely curved canals: an in vitro study. Int J Dent 2011;2011:541831. DOI: 10.1155/2011/541831.
  11. Sae-Lim V, Rajamanickam I, Lim BK, et al. Effectiveness of ProFile .04 taper rotary instruments in endodontic retreatment. J Endod 2000;26(2):100–104. DOI: 10.1097/00004770-200002000- 00010.
  12. Tachinami H, Katsuumi I. Removal of root canal filling materials using Er:YAG laser irradiation. Dent Mater J 2010;29(3):246–252. DOI: 10.4012/dmj.2008-079.
  13. Zmener O, Pameijer CH, Banegas G. Retreatment efficacy of hand versus automated instrumentation in oval-shaped root canals: an ex vivo study. Int Endod J 2006;39(7):521–526. DOI: 10.1111/j.1365-2591.2006.01100.x.
  14. Hulsmann M, Stotz S. Efficacy, cleaning ability and safety of different devices for gutta-percha removal in root canal retreatment. Int Endod J 1997;30(4):227–233. DOI: 10.1111/j.1365-2591.1997. tb00702.x.
  15. Gu LS, Kim JR, Ling J, et al. Review of contemporary irrigant agitation techniques and devices. J Endod 2009;35(6):791–804. DOI: 10.1016/j.joen.2009.03.010.
  16. Weise M, Roggendorf MJ, Ebert J, et al. Four methods for cleaning simulated lateral extensions of curved root canals: a SEM evaluation. Int Endod J 2007;40:991–992.
  17. Garip Y, Sazak H, Gunday M, et al. Evaluation of smear layer removal after use of a canal brush: an SEM study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110(2):62–66. DOI: 10.1016/j.tripleo.2010.02.037.
  18. Salman MI, Baumann MA, Hellmich M, et al. SEM evaluation of root canal debridement with sonicare CanalBrush irrigation. Int Endod J 2010;43(5):363–369. DOI: 10.1111/j.1365-2591.2009.01675.x.
  19. Mozo S, Llena C, Chieffi N, et al. Effectiveness of passive ultrasonic irrigation in improving elimination of smear layer and opening dentinal tubules. J Clin Exp Dent 2014;6(1):47–52.
  20. van der Sluis LW, Versluis M, Wu MK, et al. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 2007;40(6): 415–426. DOI: 10.1111/j.1365-2591.2007.01243.x.
  21. Shenoy A, Mandava P, Bolla N, et al. Antibacterial efficacy of sodium hypochlorite with a novel sonic agitation device. Indian J Dent RS 2013;24(5):537–541. DOI: 10.4103/0970-9290.123361.
  22. Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment. J Endod 2008;34(11):1381–1384. DOI: 10.1016/j.joen.2008.08.002.
  23. Somma F, Cammarota G, Plotino G, et al. The effectiveness of manual and mechanical instrumentation for the retreatment of three different root canal filling materials. J Endod 2008;34(4):466–469. DOI: 10.1016/j.joen.2008.02.008.
  24. Lee SJ, Wu MK, Wesselink PR. The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls. Int Endod J 2004;37(10):672–678. DOI: 10.1111/j.1365-2591.2004.00848.x.
  25. Ma J, Al-Ashaw AJ, Shen Y, et al. Efficacy of ProTaper universal rotary retreatment system for gutta-percha removal from oval root canals: a micro-computed tomography study. J Endod 2012;38(11):1516–1520. DOI: 10.1016/j.joen.2012.08.001.
  26. Walters MJ, Baumgartner JC, Marshall JG. Efficacy of irrigation with rotary instrumentation. J Endod 2002;28(12):837–839. DOI: 10.1097/00004770-200212000-00011.
  27. Gutarts R, Nusstein J, Reader A, et al. In vivo debridement efficacy of ultrasonic irrigation following handrotary instrumentation. J Endod 2005;3(3):166–171. DOI: 10.1097/01.don.0000137651. 01496.48.
  28. Passarinho-Neto JG, Marchesan MA, Ferreira RB, et al. In vitro evaluation of endodontic debris removal as obtained by rotary instrumentation coupled with ultrasonic irrigation. Aust Endod J 2006;32(3):123–128. DOI: 10.1111/j.1747-4477.2006.00035.x.
  29. Sabins R, Johnson J, Hellstein J. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 2003;29(10):674–678. DOI: 10.1097/00004770-200310000-00016.
  30. Kasam S, Mariswamy AB. Efficacy of different methods for removing root canal filling material in retreatment - An In-vitro study. JJ Clin Diagn Res 2016;10(6):6–10.
  31. Negative pressure irrigation system. Endovac J Endod 2010;36(4): 745–750. DOI: 10.1016/j.joen.2009.11.022.
  32. The self adjusting file system; an evidence based update. J Conserve Dent 2014;17(5):401–419. DOI: 10.4103/0972-0707.139820.
  33. Barletta FB, Rahde Nde M, Limongi O, et al. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc 2007;73(1):65.
  34. Hammad M, Qualtrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentation for retreatment of canals filled with different materials. J Endod 2008;34(11):1370–1373. DOI: 10.1016/j.joen.2008.07.024.
  35. Luke AM, Shetty KP, Satish SV. Comparison of spiral computed tomography and computed tomography. J Indian Acad Oral Med Radiol 2013;25(3):173–177.
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