Search

Kumaravel Kaliaperumal,1 Emna Hidoussi Sakly,1,2 Alessandro Leite Cavalcanti,3 Abinaya Gayathri,1 Kumaran Subramanian,4 Nabil Nasraoui,5 Mohammad Aly Ibrahim,6 Salma Aly Ibrahim6 1Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India; 2Department of Dentistry, Hadj Ali Soua Hospital Ksar Hellal, Oral Health and OroFacial Rehabilitation Laboratory Research (LR12ES11), Faculty of Dental Medicine of Monastir, University of Monastir, Monastir, Tunisia; 3Department of Dentistry, Universidade Estadual da Paraíba – UEPB, Center for Biological and Health Sciences, Campina Grande, PB, Brazil; 4P.G.Research Department of Microbiology, Sri Sankara Arts and Science College (Autonomous), Kanchipuram, Tamil Nadu, India; 5Dentistry-Endodontics, University of Monastir, Faculty of Dental Medicine of Monastir, Department of Restorative Monastir, Monastir, Tunisia; 6Faculty of Medicine, University of Tanta, Tanta, EgyptCorrespondence: Emna Hidoussi Sakly, Email minoumd@gmail.comIntroduction: Root canal retreatment is carried out in cases where previous endodontic therapies failed and involves the removal of root canal filling materials, followed by cleaning, shaping, and obturating of the canals.Aims: : The objective of this study was to collect information regarding attitudes, methods, and materials employed during the non-surgical endodontic retreatment (NSER) by general dentists working in Sousse Governorate, Tunisia.Materials and Methods: A descriptive cross-sectional survey was conducted among 147 general dentists working in the Sousse Governorate, Tunisia, from May to November 2021. Data were collected by sending a structured questionnaire to the dental practitioners through email. All the data were analyzed by using the SPSS 10 computer software.Results: A total of 96 dentists responded to this survey. The response rate was 63.5%, with a female predominance (53.2.3%). 81.2% of the respondents performed at least one non-surgical endodontic retreatment (NSER) weekly. Our study revealed that the mandibular first molar is the tooth that most often requires endodontic retreatment (83.5%). Half of the participants never used the rubber dam during this procedure. Moreover, the majority of respondents (61.9%) simultaneously used manual files and rotary nickel-titanium instruments for root canal desobturation. Most of the dentists (69.57%) systematically use solvents during root canal desobturation.Conclusion: Our survey highlights that the majority of general dentists have adequate knowledge about endodontic retreatment. Nevertheless, dentists are yet to start the application of these newer strategies towards the management of endodontic failures.Keywords: nonsurgical endodontic retreatment, surveys, questionnaires, general practitioners

Introduction: Endodontic retreatment differs from initial root canal treatment. Various factors govern the success of root canal treatment, and failure to achieve any of these may lead to the failure of the therapy. Retreatment decisions differ amongst general practitioners and specialists and are dependent on several factors including educational background, work experience, knowledge and economic resources. A survey was conducted to compare the practice and knowledge regarding endodontic retreatment cases amongst general practitioners and endodontists. Materials and Methods: A questionnaire was constructed with questions based on common practice and knowledge of endodontic retreatment and was distributed to general practitioners and endodontists through electronic means and personal mail. Data were analysed using the Chi-square test. P < 0.05 was considered statistically significant. Results: The results showed that there was no statistical difference in the responses by general dentists and specialists (endodontists). Conclusions: Within the limitations of this survey, it can be concluded that both the general practitioners and specialists (endodontists) have adequate knowledge and follow similar protocols when treating retreatment cases with minor differences in their approach.

Objective: The purpose of this retrospective study was to assess the variables affecting endodontic retreatment technique success. Methods: A 5-year period of 500 patient records from a dental clinic were examined. Pre-operative factors, procedure specifics, post-operative results, and demographic information were all documented. The study employed statistical analysis to determine the important factors that influence retreatment success. Findings: The average age of the study group was 45.2 years, and 56% of the participants were female. Sixty-four percent of patients had multiple root canals, and the most frequent initial diagnosis (60%) was apical periodontitis. The results of the surgery varied: 50% of patients had full healing, 30% had partial healing, and 20% had no improvement at all. Significant indicators of retreatment success were found to include age, initial diagnosis, and root canal morphology (P < 0.05). Conclusion: The effectiveness of endodontic retreatment operations is mostly influenced by age, apical periodontitis, and root canal morphology. Optimizing treatment results requires individualized treatment techniques based on each patient’s unique features. Clinicians can benefit greatly from these findings in terms of increasing endodontic retreatment success rates and enhancing patient care.

Background: Endodontic retreatment is crucial for preserving dental health but is influenced by various factors. Objective: This research aimed to assess factors affecting the success of endodontic retreatment procedures. Methods: A retrospective analysis was conducted on 250 cases of endodontic retreatment. Demographic and clinical data were collected, and treatment success was defined based on predetermined criteria. Statistical analysis was performed to evaluate associations between treatment factors and retreatment outcomes. Results: The overall success rate was 75%. Rotary instrumentation, gutta-percha obturation, and use of intracanal medication were significantly associated with higher retreatment success rates (P < 0.05). Conclusion: Factors such as instrumentation type, obturation material, and intracanal medication significantly influence endodontic retreatment success. Understanding and optimizing these factors are crucial for improving treatment outcomes and patient satisfaction.

Introduction: Endodontic treatment failures often stem from the presence of microbial pathogens, particularly Enterococcus faecalis and Candida albicans. This study systematically assesses the prevalence of E. faecalis and C. albicans in endodontic retreatment cases, aiming to explore their impact on treatment outcomes. Methods: Employing a systematic sampling approach, 30 patients with a history of previous endodontic treatment were selected. Rigorous clinical and radiographic assessments were conducted, following standardized protocols for root canal sample collection. Microbiological analysis, utilizing selective culture media, was employed to identify and quantify E. faecalis and C. albicans. Statistical analyses, including chi-square and logistic regression tests, were performed. Results: The study involved 30 patients undergoing endodontic retreatment, with comprehensive clinical and radiographic evaluations for cases with and without periradicular lesions. Microbiological analysis unveiled a significant prevalence of E. faecalis and C. albicans, establishing a robust association between these pathogens and retreatment failure. These findings underscore the critical need for targeted antimicrobial interventions to enhance the overall success rates of endodontic retreatment procedures. Conclusion: This study highlights the substantial prevalence of E. faecalis and C. albicans in endodontic retreatment cases, emphasizing the importance of identifying and effectively managing these pathogens for successful treatment outcomes. The notable association between these microbial agents and retreatment failure underscores the imperative for tailored antimicrobial strategies to enhance the efficacy of endodontic retreatment procedures.

Introduction: Secondary endodontic infections present intricate challenges in dental practice, necessitating effective retreatment strategies. The current systematic review aimed to critically evaluate the outcomes of single-visit versus multi-visit endodontic retreatment in patients with secondary endodontic infections. Materials and Methods: The current systematic review was registered in the Open Science Framework database and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches were conducted in PubMed/Medline, Scopus, and Web of Science databases for articles published until April 2023. The inclusion criteria for the current systematic review were clinical trials reporting the comparison of nonsurgical single-visit versus multiple-visit endodontic retreatments with predictive outcome. The Cochrane scale was used to assess the risk of bias. Results: Six studies were included in the systematic review. Four studies reported the incidence of postoperative pain, and two studies reported the periapical lesion healing after single- and multiple-visit endodontic retreatments with an 18- and 24-month follow-up. Three studies showed a low risk of bias, one study showed unclear risk of bias, and two studies showed a high risk of bias. Conclusion: Comparative analyses indicated that single-visit endodontic retreatment yielded comparable postoperative pain levels and healing outcomes as retreatment conducted over multiple visits. Notably, the utilization of intracanal medicaments such as calcium hydroxide and triple antibiotic paste demonstrates promise in mitigating postoperative pain subsequent to retreatment procedures.

This case report highlights the successful management of a cystic apical lesion associated with root resorption through nonsurgical endodontic retreatment, utilizing calcium-enriched mixture (CEM) cement as an obturating biomaterial. A 35-year-old woman presented with mild discomfort in the mandibular right first molar (#46), with radiographic evidence of a well-defined radiolucent lesion at the apex of the mesial root. The tooth had a history of previous failed endodontic treatment with poor root canal obturation, indicating internal root resorption. Nonsurgical endodontic retreatment was performed, and the canals were filled/sealed with CEM cement. Follow-up radiographs showed a gradual reduction in the size of the cystic lesion. At 54 months, complete bone healing of the cystic apical lesion was evident. This case report provides clinical evidence supporting the potential efficacy of nonsurgical endodontic retreatment using CEM cement in managing certain cystic apical lesions, offering a promising alternative to traditional surgical enucleation, even in cases with inflammatory root resorption. Further research is needed to validate the long-term efficacy of this approach in larger patient populations.

Taurodontism is a dental anomaly characterized by an apical displacement of the pulp chamber floor, resulting in a large pulp chamber with short roots. It can be associated with certain syndromes and abnormalities, although it is common to occur as an isolated characteristic. This anomaly can occur along with other root canal system anomalies such as C-type configuration. The aim of this report is to present the successful endodontic management of a C-shaped mesotaurodontic mandibular molar and review the literature available on this matter. A 23-year-old Persian female was referred by her dental surgeon to complete the root canal treatment of her right mandibular first molar (#46). Clinical examination showed a temporized cavity with no response to pulpoperiapical tests or visible pocket depth while an elongated root trunk with slight periodontal ligament widening, incomplete obturation of the root canal system, and periapical radiolucency was evident on the intraoral radiograph. Cone-beam computed tomography (CBCT) revealed a taurodontic and type III C-shaped root canal configuration. With a diagnosis of previous treatment and asymptomatic apical periodontitis, the patient was scheduled for root canal retreatment. The same anomaly was discovered in other molar teeth on the panoramic radiograph taken before the primary treatment of tooth #46. At a 2-month follow-up session, the tooth was found asymptomatic clinically and radiographically. The past publications about the management of nonsyndromic taurodontic molars were also reviewed. The review of 29 similar articles showed that preoperative CBCT, magnification with illumination, along with active irrigation are helpful items in managing such cases.

Dentoalveolar abscess is the term used to describe a collection of purulent secretion localized in the alveolar bone at the apex of a tooth. These abscesses can result from bacterial infections due to carious tissue, unsuccessful endodontic treatment, or pulp necrosis resulting from trauma. The symptoms involve extreme sensitivity during chewing, percussion, and palpation of the mandibular cervical lymph nodes. Treatment is performed through drainage, retreatment, or extraction, depending on the case. The aim of this study is to report the approach of an endodontic retreatment in a case of acute dentoalveolar abscess followed by prosthetic rehabilitation. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to explore the influence of a framing effect in retreatment decision‐making of a root‐filled tooth with asymptomatic apical periodontitis (AP). Method Two variants of a questionnaire were created in which the factual information about a root filled with AP was identical. The options in the first variant were framed in favor to wait and see (FW) and those in the other variant were framed in favor of retreatment (FR) Two hundred and forty‐eight volunteers were by chance given one of the two versions and were asked to choose between having retreatment or to wait and see. Results Of the 125 participants given the FW version, 69 (55.2%) chose to wait and see while out of the 123 participants who were given the FR version, 38 (30.9%) made the alike choice (p = .0002). Conclusion A framing effect is likely to play an essential role in endodontic retreatment decision‐making of root‐filled teeth with asymptomatic apical periodontitis.

Endodontic treatment failures often stem from the presence of microbial pathogens, particularly Enterococcus faecalis and Candida albicans. This study systematically assesses the prevalence of E. faecalis and C. albicans in endodontic retreatment cases, aiming to explore their impact on treatment outcomes. Employing a systematic sampling approach, 30 patients with a history of previous endodontic treatment were selected. Rigorous clinical and radiographic assessments were conducted, following standardized protocols for root canal sample collection. Microbiological analysis, utilizing selective culture media, was employed to identify and quantify E. faecalis and C. albicans. Statistical analyses, including chi-square and logistic regression tests, were performed. The study involved 30 patients undergoing endodontic retreatment, with comprehensive clinical and radiographic evaluations for cases with and without periradicular lesions. Microbiological analysis unveiled a significant prevalence of E. faecalis and C. albicans, establishing a robust association between these pathogens and retreatment failure. These findings underscore the critical need for targeted antimicrobial interventions to enhance the overall success rates of endodontic retreatment procedures. This study highlights the substantial prevalence of E. faecalis and C. albicans in endodontic retreatment cases, emphasizing the importance of identifying and effectively managing these pathogens for successful treatment outcomes. The notable association between these microbial agents and retreatment failure underscores the imperative for tailored antimicrobial strategies to enhance the efficacy of endodontic retreatment procedures. [ABSTRACT FROM AUTHOR]

Abstract Both root canal sealer-based and supplementary protocols may influence removal of filling material during endodontic retreatment. Mesial root canals of extracted mandibular molars were prepared using HyFlex EDM 25/.08, and filled with a calcium silicate sealer (Bio-C Sealer), or an epoxy resin (AH Plus), using the single cone technique (n = 12). Retreatment was performed using ProDesign Logic (PDL) RT and PDL 35/.05. The specimens were randomly divided into two experimental groups (n = 12), and the sealers were distributed similarly. A supplementary protocol was performed with PDL 50/.01 or XP-endo Finisher. Root canal transportation and volume, in addition to the remaining filling material percentage were evaluated using high-resolution (5 µm voxel size) micro-CT. Statistical analysis was performed using t-tests (α = 0.05). Root canals filled with AH Plus presented high residual filling material (p < 0.05). Both protocols decreased residual volume of filling material in the apical third (p < 0.05). PDL 50/.01 increased the apical root canal volume (p < 0.05). No difference was observed between the systems regarding canal transportation (p > 0.05). In conclusion, AH Plus is more difficult to remove from the apical third than Bio-C Sealer. PDL 50/.01 and XP-endo Finisher enabled greater removal of filling materials in the apical third, in the retreatment of curved root canals, without promoting apical transport.

Background: Endodontic retreatment involves the removal of gutta-percha and sealer from root canals to address treatment failures and persistent infections. This study aimed to systematically evaluate and compare the effectiveness of different gutta-percha removal techniques. Methods: Sixty extracted human teeth with single canals were selected. The canals were initially treated, obturated with gutta-percha, and divided into six groups (n=10 each). Each group represented a distinct removal technique: rotary instrument-driven, Gates-Glidden drill-assisted, solvent-based dissolution, ultrasonic removal, heat-based softening, and a control group. Gutta-percha mass and canal wall cleanliness were assessed post-removal. Statistical analyses were performed using ANOVA and post hoc Tukey's HSD tests. Results: The solvent-based dissolution technique exhibited the most efficient removal, achieving the lowest mean remaining gutta-percha mass (0.89 ± 0.15 mg) and the highest canal wall cleanliness (95% ± 3%). The ultrasonic technique also showed effective removal capabilities with a mean remaining mass of 1.56 ± 0.22 mg and a cleanliness of 89% ± 4%. The rotary technique resulted in a mean mass of 2.47 ± 0.30 mg and cleanliness of 84% ± 5%. Gates-Glidden drill-assisted and heat-based techniques showed moderate performance with remaining masses of 3.18 ± 0.25 mg and 2.10 ± 0.20 mg, respectively, and cleanliness percentages of 78% ± 6% and 81% ± 5%. The control group had the highest remaining mass (9.88 ± 0.42 mg) and the lowest cleanliness (10% ± 2%), confirming the efficacy of the removal techniques. Conclusion: The solvent-based dissolution technique demonstrated superior efficacy in gutta-percha removal. Ultrasonic and rotary techniques were also effective choices. Clinicians should consider these findings when selecting gutta-percha removal methods for endodontic retreatment procedures. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Recent microbiological studies have expressed ever-increasing concerns about Candida albicans as a causal factor in the failure of endodontic treatments. Real-time quantitative polymerase chain reaction (qPCR), including the SYBR Green I system, is a technique in which a fluorescent dye is incorporated into the double-stranded DNA that is produced during DNA polymerase activity.Purpose: This study aimed to determine the relative prevalence of Candida albicans in root canals of retreatment cases and its association with endodontic symptoms.Materials and Method: In the present cross-sectional/analytical study fifty subjects were selected. Clinical features and radiographic status of the teeth were also evaluated. After access cavity preparation, the retrieved material and dentinal chips removed from the root canal were transferred into 1.5-mL microtubes, followed by storage at -20ºC until used for DNA extraction. A DNeasy Tissue Kit was used to extract DNA using the DNeasy protocol for animal tissues. Master Plus SYBR Green I (Jena Bioscience, Germany) was used in a Rotor-gene Real-time PCR System for real-time PCR. The relationship between the presence of Candida albicans and the clinical and radiographic features were analyzed using McNemar’s test.Results: There was a significant relationship between the radiographic findings in endodontically treated teeth and the presence of Candida albicans. However, there was no significant relationship between the presence of Candida albicans and any of the clinical symptoms.Conclusion: In spite of the limitations of this study, we concluded that Candida albicans was associated with root canal infections in endodontic retreatment cases, but there was no relationship with the clinical symptoms.

Statement of the Problem: Recent microbiological studies have expressed everincreasing concerns about Candida albicans as a causal factor in the failure of endodontic treatments. Real-time quantitative polymerase chain reaction (qPCR), including the SYBR Green I system, is a technique in which a fluorescent dye is incorporated into the double-stranded DNA that is produced during DNA polymerase activity. Purpose: This study aimed to determine the relative prevalence of Candida albicans in root canals of retreatment cases and its association with endodontic symptoms. Materials and Method: In the present cross-sectional/analytical study fifty subjects were selected. Clinical features and radiographic status of the teeth were also evaluated. After access cavity preparation, the retrieved material and dentinal chips removed from the root canal were transferred into 1.5-mL microtubes, followed by storage at -20ºC until used for DNA extraction. A DNeasy Tissue Kit was used to extract DNA using the DNeasy protocol for animal tissues. Master Plus SYBR Green I (Jena Bioscience, Germany) was used in a Rotor-gene Real-time PCR System for real-time PCR. The relationship between the presence of Candida albicans and the clinical and radiographic features were analyzed using McNemar’s test. Results: There was a significant relationship between the radiographic findings in endodontically treated teeth and the presence of Candida albicans. However, there was no significant relationship between the presence of Candida albicans and any of the clinical symptoms. Conclusion: In spite of the limitations of this study, we concluded that Candida albicans was associated with root canal infections in endodontic retreatment cases, but there was no relationship between root canal infections and the clinical symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Apical periodontitis is one of the common dental diseases. Microorganisms are the main reasons for these lesions; irrigations are used to remove them, but because of limited penetration, the rinsing agents may not always kill the microorganisms. Laser irradiation is effective in canal disinfection. The goal of this study was to compare the effect of calcium hydroxide (Ca(OH) 2 ) and diode laser on the improvement of apical periodontitis following root canal retreatment (RCR). Methods: Twenty-four teeth of 19 patients with periapical lesions which needed RCR were divided into two groups (Ca(OH) 2 and Ca(OH) 2 +laser irradiation [LI]). In the first session, after gutta-percha removal, cleaning, and shaping, Ca(OH) 2 was used for 10 days. In the second session, in the Ca(OH) 2 +LI group, the irradiation utilizing a diode laser (using non-initiated 200-µm fiber, continuous wave (CW), power output of 1W) was done. The periapical radiographic healing was assessed before the retreatment and after 3-month and 6-month follow-ups by periapical index (PAI) Qrstavik. The quantitative data were analyzed ( P <0.05). Results: The initial periapical lesion score was 3.75 and 3.88 in the Ca(OH) 2 and Ca(OH) 2 +LI groups, respectively. In the Ca(OH) 2 and Ca(OH) 2 +LI groups, 3 months after the RCR, the average periapical lesion score was 2.94 and 3.05, respectively. In the Ca(OH) 2 and CA(OH) 2 +LI groups, 6 months after the RCR, the average periapical lesion score was 1.80 and 1.75, respectively. No significant differences were found at the 3 and 6 months between the experimental groups. Conclusion: The diode laser can reduce the periapical lesion, but there was no significant difference between CA(OH) 2 +LI and Ca(OH) 2 at 3-month and 6-month follow-ups., Competing Interests: The authors deny any conflicts of interest., (Copyright © 2024 J Lasers Med Sci.)

Background: Despite the general guidelines for retreatment, differences in decision making exist for secondary endodontic treatment and may be related to many factors including education, clinical experience, dentist specialty, patient preferences and economic resources. Aim of the study was to evaluate the decision making of the Saudi Board in Restorative Dentistry (SBRD) senior residents in the endodontic retreatment of molar teeth as per the scientific guidelines of the American Association of Endodontists (AAE) and also to identify the causes of retreatment and measure how far they become deviated from their taught retreatment principles and inter-individual variability. Materials and methods: Case histories have been obtained from the files of cases treated in the SBRD Resident Comprehensive Case Archives in the SCHS from 2003 to 2015 in Riyadh region. The cases were only confined to Complex I and Complex II cases according to RDITN (Restorative Dental Index of Treatment Need), and seen by R3 and R4 residents only. Residents’ diagnosis was recorded as well as their treatment plan and any given notes regarding their decisions to retreat. Differences between the two groups (R3 and R4) residents and within the same group, regarding endodontic retreatment decisions and reasons for their treatment options were analyzed using Chi-Square test and Fisher’s Exact test. Results: The majority of residents in both R4 and R3 groups followed the recommended guidelines. R3 residents preferred to retreat all cases while R4 chose ‘no to retreat’ in few cases. Although R4 residents preferred nonsurgical retreatment more than R3 residents, the difference was insignificant. R4 residents preferred ‘no therapy’ or ‘follow up’ more frequent than R3 residents. Members of the R3 residents agreed more or less with each other as did those of the R4 residents without significant inter-individual variations within each group regarding the choice of retreatment). Conclusions: R4 residents appeared more likely, although not significant, to choose no retreatment or follow up than R3 residents. Conventional nonsurgical retreatment had the highest selection by both R3 and R4 residents. No significant inter-individual variations within each group regarding the choice of retreatment. There is a need to establish evidence based guidelines for more uniform management of failed root treated teeth.

Objective: The purpose of this in vitro investigation was to assess the effectiveness of various gutta-percha retrieval methods in endodontic retreatment., Methods: Five groups were randomly allocated to extract human teeth that had already had root canal therapy: manual files, rotary tools, heat, solvents, and ultrasonics. By evaluating the amount of filling material still present, gutta-percha clearance was quantitatively examined, and root canal cleanliness was qualitatively appraised. To compare the effectiveness of retrieval approaches, statistical analysis was done., Findings: Hand files, heat, and solvents were less effective than rotary devices and ultrasonics at removing gutta-percha ( P < 0.05). A quantitative investigation showed that the groups using rotary instruments (0.87 mm) and ultrasonics (0.68 mm) had much less gutta-percha left. The qualitative evaluation revealed that rotary instruments (2.12) and ultrasonics (2.45) had greater cleaning ratings compared to other methods., Conclusion: In conclusion, gutta-percha can be effectively removed during endodontic retreatment by using rotary tools and ultrasonics, which provide both quantitative efficiency and qualitative purity. The implementation of sophisticated retrieval procedures to maximize treatment results in clinical practice is supported by these findings., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: Endodontic retreatment is essential for periapical healing, involving the removal of inadequate fillings, thorough cleaning, and new filling application to prevent leakage. This study compares the dissolving abilities of Eucalyptus, Orange, and Castor oils in the re-treatment of resin-based endodontic fillings using conventional and rotary techniques., Methodology: Thirty single-rooted human teeth were prepared and filled with gutta-percha and AH Plus sealer. They were divided into three groups (n=10) based on the solvent used (Eucalyptus, Orange, or Castor oil) and further subdivided based on the techniques used (conventional and rotary). Standardised re-treatment procedures were performed, and the amount of residual material was measured., Results: A significant difference (p<0.001) was found among the groups, indicating that both the type of solvent and the technique significantly affected the amount of residual material. The rotary technique generally left less residual material compared to the conventional technique for all solvents. Eucalyptus oil with the rotary technique showed the least residual material (mean = 5.8), while Castor oil with the conventional technique showed the most (mean = 10.2)., Conclusion: Eucalyptus oil, especially when used with rotary techniques, is highly effective in removing resin-based endodontic fillings, providing a viable and safer alternative to traditional solvents. The study underscores the importance of selecting appropriate solvents and techniques for successful endodontic re-treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. S. Nialingappa Institute of Dental Sciences and Research Institutional Ethics Committee issued approval HKES/SNIDSR/IEC/SS/10/22. S. Nialingappa Institute of Dental Sciences and Research Institutional Ethics Committee reviewed and discussed your application to conduct clinical research and approved the trial to be conducted in its present form. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Siraparapu et al.)

Objectives: To evaluate and compare the efficacy of XP-endo Finisher R (FKG Dentaire, Le Locle, Neuchatel, Switzerland), EDDY (VDW Dental, Munich, Germany), and passive ultrasonic irrigation (PUI) as supplementary steps following the D-RaCe retreatment file system (FKG Dentaire) in the removal of root canal obturation material using cone beam CT., Materials and Methods: A total of 45 two-rooted permanent maxillary first premolars were selected. Following access preparation, cleaning, and shaping with Hero Shaper (Micro Mega, Besançon, BFC, France) rotary file up to 25/04%, thermoplasticized obturation was performed with TotalFill BC sealer (FKG Dentaire) and gutta-percha. The specimens were subjected to routine retreatment using the D-RaCe retreatment file system. Cone beam computed tomography (CBCT) and volumetric analysis were performed before and after this procedure. The samples were divided into group A (XP-endo Finisher R: n=15), group B (EDDY: n=15), and group C (PUI: n=15). Finally, a third CBCT was taken and a volumetric analysis was done. Statistical analysis was done using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA)., Results: The lowest mean residual volume of obturation material was seen with XP-endo Finisher R (1.6 mm 3 ), followed by PUI (1.7 mm 3 ). The EDDY showed the least efficiency in complete debridement of the root canals (3.6 mm 3 ). This difference in values was statistically significant., Conclusion: The XP-endo Finisher R and PUI showed superior performance than EDDY in the removal of remaining obturation material from the root canal system after retreatment with the D-RaCe retreatment file system. However, none of the systems were able to completely remove the root canal obturation materials., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Malabar Dental College and Research Center issued approval IEC/04/CONS-B/MDC/2020. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, N et al.)

Introduction: This study aimed to evaluate and compare postoperative pain (PP) in single-visit nonsurgical endodontic retreatment (SV NSER) with 2% chlorhexidine (CHX), 0.1% octenidine (OCT) with or without ozone, and 5.25% sodium hypochlorite (NaOCl)., Materials and Methods: In this randomized, parallel, prospective, double-blind, clinical trial, 132 single-rooted, root-filled teeth with symptomatic apical periodontitis (AP) requiring NSER were allocated into six groups randomly (n = 22/group): 2% CHX with NaOCl (CHXH), 2% Ozonated CHX without NaOCl (OCHX), 2% Ozonated CHX with NaOCl (OCHXH), 0.1% OCT with NaOCl (OCTH), 0.1% Ozonated OCT without NaOCl (OOCT), and 0.1% Ozonated OCT with NaOCl (OOCTH). Standard NSER protocol was followed groups were irrigated with 15 ml of ozonated or nonozonated irrigant (CHX/OCT) for 3-5 min with ultrasonic agitation. PP at baseline, after 6, 12, 24, 48 h, and 7 days was recorded using the Visual Analog Scale (VAS). Logistic regression of predictor variables was compared using the Chi-square test. For group-wise and time-wise comparisons, a two-way analysis of variance followed by the post hoc Bonferroni test was carried out., Results: None of the patient-related variables in logistic regression obtained a statistically significant (P > 0.05) role in PP. The VAS score after 6 h was OCHX (4.72) > OOCT (4.42) > CHXH (4.23) > OCTH (3.95) > OCHXH (3.42) > OOCTH (3.21). OOCTH and OCHXH groups demonstrated statistically significant reductions in VAS scores at various time intervals (P < 0.05)., Conclusion: SV NSER with ozonated OCT, CHX irrigation, and NaOCl resulted in lesser PP at all time intervals, i.e., 6, 12, 24, 48 h, and 7 days in patients with symptomatic AP., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Aim: To evaluate cleaning efficacy and debris extrusion of supplementary file systems XP Endo Finisher (XPEF) and XP Endo Finisher R (XPEFR) in endodontic retreatment., Materials and Methods: Thirty single-rooted teeth with single canals were selected, canal preparation done till file #30 6% and obturation completed using lateral condensation technique with AH Plus sealer. The samples were stored at 37°C in a 100% humidity incubator for 7 days. The samples were distributed across the three groups according to the method of retreatment ( n = 10): Group I: Neo Endo retreatment (NER) files, Group II: NER files + XPEF, and Group III: NER files + XPEFR. Removal of gutta percha using each file system according to the distributed groups was performed. The extruded debris was collected in an Eppendorf tube, dried in a hot air oven, and weighed. Teeth were sliced longitudinally using carborundum discs. Coronal, middle, and apical thirds were assessed for cleaning efficacy under a stereomicroscope. Results were tabulated and subjected to the statistical analysis using the Kruskal-Wallis H -test followed by post hoc turkey HSD test. All statistical tests were carried out at significance level P < 0.05., Results: It was seen that Group II (NER files + XPEF) exhibited better cleaning efficacy than Group III (NER files + XPEFR), although the results were not statistically significant. Greater debris extrusion was seen with Group III when compared to Group II., Conclusion: Supplementary files XPEF/XPEFR enhance the cleaning efficacy in endodontic retreatment, but the debris extrusion of XPEFR is more than XPEF., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Statement of the Problem: The success of root canal therapy depends on root canal irrigation, disinfection, and sealing of root canal. Wettability and roughness of root dentine surface are important factors in root canal disinfection and sealing.Purpose: This study aimed to assess the effect of chloroform application on roughness and wettability of the root canal walls in endodontic retreatment.Materials and Method: This in vitro experimental study evaluated 70 sound extracted human anterior teeth. The specimens were then randomly assigned to 7 groups as follows: Chloroform (group 1), 1g gutta percha+chloroform (group 2), 2g gutta percha+ chloroform (group 3), 1g gutta percha+ 1g sealer+ chloroform (group 4), 2g gutta perch+ 2g sealer+chloroform (group 5), 1g sealer + chloroform (group 6) and 2g sealer + chloroform (group 7). One drop of distilled water was placed on each tooth to measure the contact angle and wettability. Photographs were obtained of an area measuring 50×50 µm2 in three directions under an atomic force microscope to measure the roughness. The tooth blocks were exposed to the abovementioned mixtures for 10 min, and then rinsed with saline. The roughness and wettability of each sample were measured before and after treatment. Data was analyzed using one-way ANOVA and Tukey’s test.Results: The roughness of all groups significantly decreased following treatment, except for groups 1 and 4. The contact angle increased in all groups after treatment (except for the chloroform group), which indicated decreased wettability. The roughness and the contact angle have shown no correlation.Conclusion: Application of chloroform for removal of gutta-percha and sealer in endodontic retreatment decreases the roughness and wettability of dentine.

Background: Removal of the root canal filling material in the course of the endodontic retreatment is achieved by the use of various instruments and techniques. Purpose: The aim of this article is to systematically analyze published in vitro investigations over a five-year period of time (2018-2022), assessing the efficacy of the XP-Endo Finisher R file as a supplementary approach in orthograde endodontic retreatment. Materials and methods: The literature data was acquired through PubMed - MEDLINE, The Cochrane Library and Science Direct database and hand web search, then the articles were assessed by three independent reviewers. Results: An overall number of eighteen papers out of 108 titles met the eligibility criteria and were finally chosen for quantitative synthesis. Most of the studies affirmed the effectiveness of XP-Endo Finisher R by means of microcomputed tomography. Shaping with the file is not able to guarantee root canal walls free of remnants. Conclusions: XP-Endo Finisher-R is an effective supplementary approach in endodontic retreatment procedures. Nonetheless, it is rarely reported to achieve the complete removal of the root canal filling material. Micro-CT is a reliable, non-invasive analytical tool that can accurately measure the volume and the percentage of the remaining root canal fillings.

Introduction: Secondary endodontic infections present intricate challenges in dental practice, necessitating effective retreatment strategies. The current systematic review aimed to critically evaluate the outcomes of single‑visit versus multi‑visit endodontic retreatment in patients with secondary endodontic infections. Materials and Methods: The current systematic review was registered in the Open Science Framework database and followed the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses. Searches were conducted in PubMed/Medline, Scopus, and Web of Science databases for articles published until April 2023. The inclusion criteria for the current systematic review were clinical trials reporting the comparison of nonsurgical single‑visit versus multiple‑visit endodontic retreatments with predictive outcome. The Cochrane scale was used to assess the risk of bias. Results: Six studies were included in the systematic review. Four studies reported the incidence of postoperative pain, and two studies reported the periapical lesion healing after single‑ and multiple‑visit endodontic retreatments with an 18‑ and 24‑month follow‑up. Three studies showed a low risk of bias, one study showed unclear risk of bias, and two studies showed a high risk of bias. Conclusion: Comparative analyses indicated that single-visit endodontic retreatment yielded comparable postoperative pain levels and healing outcomes as retreatment conducted over multiple visits. Notably, the utilization of intracanal medicaments such as calcium hydroxide and triple antibiotic paste demonstrates promise in mitigating postoperative pain subsequent to retreatment procedures. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the antimicrobial efficacy of endodontic retreatment of patients with destructive forms of persistent periodontitis using a combined approach to disinfection of the root canal system and a hyaluronic acid medication.Materials and methods. Group № 1 – endodontic retreatment with root canal disinfection by Hypochloran-3; group № 2 – the same, but for root canal disinfection, first "Hypochloran-3" was applied, and then photodynamic therapy using a 662 nm diode laser and a photosensitizer "ELOFIT®"; group № 3 – in addition to the manipulations carried out in group № 2, of the "Revident" medication was injected twice in the projection of the apical part of the causative tooth. Antibacterial efficacy was assessed according to the results of microbiological studies of biological samples taken before and 2 weeks after endodontic retreatment. The identification of microorganism colonies was carried out by mass spectrometry.Results. In patients with destructive forms of persistent periodontitis, both before and after root canals disinfection, Enterococcus faecalis ranked the first in terms of the frequency of detection in biological samples, Candida albicans the second, and Veillonella parvula the third. At the same time, before the treatment of root canals, the predominance (more than 80%) of polymicrobial associations with their participation was shown. After root canal treatment, the number of obtained microorganism isolates in groups 1-3 significantly decreased: by 60.0%, 74.3%, and 76.0%. Against this background, the share of strict anaerobes and microaerophiles in groups 1-3 decreased: by 60.6%, 81.3%, and 78.1%. The share of facultative anaerobes also significantly decreased by 59.7%, 79.7%, and 83.8%.Conclusions. Endodontic retreatment of patients with destructive forms of chronic periodontitis using combined disinfection of root canals both without and in combination with a hyaluronic acid medication is accompanied by a statistically significant reduction in species diversity, associations, and content of periodontal pathogenic microbiota.

Introduction: The successful outcome of endodontic retreatment heavily relies on the thorough removal of root canal filling materials. This study aimed to quantitatively and qualitatively assess the efficacy of various retreatment file systems using nano-computed tomography (nano-CT) imaging. Materials and Methods: Thirty recently extracted human mandibular molars with mesial roots having curvatures <20° were chosen and sectioned to 16 mm in length. The root canals were prepared with the ProTaper Gold system up to size F2 and they were filled with gutta percha and AH Plus sealer. After obturation, all the samples were randomly assigned to two groups (n = 15 each) for retreatment: Group 1 utilized Solite RE Black retreatment files, while Group 2 employed Coltene HyFlex Remover files. Nano-CT imaging was employed to measure pre- and postoperative volumes of remaining filling material and remaining dentin thickness and the time taken for retreatment was measured in seconds. The obtained values were analyzed statistically (P < 0.05). Results: Nano-CT analysis showed a significant difference (P < 0.05) in the volume of remaining filling material between the Solite RE Black and Coltene HyFlex Remover groups. However, no significant difference was observed in the time required for gutta-percha removal. The Solite RE Black system showed comparatively less dentin removal than the Coltene HyFlex Remover system (P < 0.05). Conclusion: The Solite RE Black retreatment file system demonstrated promising efficacy in removing filling material while preserving dentin integrity compared to the Coltene HyFlex Remover system. These findings support its potential as an effective tool for endodontic retreatment, emphasizing the need for further clinical trials to validate its performance across various clinical scenarios. [ABSTRACT FROM AUTHOR]

Mandibular canines usually have one root with one root canal. However, variations may occur. The present study reports two cases of successful retreatment of two mandibular canines with two roots and two root canals, a rarer configuration. In both cases reported, the unsuccessful treatment in the primary endodontic intervention was due to overlooking the lingual root canals, which were identified when periapical radiographs were taken at a mesial angle. Because canals missed during endodontic therapy may lead to periapical periodontitis, it is important to take radiographs from different angles, analyze the pulp chamber floor, and consider the variations in root canal morphologies. After performing the access cavity and observing an isthmus in both cases, the lingual root canals were located and instrumented. Calcium hydroxide dressing was used between appointments, and the root canals were filled with different sealers in each case (epoxy resin-based and bioceramic sealers). The follow-up X-rays taken 18 months later in the first case and 5 months later in the second case suggested normality of the periapical tissues. It is essential to use strategies that enable reaching the whole complexity of the root canal system during the canal cleaning, shaping, disinfection, and filling procedures in order to control the infection and achieve a successful endodontic treatment outcome.

Introduction Non-surgical retreatment is seen as a conservative choice for dealing with recurrent infections, instead of opting for periapical surgery. The retreatment processes should be promptly and efficiently carried out, utilizing a suitable armamentarium. The objective of this experiment is to evaluate the quantity of root dentin that remains following the removal of gutta-percha (GP) from the root canal employing two distinct retreatment files. Materials and methods Sixty single-rooted teeth were selected for the examination. The process of shaping and cleaning was performed using the step-back approach, with a master apical file size of 40. The smear layer was effectively eliminated by rinsing with a solution of 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Paper points were employed to desiccate the canals. The obturation process involved the utilization of the lateral compaction technique with the AH Plus sealer (Dentsply Sirona, NC, USA). The teeth were classified into two groups: Group I (n=30) underwent retreatment using HyFlex Remover (Coletene India, Pvt., Ltd.), whereas Group II (n=30) received therapy with Solite RS3 retreatment files (Solite Dental in Chennai, India). The remaining dentin thickness (RDT) was assessed by cone beam computed tomography at levels 3, 6, and 9 mm from the cemento enamel junction after the removal of GP. The acquired data underwent examination using an independent t-test to determine statistical significance. Results The findings demonstrate that the utilization of Solite RS3 files led to a higher level of dentin thickness remaining at 3 mm, 6 mm, and 9 mm on the mesial side in comparison to HyFlex Remover retreatment files. The observed difference was found to be statistically significant at a significance level of p<0.05 on the mesial side. Nevertheless, there was no notable disparity seen between the two file types at these three levels on the distal side (p>0.05). Conclusion Based on the obtained results of the study, it can be concluded that Solite RS3 files show promise in preserving the RDT. However, further studies encompassing diverse parameters are needed to establish a conclusive and definitive conclusion., Competing Interests: Patent application number 202241008949 for Solite RS3 endodontic retreatment rotary file., (Copyright © 2024, Sankar et al.)

The present study aimed to evaluate the accuracy of four different Electronic Foraminal Locators (EFLs): Root ZX II (J. Morita, Tokyo, Japan), RomiApex A15 (Romidan, Kiryat-Ono, Israel), FinePex (Schuster, Porto Alegre, Brazil) and VDW Gold (VDW, Munich, Germany), in determining root length during endodontic retreatment steps. Twenty-seven human unirooted teeth had their crowns sectioned to standardize the teeth to 17 mm. The actual tooth length was visualized with an operating microscope and a #15 file juxtaposed to the apical foramen. Teeth were instrumented with files R25 and R40, and at the end of each instrumentation, measurements of root canal lengths were made with files #25 and #40. Then, the teeth had their root canals filled with standardized Gutta-Percha R40 cones and Endofill cement, and after seven days, they were uncovered with R25 and R40 files, respectively. New measurements were made with #25 and #40 files between the uncovering with each file. The data were statistically analyzed by ANOVA and Chi-square tests, considered significant when P <0.05. All devices tended to under-measurement when the obturating material was partially removed with the R25 file. When the canals were uncovered with the R40 instrument, the effectiveness of the appliances increased significantly ( P <0.05). At 0.40 mm diameter, the mean accuracy of the Romiapex A15 appliance was statistically lower than the other EFLs ( P <0.001), showing a tendency to over-measurement. In conclusion, all the tested appliances showed similar efficacy when acceptable limits were observed. The permanence of the remaining filling material in the apical third influenced the accuracy and efficacy of EFLs in endodontic retreatment cases. Key words: Endodontics, odontometry, apical foramen., Competing Interests: Conflicts of interest None declared., (Copyright: © 2024 Medicina Oral S.L.)

Context: Safe and efficient removal of all root filling materials from the root canal system without compromising radicular dentin structure is essential for optimal nonsurgical retreatment., Aims: The aim of this study was to evaluate and compare the incidence of dentinal defects caused during root canal filling removal using conventional, rotary, and reciprocating retreatment file systems., Settings and Design: A detailed protocol explaining purpose and procedures of the study was submitted to the Institutional Ethics Committee and ethical clearance obtained., Subjects and Methods: Sixty human maxillary permanent central incisors were collected and decoronated to 12-mm standardized length. The canals prepared up to a master apical file size F3 with Protaper hand files, obturated using AH plus sealer, examined under the stereomicroscope (×40 magnification): Group I: Control ( n = 15), Group II: Conventional ( n = 15), Group III: Protaper Universal Retreatment Files ( n = 15), and Group IV: Reciproc Blue ( n = 15). After instrumentation, teeth were sectioned at 3, 6, and 9 mm from the apex to evaluate the presence of dentinal defects under the stereomicroscope., Statistical Analysis Used: Statistics were performed using the SPSS, version, 25 (SPSS Inc., Chicago, IL, USA). Initially, normality test was done using the Shapiro-Wilk test and data were not normally distributed followed by Kruskal-Wallis test. P < 0.05 is considered statistically significant., Results: Maximum percentage increase in dentinal defects was observed in Protaper Universal Retreatment Files followed by Conventional method and Reciproc Blue., Conclusions: Significantly Reciproc Blue reduced the incidence of dentinal defects after root canal preparation., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Context: Complementary procedures have been proposed to improve the endodontic retreatments., Aim: The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment., Methods: Thirty-six mesial roots of the lower first molars were divided into four groups ( n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group., Results: Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers ( P < 0.05)., Conclusion: Both complementary cleaning procedures promoted dentin wear and must be used cautiously., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Non-surgical endodontic retreatment is a reliable conservative option for managing post-treatment apical periodontitis. However, effective microbial control, based on the maximization of filling removal and disinfection protocols, is not yet predictable. Traditional gutta-percha solvents, which are indistinctively used for both the core and sealer filling materials, became obsolete due to unprecedented advances in endodontic technology. Nonetheless, microtomography, scanning electronic microscopy findings, and histobacteriological analysis tend to confirm the persistence of filling materials and the lack of association between root canal enlargement and superior disinfection. There is a controversy regarding the most suitable clinical protocols surrounding the shaping procedures and the supplementary disinfection steps. Based on the literature and the previous work of the team, the authors aimed to summarize the current knowledge regarding specific solvent formulations that target filling materials. Additionally, the advantage of an additional irrigation step to optimize disinfection was highlighted. This adjunctive procedure serves a dual role in the dissolution of filling materials, and in conferring an antibiofilm effect. Further research is needed to understand the novel contribution of these strategies upon clinical practice outcomes.

Statement of the Problem: The success of root canal therapy depends on root canal irrigation, disinfection, and sealing of root canal. Wettability and roughness of root dentine surface are important factors in root canal disinfection and sealing. Purpose: This study aimed to assess the effect of chloroform application on roughness and wettability of the root canal walls in endodontic retreatment. Materials and Method: This in vitro experimental study evaluated 70 sound extracted human anterior teeth. The specimens were then randomly assigned to 7 groups as follows: Chloroform (group 1), 1g gutta percha+chloroform (group 2), 2g gutta percha+ chloroform (group 3), 1g gutta percha+ 1g sealer+ chloroform (group 4), 2g gutta perch+ 2g sealer+chloroform (group 5), 1g sealer + chloroform (group 6) and 2g sealer + chloroform (group 7). One drop of distilled water was placed on each tooth to measure the contact angle and wettability. Photographs were obtained of an area measuring 50×50 µm2 in three directions under an atomic force microscope to measure the roughness. The tooth blocks were exposed to the abovementioned mixtures for 10 min, and then rinsed with saline. The roughness and wettability of each sample were measured before and after treatment. Data was analyzed using one-way ANOVA and Tukey’s test. Results: The roughness of all groups significantly decreased following treatment, except for groups 1 and 4. The contact angle increased in all groups after treatment (except for the chloroform group), which indicated decreased wettability. The roughness and the contact angle have shown no correlation. Conclusion: Application of chloroform for removal of gutta-percha and sealer in endodontic retreatment decreases the roughness and wettability of dentine. [ABSTRACT FROM AUTHOR]