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Abstract Background Endodontic surgical procedures, when performed, require retrograde filling materials that are biocompatible, non-toxic, non-irritant, dimensionally stable, and ideally promote bone formation. Precise evaluation of retrograde filling materials in clinical trials is necessary to give holistic view for properties of material and potential outcome from its use. The purpose of this review is to evaluate the effect of retrograde material type and surgical techniques on the success rate of surgical endodontic retreatment. Methods An electronic search was performed in the time frame between 1st of January 2000 to 1st of September 2020 using database. Sources Web of Science, PubMed and redundant hand searches through their references. Seven inclusion–exclusion criteria were set for the selection and identification of relevant articles. Risk of bias was conducted for the included studies. Results Nine randomized clinical trials (RCTs) fulfilled the inclusion criteria for this systematic review. The outcome of this review revealed that none of the reviewed trials totally-fulfilled CONSORT 2010 criteria. Conclusions In light of the outcome of this review, there is no enough evidence to support the superiority of certain retrograde filling material or surgical technique over another in the success rate of surgical endodontics retreatment. The variety of methodologies and strategies, such as patient selection, the method of treatment and study analysis, led to doubtful credibility of the obtained clinical evidence. Further prospective randomized controlled clinical trials evaluating the specific effect of the various used materials are needed.

Aim. To assess the need for repeated endodontic treatment and to determine the possible reasons for the repeated revision of the root canals according to the archival material of the state polyclinic in the period 2015-2020.Materials and methods. Archival data of the registry of the state polyclinic in the period from 2015 to 2020, containing information on repeated endodontic treatment, namely: data on the treatment of patients and the condition of their teeth with apical periodontitis on the admission of CHI, repeated revision of root canals, method and means of mechanical and drug treatment of canals, filling material before and after the revision of root canals, X- rays at all stages of treatment with their description. In accordance with the purpose of the study, descriptive statistics were carried out, the data that were obtained as a result of processing information on the material of the archive of the dental clinic were analyzed and described, absolute frequencies and their proportions were indicated, which are shown in the diagrams, it was done in the Microsoft Excel program.Results. In 505 teeth (54%), the root canals were obturated with resorcinol - formalin paste, most of the root canals of the teeth - 373 (40%) were sealed at half their length, on sighting radiographs in 80% of cases an expansion of the periodontal gap was revealed, in addition to destructive changes in bone tissue, basically all cases were treated under a temporary calcium- containing paste, 4% of the root canals of the teeth (35) were not obturated with permanent material, due to the absence of patients, 5 teeth (0.5%) underwent surgical treatment. Of all the cases identified, only 1% (10 cases of repeated endodontic treatment) have information about long-term results, which are positive.Conclusions. Thus, a complex of factors contributes to the occurrence of apical periodontitis, and the selection of one of them, as the main one, will not solve the problem of this complication. Dentists - therapists should focus their attention at each stage of primary and/or repeated endodontic treatment, adherence to the irrigation protocol, mechanical treatment of root canals, high- quality obturation, and most importantly, motivate patients to follow- up visits and control long-term treatment results through computed tomography and control sighting pictures.

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used., Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer., Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device ( P <0.001)., Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device., Competing Interests: None.

The aim of the study was to evaluate the impact of kinematics and irrigation protocols on the extrusion of apical debris during removal of different obturation techniques. A total of 144 single-rooted teeth were instrumented and obturated with Thermafil+AH Plus, Thermafil+AH Plus Bioceramic and single gutta-percha cone+AH Plus Bioceramic. Samples were divided according to the retreatment kinematics: continuous rotation or Jeni motion. Each sub-group was subjected to conventional irrigation or irrigation activated by EDDY. Extruded debris was collected in Eppendorf tubes, weighted and retreatment time was digitally recorded. Data were analysed with two-way ANOVA (p < 0.05). Debris extrusion was not significantly different between all groups. EDDY activation system and CanalPro Jeni required significantly longer time compared with other groups to remove Thermafil+AH Plus and single cone+AH Plus Bioceramic. Within current limitations, obturation technique, irrigation protocol and kinematics tested had no influence on apical extrusion debris, while they significantly impacted the retreatment time., (© 2023 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Introduction: This systematic review investigates the crucial need for solvent use in root canal retreatment, as it effectively removes filling materials, reduces apical debris extrusion, and alleviates postoperative pain, ultimately enhancing treatment success. The review aims to assess the success rates, compare outcomes, explore benefits and drawbacks, and identify subgroups where solvent use may be more effective during root canal retreatment., Materials and Methods: The search was performed in PubMed Central, Scopus, Cochrane, LILAC, ScienceDirect, Google Search, Web of Science, and manually using the search items alone and in combination by means of PUBMED search builder. The studies were assessed for eligibility according to the eligibility criteria by two independent reviewers. Groups containing solvent with nonsolvent groups and randomized control trials were included and in vitro studies, retrospective studies, and animal studies were excluded from the study. Quality assessment was performed using the risk of bias (RoB) 2.0 tool., Results: Out of the 596 articles obtained, 14 were shortlisted for full-text reading and finally two articles were included in the study. The studies were assessed for quality, and data were extracted in a tabulated form. Overall RoB is low, but due to the lack of homogeneity, meta-analysis could not be conducted., Conclusion: The use of solvent does not cause any significant difference in the postoperative pain levels or analgesic intake for retrieval of gutta-percha in cases of root canal retreatment. Due to the limited number of studies available and the lack of clinician-related outcomes such as time taken to retrieve the gutta-percha, these results should be taken into consideration with caution., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Conservative Dentistry and Endodontics.)

Aim. Optimization of an endodontic retreatment by performing the following tasks, including the selection of an optimal and safe solvent.Materials and methods. In order to choose the most suitable solvent for the problem, an experiment was conducted with clove, mint, eucalyptus, orange, and grapefruit oils. The surface tension coefficient was measured by the Rebinder apparatus. In order to justify the choice of an effective essential oil, as well as the dissolving ability and the absence of solvent and debris after irrigation with sodium hypochlorite in the root canal, a tube-shaped electron scanning microscopy was performed.Results. Grapefruit oil has the most dissolving activity (p < 0.05). In addition to the solubility of the filler and siller, grapefruit essential oil is able to dissolve the smear layer.Conclusion. Optimization of the endodontic retreatment with root canals previously filled with gutta-percha, is possible using essential oils, however, a grapefruit oil is the most effective.

Aim: The purpose of the present study was to compare the efficacy of three different file systems in removing gutta-percha during endodontic retreatment with or without solvents., Materials and Methods: The current study used 120 freshly extracted, single-rooted human mandibular premolars extracted for orthodontic procedures. The canal was prepared utilizing the step-back technique and obturation was done. The samples were allocated into three experimental groups at random, group I: Hedstrom Files, group II: D-RaCe rotary system, and group III: Mtwo retreatment files system. The three groups were again split into two subgroups of 20 samples each, i.e., with solvent and without solvent. Then, a stereomicroscope with a magnification of × 20 was used to examine the samples. The amount of GP and sealer left was measured in three sections: At apical third (1 mm above the apex), middle third (8 mm from the apex), and coronal third (2 mm below the cementoenamel junction). The obtained data were analyzed using parametric Analysis of Variance (ANOVA). p -values less than 0.05 were considered significant., Results: The overall least debris on the dentinal surface was found in the middle third with/without solvent. The D-RaCe rotary system was 1.24 ± 0.11 and 1.44 ± 0.14, Mtwo retreatment files system was 1.38 ± 0.17 and 1.72 ± 0.09 and Hedstrom files was 2.08 ± 0.21 and 2.18 ± 0.16 respectively and A significant difference was found between the three different file system groups ( p < 0.001)., Conclusion: The current study concluded that, when combined with a solvent, the D-RaCe rotary retreatment system is more effective than the Mtwo rotary retreatment system and Hedstrom Files in removing gutta-percha and sealant from root canal walls., Clinical Significance: When it comes to treating chronic infections, non-surgical retreatment is a more cautious method than periapical surgery. Retreatment should be performed efficiently and with appropriate instruments to ensure effective treatment.

Aims: To evaluate and compare the treatment outcome of root filled teeth with apical periodontitis treated either non-surgically or by endodontic microsurgery, and to assess the influence of an intra-radicular post, clinical and demographic factors., Methodology: Clinical and radiological data from 1157 patients with apical periodontitis in previously root filled teeth treated by postgraduate students at the Department of Endodontics, University of Oslo, between September 2010 and January 2020 with recall data at least 11 months from completion were studied. Surgical cases were scored using the Rud/Molven criteria and grouped into success, uncertain or failure at control. Non-surgical cases were scored with the periapical index (PAI) and similarly grouped into success, uncertain or failure at control. Chi-square analyses were used for comparison of subgroups of teeth treated and logistic regression analyses for assessment of the influence of clinical variables., Results: Non-surgical retreatment was performed on 351 teeth and 107 teeth were treated with endodontic microsurgery, with overall success rates of 65.5% and 77.6%, respectively. The difference was statistically significant. Teeth with an intra-radicular post treated non-surgically (n = 30) were successful in 73.3% of cases, whereas teeth with intra-radicular post treated with endodontic microsurgery (n = 30) had a lower, 66.7% success rate. The distribution of tooth groups (anterior, premolar and molar) differed significantly between surgical and non-surgical cases, with maxillary anterior and premolar teeth more often treated surgically. Non-surgical retreatment cases were significantly influenced by patients' age (older patients had poorer outcome) and pre-operative PAI score (negatively correlated with outcome). Surgical cases were not significantly influenced by the factors studied here., Conclusions: The tooth type differed significantly for teeth treated by surgical versus non-surgical methods. Microsurgical treatment with apicectomy and retrograde filling showed significantly better treatment results than non-surgical retreatment of teeth with apical periodontitis, whereas treatment outcome in teeth with posts after non-surgical treatment tended to be better than after surgical treatment. Outcome of non-surgical retreatment was negatively influenced by older age and higher pre-operative PAI score., (© 2023 British Endodontic Society. Published by John Wiley & Sons Ltd.)

Continuing pain after root canal treatment, swelling, the occurrence of fistulous, the severity of periapical changes are the indications for repeated endodontic treatment. Mineral trioxide aggregate (MTA) is a reliable bioactive material proposed for widespread use in endodontics, in particular as an obturation material. The article contains a review of the literature on the use of MTA as an intracanal filling material, a comparison of the clinical effectiveness of the methods and principles of its placement, a description of the results of treatment of apical periodontitis. A technique and clinical cases of MTA use in conjunction with thermocompaction of gutta-percha. A new technique combining materials, which can increase positive outlook during the endodontic retreatment.

Introduction: Fiberglass Posts (FGPs) associated with composite resin foundation materials have become the primary alternative to restoring teeth with root canal treatment presenting excessive coronal destruction. Despite technical evolution, loss of retention between FGP and root dentine continues to be reported. Aim: To examine the effect of endodontic retreatment protocols on the bond strength of FGP to radicular dentine. Materials and Methods: This in-vitro study was conducted at Evangelical University of Goiás, Brazil from August 2019 to June 2020. A total of 30 freshly extracted bovine incisors were instrumented, filled and distributed into three experimental groups with 10 incisors in each groups. Group 1 was control, group 2 had incisors with gutta-percha removed using K-type files and group 3 had incisors with gutta-percha removed using ProTaper Universal Retreatment instruments. After root canal retreatment and re-sealing, the fiber posts were cemented into prepared post spaces using a resin-based cement. Roots were transversally sectioned into six 1 mm thick specimens. The push-out test was performed, and the modes of failure were evaluated. Data were analyzed with two-way Analysis of Variance (ANOVA) and Tukey’s test. Results: There was no significant difference between the mean bond strength values in group 1, 2 and 3 with p-value>0.05. The cervical third of root canal presented higher bond strength values compared with the middle and apical thirds. However, significant differences were observed only for the control group (p-value=0.005). Adhesive failure between resin cement and radicular dentine was the most prevalent type of failure. Conclusion: The endodontic retreatment protocol did not influence the bond strength of FGP to radicular dentine.

Endodontics is the science and art that involves the etiology, prevention, diagnosis, and treatment of pathological changes of the dental pulp and its repercussions in the periapical region and, consequently, in the body. The performance of an endodontic treatment implies a series of phases that, clinically, imposes on the professional basic biological knowledge, clinical experience, appropriate equipment, and instruments, otherwise, the apparently simple treatment can become difficult and often impractical. However, it is perceived that professional conducts, errors in diagnosis and failures in techniques during treatment are factors that can also increase the chances of failures in endodontic treatment. Parendodontic surgery emerges as a safe and appropriate surgical procedure for the treatment of teeth with periapical lesions, which do not respond to conventional endodontic treatment, or when retreatment is not possible to be performed. Parendodontics is a surgical technique that should be considered as a treatment option to solve periapical problems. Such a procedure is an alternative to avoid tooth extractions, being a treatment option when the conservative endodontic procedure has failed. [ABSTRACT FROM AUTHOR]

Introduction. Endodontic retreatment is a complex intervention that requires detailed analysis of possible reasons for failure, and flawless practical execution of the procedure. Objective. The aim of the study was to assess the outcome of endodontic retreatment based on clinical and radiographic criteria after a two-year observation period. Methods. Clinical study included 49 teeth indicated for endodontic retreatment based on periapical index (PAI). All teeth were divided into two groups. Group I comprised teeth without any periapical lesion (PAI score of 1 and 2) while Group II consisted of teeth with visible periapical radiolucency (PAI score of 3, 4, and 5). Endodontic retreatment was completed in two visits with inter-appointment medication of 2% chlorhexidine and calcium hydroxide for two weeks. Outcome of endodontic retreatment was evaluated 12-24 months after final obturation. Results. Endodontic retreatment was successful in 93.3% in Group I after 24 months. In Group II, successful treatment and complete healing was found in 52.9% of teeth, whereas 14.7% of teeth showed only partial healing. However, clinical symptomatology was not present in any of the cases. Considering the absence of clinical signs and subjective symptoms, retreatment was successful in 67.6% of cases where chronic periapical inflammation was present. Conclusion. Endodontic retreatment was successful in high percentage in teeth with and without periapical lesions.

Introduction The aim of this study was to investigate the solubility of gutta-percha points and various endodontic sealants in essential oils. Materials and method Ninety-six gutta-percha points were divided into the four groups of 24 samples for every essential oil and subsequently divided into the three subgroups corresponding to the immersion times (2,10 and 15 min). The post-immersion amount was obtained for each. Endodontic sealers AHplus, Acroseal, Endomethasone N were included in the research. Samples were treated with corresponding oil for 10 min. Each sample was measured and the amount was obtained. Results Orange oil was the most effective in dissolving gutta-percha compared to other tested essential oils (p < 0.05). Eucalyptol was more effective in dissolving gutta-percha than tea tree after 10 min (p < 0.05). There was no statistical significance in the effectiveness of essential oils in relation to the time of action (10 or 15 minutes) (p > 0.05). Most weight loss was recorded with Endomethasone for all solvents, but the highest in orange oil and tea tree, followed by eucalyptus and clove oil. Tea tree dissolved AH Plus more efficiently compared to Acroseal. Conclusion Essential oils showed promising results in dissolving gutta-percha and sealers.

Aim: The targets of the endodontic therapy are damaged tissue and bacteria removal from the canals and dentinal tubules and the prevention of recontamination after the treatment. Introduction: Correct endodontic treatment has to follow several parameters: proper diagnosis, isolation of operating field, full chemo-mechanical preparation of the complex endodontic system, three-dimensional obturation of the root canals, post endodontic restoration. Respecting all these parameters short and long term success can be achieved. Materials and methods: In this article an orthograde retreatment of maxillary first molar has been described, which showed at pre-operative X-ray, an incongruous endodontic therapy, the failed finding of the fourth canal and the presence of periapical lesions. Discussion: A high percentage of failures is due to missed root canals and therefore not cleansed, shaped and it is essential to use modern technologies to achieve safe and reproducible results. Conclusions: The endodontic retreatment of this right maxillary first molar was performed with the proper protocols and sophisticated tools, with which we can achieve success in the short- and long-term treatments.

Aim: to evaluate the amount of debris extruded apically as well as the time needed for removal of root canal filling material using ProTaper, MTwo, REndo NiTi rotary retreatment systems and hand files.

Resumen Las evaluaciones radiográficas de tratamientos endodónticos realizadas por graduados muestran un alto porcentaje de procedimientos incorrectos. Esta circunstancia lleva a la realización de un elevado número de retratamientos ortógrados y retrógrados, con los inconvenientes y desventajas que conlleva recurrir a una reintervención endodóntica. Es responsabilidad de los profesionales, docentes y autoridades universitarias y gubernamentales revertir esta situación que afecta a la salud bucal de la sociedad. En el presente editorial se proponen diferentes alternativas para intentar modificar este preocupante panorama. Palabras clave: Endodoncia, evaluación radiográfica, retratamientos endodónticos, tratamientos endodónticos// Abstract radiographic evaluations of endodontic treatments performed by graduates show a high percentage of incorrect procedures. this circumstance leads to the performance of a high number of orthograde and retrograde retreatments, with the inconveniences and disadvantages that entails resorting to an endodontic reintervention. it is the responsibility of professionals, teachers, university and government authorities to reverse this situation that affects the oral health of society. in this editorial, different alternatives are proposed to try to modify this worrying outlook. Key words: Endodontics, endodontic retreatments, endodontic treatments, radiographic evaluation.

Aim: To alleviate the patient's symptoms and promote periapical healing in teeth with failure of root canal treatment, without the removal of previous obturating material using lesion sterilization and tissue repair (LSTR) 3 MIX-MP noninstrumentation endodontic treatment (NIET). Materials and Methods: Fifteen single-rooted teeth with a history of root canal treatment 1–2 years previously, requiring retreatment, with pain, sinus tract, swelling and periapical lesions, and having acceptable obturation were included in the study. The previous coronal restoration was removed, and a medication cavity was prepared for placement of 3MIX MP; this was followed by lining with Glass ionomer cement and a coronal restoration with composite resin. Results: At 8 weeks, all patients did not have either pain, tenderness on vertical percussion, pain on biting, or swelling (asymptomatic). Radiographically, the periapical lesions had reduced by 1 mm in five cases. In six patients, the lesion size remained unchanged. Conclusion: LSTR NIET is an excellent, inexpensive, less traumatic, and least time-consuming alternative to treat symptomatic teeth requiring endodontic retreatment.

Aim: Orthograde retreatment after failed apicectomy maybe a treatment alternative to endodontic resurgery. The purpose of this study was to examine the clinical outcome of orthograde endodontic retreatment after failed apicectomy. Methodology: Success was rated radiographically in 191 cases of orthograde retreatment after failed apicectomy that were treated in a private practice with a documented recall of at least 12 months. The radiographs were rated individually by two observers, in cases of disagreement a consensus was reached by joint discussion with a third observer. Success or failure were evaluated according to previously described criteria. The success rate and the median survival were calculated using the Kaplan–Meier survival analysis. The log rank test was used to evaluate the effect of prognostic factors/predictors. Hazard ratios of predictors were analysed using Univariate Cox Proportional Hazard regression analysis. Results: The mean follow‐up of the included 191 patients (124 females, 67 males) was 32.13 (±23.68) months and the median was 25 months. The overall recall rate was 54%. Cohen Kappa analysis revealed nearly perfect agreement between both observers (k = 0.81; p = 1.0). The overall percentage of success was 84.82% (complete healing 79.06%, incomplete healing 5.76%). The median survival was 86 months (95% CI: 56–86). None of the selected predictors had an influence on the treatment outcome (p >.05). Conclusions: Orthograde retreatment should be considered a valuable treatment option after failed apicectomy. A surgical endodontic retreatment can still be a treatment option after orthograde retreatment to obtain outcome for the patient. [ABSTRACT FROM AUTHOR]

Perforation teeth are considered the second most important cause of failure of endodontic treatment. The article puts forward a method of repeated endodontic treatment with «Osteoplast» material application for retreatment of chronic destructive forms of periodontitis, complicated with tooth perforation. We have treated 25 people with chronic destructive periodontal disease at the age of 25-35 years of age with a history of endodontic intervention. The efficiency of application of the proposed comprehensive treatment.

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., (© 2023 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)