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Abstract Background Evaluating the effect of different obturation techniques on postoperative pain level and radiographic healing on non-surgical endodontic retreatment (NSER) applied in a single visit in teeth with a single root canal and apical periodontitis (AP). Materials and methods Sixty-three teeth from 50 systemically healthy patients (mean age 34.19 ± 9.75 years; 27 women, 23 men) were included in the study. Residual root canal filling materials were removed. All teeth were randomly divided into three groups according to the obturation technique: cold lateral compaction (CLC), continuous wave compaction (CWC), and thermoplasticized gutta-core (TGC). Pain status was evaluated using the Numerical Pain Rating Scale (NRS) in all cases. Periapical index (PAI) scores were recorded in preoperative and postoperative 6-month on the periapical radiographs. Data were analyzed as statistically (IBM, Armonk, NY, USA). The significance level was determined as p 0.05). There was no difference in the PAI scores recorded at six months between obturation techniques for all periods (p > 0.05). Similar radiographic improvement was observed in all obturation techniques at 6-months (p > 0.05). Conclusion CLC, CWC, and TGC root canal obturation techniques were found to have similar efficacy after NSER in a single visit in teeth with AP at six months. Trial registration The research was retrospectively registered on the website www.clinicaltrials.gov with the registration number NCT06226740 on 26/01/2024.

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.

Abstract Background Infected dentinal tubules are a possible source of bacteria that are responsible for the failure of root canal treatment. Therefore, disinfection of dentinal tubules by increasing the penetration of the irrigation solution is important for success in retreatment cases. This study utilized confocal laser scanning microscopy (CLSM) to assess and compare the impact of XPR, ultrasonic irrigation (UI) and sonic activation (SA) on NaOCl penetration into dentinal tubules following endodontic retreatment. Methods A total of forty mandibular premolars were enrolled in this investigation. Following root canal preparation up to ProTaper X3 file (30/0.07), root canals were obturated with gutta-percha and bioceramic root canal sealer with single cone technique. The root canal filling materials were removed using ProTaper nickel-titanium rotary retreatment files until the working length was reached. The retreatment procedure was finalized using the ProTaper Next X4 (40/0.06). The teeth were divided into four groups based on the irrigation activation technique: control (conventional needle irrigation), SA, UI and XPR. During the final irrigation procedure, Rhodamine B dye was introduced to 5% NaOCl for visualization via CLSM. Subsequent to image acquisition, the maximum penetration, penetration percentage, and penetration area were calculated. Data were statistically analyzed using the Kruskal-Wallis, Friedman, and Bonferroni Dunn multiple comparison tests through R software (p

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.

Abstract Background This randomized clinical trial aimed to evaluate the effect of intracanal cryotherapy with 2–4 °C normal saline irrigation on post-operative pain after single-visit non-surgical root canal retreatment. Methods Forty-six single-rooted, single-canal teeth requiring non-surgical root canal retreatment were randomly assigned to two groups (n = 23): a cryotherapy group and a control group. All the treatments were completed during a single visit. A combination of nickel-titanium and stainless-steel files was used for the removal of gutta-percha and root canal preparation, and irrigation was performed using 5.25% NaOCl and 17% EDTA. The cryotherapy group had a final irrigation temperature of 2–4 °C for 5 min before root canal obturation, whereas the control group received irrigation at room temperature. Post-operative pain levels were assessed via the Numerical Rating Scale at 6, 18, 24, 48, 72, and 168 h (up to 7 days). The number of analgesics consumed at the same intervals was also recorded. Statistical analysis was performed using the Chi-Square test, Mann-Whitney test, and Independent Samples test, with the significance level set at 0.05. Results There was a statistically significant difference in post-operative pain between the cryotherapy group and the control group at 6 h after treatment (P 0.05). Additionally, there was no statistically significant difference between the groups in terms of analgesic intake (P > 0.05). Conclusion Intracanal cryotherapy can effectively reduce short-term post-operative pain, but it has no effect on long-term pain or the need for analgesics.

Abstract The root canal systems of maxillary first molar (MFM) and maxillary second molar (MSM) variations represent a clinical challenge for endodontists, especially the prevalence of fused C-shaped roots. Having a thorough knowledge of root canal configuration is an extremely important point for a successful root canal treatment to avoid missing extra canals. The aim of this article was to present 2 cases of maxillary molar with an unusual C-shaped configuration diagnosed during root canal retreatment/treatment and conduct a literature review of the MFM and MSM anatomy. Case 1 reports that three separate palatal root canals fused into a C-shaped configuration in the MFM, which with an enamel pearl in the furcation, was classified as Type D and first reported in MFM. Case 2 reflects the fusion of all three buccal canals of the MSM into a C-shaped configuration that finally formed an apical foramen with a supernumerary tooth, and the configuration was Type B. Evaluation at an 18-month and a 9-month recall revealed that two patients were symptom-free after the conduct of a non-surgical retreatment/treatment, and the X-ray revealed normal periapical tissue. In addition, the thickness of the Schneiderian membrane due to odontogenic maxillary sinusitis returns to normal after an effective retreatment in case 1. These reports serve to remind endodontists of the importance and complexity of anatomical variations, which should always be considered when formulating an effective root canal treatment plan. The combined use of cone-beam computerized tomography (CBCT) and a dental operating microscope (DOM) will be profitable to locate and identify extra canals when a periapical radiograph shows signs of an unusual canal morphology.

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 Background To evaluate the accuracy of the electronic apex locators (EALs), and Cone-Beam Computed Tomography (CBCT) scanning, both in working length (WL) determination and in the detection of root canal perforations in retreatment cases. Methods Sixty human mandibular premolars were selected. After crown removal partially and canal access, root canals were instrumented and irrigated. The obturation process utilized gutta-percha and sealer with warm vertical compaction. Two groups were distinguished: one without perforation (Group 1) and the other with an apical third perforation (Group 2). Retreatment included filling removal, apical preparation, and irrigation. Actual working lengths (AWL) were determined using a stereomicroscope. CBCT images were used to measure CBCT working length (CWL), with adjustments for optimal views. Propex II and Dentaport ZX were used to measure electronic working length (EWL). Differences between EWL and AWL, as well as CWL, were analyzed to gauge accuracy. Data underwent Two-way ANOVA analysis. Measurements within ± 0.5 and ± 1 mm tolerance ranges were deemed successful for each device, followed by applying the Pearson Chi-square test. Results The study reveals no significant inter-group variations in device performance (p > .05). Dentaport ZX missed detecting perforation in two Group 2 (apical perforation) cases. For ± 1 mm tolerance, Propex II displayed the highest success in Group 2 (apical perforation). Conclusion This study demonstrates the comparable performance of Propex II, Dentaport ZX, and CBCT in endodontic retreatment, providing insights into diagnostic reliability.

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.

الخلاصة: الهدف: الهدف من هذه الدراسة هو مقارنة فعالية المبارد اليدوية نوع هيدستروم و بين مبارد البروتيبر المستخدمة في علاج وإعادة علاج الجذور، في إزالة اقماع الجوتابيركا أثناء إعادة المعالجة اللبية باستخدام تقنية التصوير الإشعاعي الرقمي. الطرق: هذه الدراسة تمت خارج الأجسام الحيه / دراسية مختبريه، استخدمت تقنية أخذ العينات المتتالية غير الاحتمالية. واستُخدمت الدراسة ستين من الأسنان الأمامية الدائمة احادية الجذور ذات القنوات المستقيمة. بعد تحضير الاسنان تم حشو القنوات واروائها بأقماع الجوتابيركا ومالئ الفجوات ومن ثم تم الاحتفاظ بها لمدة اربعة عشر يوما في بيئة رطبة في درجة حرارة ٣٧ مئوية. ثم تم اختيار ثلاثة وثلاثين من الاسنان بصورة عشوائية لمجموعتي المراقبة (المجموعة الأولى) والمجموعة التجريبية (المجموعة الثانية). تمت عملية إزالة الجوتابيركا بمبارد الهيدستروم اليدوية في المجموعة الاولي ومبارد البروتيبر الممكنة المستخدمة في علاج الجذور وإعادة علاج الجذور في المجموعة الثانية. وتم الحصول على إشعاعات رقمية باستخدام برنامج كيرستريم ( كودك) إصدار رقم RVG VER.6.10.8.3-A ، وجرى تحليلها لمعرفة الفرق بين الشوائب التي تمثل بقايا الجوتابيركا. واستُخدم برنامج AutoCAD 2006 في توضيح قنوات الجذور وبقايا حشوات الجذور. واستُخدم اختبار العينة المستقلة t لمقارنة مجموع ما تبقى من الجوتابيركا في كلتا المجموعتين. النتائج: لم تتم ملاحظة أي فروق ذات دلالة إحصائية في بقايا حشو العصب باستخدام الطرق المختلفة التي تم اختبارها ومقارنتها. في كلا المجموعتين، كان الجزء المتبقي من حشو العصب محصورًا في الثلث الاسفل من الجذور. الاستنتاجات: تعد مبارد البروتيبر الممكنة ومبارد الهيدستروم اليدوية فعالة بنفس القدر لإزالة حشو العصب من الاسنان احادية الجذور ذات القنوات المستقيمة. Abstract: Objective: This research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. Methods: This ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. Results: The remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. Conclusions: Pro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.

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.

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. [ABSTRACT FROM AUTHOR]

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.

This study evaluated the reliability of sealer penetration measurement methods used with confocal laser scanning microscopy in correlation with the percentage of residual root filling and examined the effect of residual root-filling material on dentine penetrability after retreatment. Extracted teeth were randomly divided into different groups according to the obturation sealer used (n = 6); BioRoot RCS; MTA Fillapex; Bio-C and AH Plus. Root-filling material was removed before the secondary chemo-mechanical preparation and obturation using fluorescein labelled AH Plus. Multiple micro-computed tomography scans were obtained followed by confocal laser scanning microscopy to measure the penetration of the labelled sealer into the dentinal tubules using four different methods. Measuring sealer penetration into radicular dentine using the penetration percentage method was found to be the most reliable. Dentine penetrability during retreatment did not seem to be affected by the type of residual root-filling material., (© 2024 Australian Society of Endodontology Inc.)

ABSTRACT: Background: Root canal re-treatment (RCR) cases are considered some of the most challenging cases in the field of endodontics, as they are mostly associated with various iatrogenic errors such as ledge formation, incomplete biomechanical preparation, file separation, and incomplete obturation. These iatrogenic errors lead to defective niches within root canals that may act as reservoirs for various viable microorganisms. Such residual microbial niches may cause postoperative pain even after thorough debridement and reshaping the canals, ultimately leading to a poor prognosis for the tooth. Nowadays, prevention of postoperative pain in re-treatment cases and prognosis are effectively managed by photobiomodulation therapy (PBMT). Method: Relevant studies in the English language published before November 2022 were identified using electronic databases like PubMed, SCOPUS, and EBSCO to conduct bibliographic research. This systematic review is based on 3 studies that were found eligible as per the inclusion and exclusion criteria. This systematic review is in accordance with PRISMA guidelines. Results: The systematic review indicated a positive impact by significantly decreasing postoperative pain in RCR cases when treated with PBMT. The variation was statistically significant at 24 hours (P = .0002), 48 hours (P = .03), and 72 hours (P = .02). The mean difference at 24 hours was 0.65 (95% CI, 0.32–0.99), at 48 hours was 0.46 (95% CI, 0.05–0.87), and at 72 hours was 0.40 (95% CI, 0.07–0.74). There was no statistical heterogenicity at 24 hours (P > .05), but a medium heterogenicity was observed at 48 hours and 72 hours. Practical implication: PBMT or low-level laser therapy has shown superior results as compared to the conventional pharmacologic approach in postoperative pain management in RCR cases.

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.

The primary objective of endodontic treatments or any pulp therapy is to maintain the integrity and health of oral tissues. Endodontic treatments aim to disinfect and shape the root canal system completely and obturate it in 3D to prevent reinfection. Although initial root canal therapy has high success rates, failures can occur. The term 'retreatment' denotes a new intervention to retain the tooth in the oral cavity. Nonsurgical endodontic retreatment can preserve previously treated teeth with persistent periapical lesion(s), if the tooth is restorable and periodontally sound, and patient wants to keep it. The clinician and patient should select the treatment with the best long-term outcome. This case series describes endodontically treated teeth that required nonsurgical endodontic retreatment due to inadequate obturation, persistent periradicular lesion and loss of coronal seal. [ABSTRACT FROM AUTHOR]

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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]

The removal of fiber posts for the retreatment of root canals can be challenging. An autonomous robotic (ATR) system was used for accurate and minimally invasive endodontic retreatment in a patient who presented with symptomatic apical periodontitis and pain emanating from the mandibular left first molar, which had been previously restored with 3 fiber posts. Intraoral scanning data, radiographic data, and bur sizes were integrated into preoperative software program to design a treatment plan. The ATR system enabled precise and efficient post removal. The remnant filling material was removed before endodontic retreatment, and radiographs at 3 months after the procedure showed satisfactory healing. This treatment demonstrated the accuracy and efficiency of the ATR system for the removal of fiber posts from pretreated teeth, while minimizing the duration of the procedure and avoiding excessive tissue removal., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

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.