In Vitro Comparison of Efficacy of Neolix and ProTaper Universal Retreatment Rotary Systems in Removal of Gutta-Percha Combined with Two Different Sealers

Sadat Shojaee, Nooshin; Vakilinezhad, Ehsan; Shokouhui, Mohammad Mehdi

doi:10.30476/dentjods.2019.77825.

In Vitro Comparison of Efficacy of Neolix and ProTaper Universal Retreatment Rotary Systems in Removal of Gutta-Percha Combined with Two Different Sealers

Document Type : Original Article

Authors

Nooshin Sadat Shojaee ¹

Ehsan Vakilinezhad ²

Mohammad Mehdi Shokouhui ¹

¹ Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

² Undergraduate Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

https://doi.org/10.30476/dentjods.2019.77825.

Abstract

Statement of the Problem:The complete removal of filling material is an important step to regain access to the entire canal and facilitate the disinfection of the root canal system. Rotary nickel–titanium (NiTi) instruments systems have been proposed as an effective removal technique for root canal retreatment.
Purpose: The aim of this study was to evaluate the efficacy of Neolix rotary system and ProTaper Universal retreatment system in the removal of gutta-percha combined with two different sealers.
Materials and Method: In vivo study, eighty extracted human permanent mandibular premolarswere prepared using the ProTaper Universal rotary system to an apical size 30 (F3/0.06). The specimens were randomly divided into 4 groups (n=20) and subsequently filled with lateral condensation of gutta-percha and two sealers: AH-26 and Sure-Seal Root. The teeth were stored for 4 weeks at 37°C and 100% humidity and then retreated by one of the following rotary systems: Neolix or ProTaper Universal retreatment system. Teeth were then grooved and monitored under a stereomicroscope with 8× magnification. The images were transferred to the computer and the amount of filling material that remained on the root canal walls was scored using AutoCAD 2017 version 1.1software. Results were analyzed using one-way analysis of variance test and post hoc Tukey-HSD test (p < 0.05).
Results:The mean percentage of remaining gutta-percha and sealer was significantly higher in apical third in all groups (p < 0.01). Post hoc Tukey test showed that there is significantly higher residual filling material in the group filled with gutta-percha and Sure-Seal Root sealer and retreated by Neoniti rotary system compared with other groups in both coronal and middle third of the canal.
Conclusion: The Neoniti rotary system was as effective as ProTaper Universal retreatment system in retreatment of gutta-percha and AH-26 sealer but was significantly less effective in groups obturated with Sure-Seal Root sealer.

Keywords

Retreatment ● AH26 ● Ni

1. Siqueira JF Jr, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008; 34: 1291–1301. [PubMed] [Google Scholar]

2. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009; 35: 930–937. [PubMed] [Google Scholar]

3. Ruddle CJ. Nonsurgical retreatment. J Endod. 2004; 30: 827–845. [PubMed] [Google Scholar]

4. Wilcox LR, Krell KV, Madison S, Rittman B. Endodontic retreatment: evaluation of gutta-percha and sealer removal and canal reinstrumentation. J Endod. 1987; 13: 453–457. [PubMed] [Google Scholar]

5. Friedman S, Moshonov J, Trope M. Efficacy of removing glass ionomer cement, zinc oxide eugenol, and epoxy resin sealers from retreated root canals. Oral Surg Oral Med Oral Pathol. 1992; 73: 609–612. [PubMed] [Google Scholar]

6. Schirrmeister JF, Wrbas KT, Schneider FH, Altenburger MJ, Hellwig E. Effectiveness of a hand file and three nickel-titanium rotary instrumentsfor removing gutta-percha in curved root canals during retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101: 542–547. [PubMed] [Google Scholar]

7. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3 . Retreatment techniques J Endod. 1990; 16: 543–549. [PubMed] [Google Scholar]

8. Friedman S, Mor C. The success of endodontic therapy--healing and functionality. J Calif Dent Assoc. 2004; 32: 493–503. [PubMed] [Google Scholar]

9. Krell KV, Neo J. The use of ultrasonic endodontic instrumentation in the re-treatment of a paste-filled endodontic tooth. Oral Surg Oral Med Oral Pathol. 1985; 60: 100–102. [PubMed] [Google Scholar]

10. Jeng HW, ElDeeb ME. Removal of hard paste fillings from the root canal by ultrasonicinstrumentation. J Endod. 1987; 13: 295–298. [PubMed] [Google Scholar]

11. Wilcox LR. Endodontic retreatment: ultrasonics and chloroform as the final step in reinstrumentation. J Endod. 1989; 15: 125–128. [PubMed] [Google Scholar]

12. Masiero AV, Barletta FB. Effectiveness of different techniques for removing gutta-percha during retreatment. Int Endod J. 2005; 38: 2–7. [PubMed] [Google Scholar]

13. Ring J, Murray PE, Namerow KN, Moldauer BI, Garcia-Godoy F. Removing root canal obturation materials: a comparison of rotary filesystems and re-treatment agents. J Am Dent Assoc. 2009; 140: 680–688. [PubMed] [Google Scholar]

14. Gergi R, Sabbagh C. Effectiveness of two nickel-titanium rotary instruments and a hand file for removing gutta-percha in severely curved root canals during retreatment: an ex vivo study. Int Endod J. 2007; 40: 532–537. [PubMed] [Google Scholar]

15. Hülsmann M, Bluhm V. Efficacy, cleaning ability and safety of different rotary NiTi instruments in root canal retreatment. Int Endod J. 2004; 37: 468–476. [PubMed] [Google Scholar]

16. Schirrmeister JF, Wrbas KT, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod. 2006; 32: 469–472. [PubMed] [Google Scholar]

17. Betti LV, Bramante CM. Quantec SC rotary instruments versus hand files for gutta-percharemoval in root canal retreatment. Int Endod J. 2001; 34: 514–519. [PubMed] [Google Scholar]

18. Imura N, Kato AS, Hata GI, Uemura M, Toda T, Weine F. A comparison of the relative efficacies of four hand and rotaryinstrumentation techniques during endodontic retreatment. Int Endod J. 2000; 33: 361–366. [PubMed] [Google Scholar]

19. Ferreira JJ, Rhodes JS, Ford TR. The efficacy of gutta-percha removal using ProFiles. Int Endod J. 2001; 34: 267–274. [PubMed] [Google Scholar]

20. Belli S, Ozcan E, Derinbay O, Eldeniz AU. A comparative evaluation of sealing ability of a new, self-etching, dual-curable sealer: hybrid root SEAL (MetaSEAL) Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: e45–e52. [PubMed] [Google Scholar]

21. Sure-endo corp. Sure-Seal Root, bioceramic sealing material. Available at: [http://www.suredent.com/en/seal /01.htm. ] [Google Scholar]

22. Lee KW, Williams MC, Camps JJ, Pashley DH. Adhesion of endodontic sealers to dentin and gutta-percha. J Endod. 2002; 28: 684–688. [PubMed] [Google Scholar]

23. Bürklein S, Hinschitza K, Dammaschke T, Schäfer E. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and Protaper. Int Endod J. 2012; 45: 449–461. [PubMed] [Google Scholar]

24. Pirani C, Ruggeri O, Cirulli PP, Pelliccioni GA, Gandolfi MG, Prati C. Metallurgical analysis and fatigue resistance of WaveOne and Protaper nickel-titanium instruments. Odontology. 2014; 102: 211–216. [PubMed] [Google Scholar]

25. Capar ID, Ertas H, Ok E, Arslan H, Ertas ET. Comparative study of different novel nickel-titanium rotary systems for root canal preparation in severely curved root canals. Journal of Endodontics. 2014; 40: 852–856. [PubMed] [Google Scholar]

26. Hiranus S, Pimkhaokham S, Sawasdichai J, Ebihara A, Suda H. Shaping ability of Protaper NEXT, Protaper Universal and iRace files in simulated S-shaped canals. Aust Endod J. 2016; 42: 32–36. [PubMed] [Google Scholar]

27. Aminsobhani M, Meraji N, Sadri E. Comparison of Cyclic Fatigue Resistance of Five Nickel Titanium Rotary File Systems with Different Manufacturing Techniques. J Dent (Tehran) 2015; 12:636–646. [PMC free article] [PubMed] [Google Scholar]

28. Moazzami F, Khojastepour L, Nabavizadeh M, Seied Habashi M. Cone-Beam Computed Tomography Assessment of Root CanalTransportation by Neoniti and Reciproc Single-File Systems. Iran Endod J. 2016; 11: 96–100. [PMC free article] [PubMed] [Google Scholar]

29. Rios Mde A, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, et al. Efficacy of 2 reciprocating systems compared with a rotary retreatmentsystem for gutta-percha removal. J Endod. 2014; 40: 543–546. [PubMed] [Google Scholar]

30. Zuolo AS, Mello JE Jr, Cunha RS, Zuolo ML, Bueno CE. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J. 2013; 46: 947–953. [PubMed] [Google Scholar]

31. Khoshbin E, Donyavi Z, Abbasi Atibeh E, Roshanaei G, Amani F. The Effect of Canal Preparation with Four Different Rotary Systems on Formation of Dentinal Cracks: An In Vitro Evaluation. Iran Endod J. 2018; 13: 163–168. [PMC free article] [PubMed] [Google Scholar]

32. Schirrmeister JF, Liebenow AL, Braun G, Wittmer A, Hellwig E, Al-Ahmad A. Detection and eradication of microorganisms in root-filled teethassociated with periradicular lesions: an in vivo study. J Endod. 2007; 33: 536–540. [PubMed] [Google Scholar]

33. Stabholz A, Friedman S. Endodontic retreatment--case selection and technique. Part 2: Treatmentplanning for retreatment. J Endod. 1988; 14: 607–614. [PubMed] [Google Scholar]

34. Rios Mde A, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, et al. Efficacy of 2 reciprocating systems compared with a rotary retreatmentsystem for gutta-percha removal. J Endod. 2014; 40: 543–546. [PubMed] [Google Scholar]

35. Takahashi CM, Cunha RS, de Martin AS, Fontana CE, Silveira CF, da Silveira Bueno CE. In vitro evaluation of the effectiveness of Protaper universal rotaryretreatment system for gutta-percha removal with or without a solvent. J Endod. 2009; 35: 1580–1583. [PubMed] [Google Scholar]

36. Sae-Lim V, Rajamanickam I, Lim BK, Lee HL. Effectiveness of ProFile .04 taper rotary instruments in endodonticretreatment. J Endod. 2000; 26: 100–104. [PubMed] [Google Scholar]

37. Kosti E, Lambrianidis T, Economides N, Neofitou C. Ex vivo study of the efficacy of H-files and rotary Ni-Ti instruments to remove gutta-percha and four types of sealer. Int Endod J. 2006; 39: 48–54. [PubMed] [Google Scholar]

38. De Carvalho Maciel AC, Zaccaro Scelza MF. Efficacy of automated versus hand instrumentation during root canalretreatment: an ex vivo study. Int Endod J. 2006; 39: 779–784. [PubMed] [Google Scholar]

39. Uzunoglu E, Yilmaz Z, Sungur DD, Altundasar E. Retreatability of root canals obturated using gutta-percha with bioceramic, MTA and resin-based sealers. Iran Endod J. 2015; 10: 93–98. [PMC free article] [PubMed] [Google Scholar]

40. Teplitsky PE, Rayner D, Chin I, Markowsky R. Gutta percha removal utilizing GPX instrumentation. J Can Dent Assoc. 1992; 58: 53–58. [PubMed] [Google Scholar]

41. Ersev H, Yilmaz B, Dinçol ME, Dağlaroğlu R. The efficacy of ProTaper Universal rotary retreatment instrumentation to remove single gutta-percha cones cemented with several endodontic sealers. Int Endod J. 2012; 45: 756–762. [PubMed] [Google Scholar]

42. Só MV, Saran C, Magro ML, Vier-Pelisser FV, Munhoz M. Efficacy of ProTaper retreatment system in root canals filled with gutta-percha and two endodontic sealers. J Endod. 2008; 34: 1223–1225. [PubMed] [Google Scholar]

43. Nagas E, Cehreli Z, Uyanik MO, Durmaz V. Bond strength of a calcium silicate-based sealer tested in bulk or with different main core materials. Braz Oral Res. 2014; 28: 1–7. [PubMed] [Google Scholar]

44. Khoshbin E, Shokri A, Donyavi Z, Shahriari S, Salehimehr G, Farhadian M, et al. Comparison of the root canal debridement ability of two single filesystems with a conventional multiple rotary system in long oval-shapedroot canals: In vitro study. J Clin Exp Dent. 2017; 9: e939–e944. [PMC free article] [PubMed] [Google Scholar]

45. Fatima K, Nair R, Khasnis S, Vallabhaneni S, Patil JD. Efficacy of rotary and reciprocating single-file systems on differentaccess outlines for gutta-percha removal in retreatment: An in vitro study. J Conserv Dent. 2018; 21: 354–358. [PMC free article] [PubMed] [Google Scholar]