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  1. Rossi-Fedele G, Ahmed HM
    J Endod, 2017 Apr;43(4):520-526.
    PMID: 28214018 DOI: 10.1016/j.joen.2016.12.008
    INTRODUCTION: The removal of obturation materials from the root canal system is a primary objective in root canal retreatment procedures. This systematic review aims to discuss the effectiveness of different instrumentation procedures in removing root-canal filling materials assessed by micro-computed tomography.

    METHODS: An electronic search in PubMed and major endodontic journals was conducted using appropriate key words to identify investigations that examined the effectiveness of obturation material removal assessed by micro-computed tomography.

    RESULTS: Among 345 studies, 22 satisfied the inclusion criteria. Seven studies compared hand instrumentation with Nickel-Titanium rotary or reciprocating systems. Three studies investigated rotary systems, and another three studies explored reciprocation. Eight studies compared rotary systems and reciprocation in removing filling materials from the root canal system. Other factors, such as the role of solvents and irrigant agitation, were discussed.

    CONCLUSIONS: The application of different instrumentation protocols can effectively, but not completely, remove the filling materials from the root canal system. Only hand instrumentation was not associated with iatrogenic errors. Reciprocating and rotary systems exhibited similar abilities in removing root filling material. Retreatment files performed similarly to conventional ones. Solvents enhanced penetration of files but hindered cleaning of the root canal. The role of irrigant agitation was determined as controversial.

    Matched MeSH terms: Root Canal Obturation/methods*
  2. Roy D, Chowdhury F, Shaik MM, Alam MK
    Dent Res J (Isfahan), 2014 Mar;11(2):222-7.
    PMID: 24932193
    Endodontic leakage research focus mainly on the quality of the apical seal of the root canal system and the newly introduced resilon/epiphany system claim to be superior to Gutta-percha in respect to obturation procedure. The aim of this study is to evaluate the root canal obturation completed by resilon/epiphany system.
    Matched MeSH terms: Root Canal Obturation
  3. Said HM, Bakar WZ, Farea M, Husein A
    J Conserv Dent, 2012 Jul;15(3):257-60.
    PMID: 22876014 DOI: 10.4103/0972-0707.97952
    The aim of this in vitro study was to evaluate the sealing ability of an endodontic sealer following different techniques of its placement.
    Matched MeSH terms: Root Canal Obturation
  4. Baranwal AK, Paul ML, Mazumdar D, Adhikari HD, Vyavahare NK, Jhajharia K
    J Conserv Dent, 2015 Sep-Oct;18(5):399-404.
    PMID: 26430305 DOI: 10.4103/0972-0707.164054
    Where nonsurgical endodontic intervention is not possible, or it will not solve the problem, surgical endodontic treatment must be considered. A major cause of surgical endodontic failures is an inadequate apical seal, so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical.
    Matched MeSH terms: Root Canal Obturation
  5. Soo WK, Thong YL, Gutmann JL
    Int Endod J, 2015 Aug;48(8):736-46.
    PMID: 25130364 DOI: 10.1111/iej.12371
    To compare four gutta-percha filling techniques in simulated C-shaped canals based on filling quality at three cross-sectional levels, filling time and the apical extrusion of gutta-percha.
    Matched MeSH terms: Root Canal Obturation
  6. Lee, S.W., Tan, S.T., Che Ab Aziz, Z.A.
    Ann Dent, 2005;12(1):-.
    MyJurnal
    Thirty extracted mandibular premolars were randomly divided into 3 groups. Canals were cleaned, obturated and the teeth incubated. Guttapercha removal was performed using: Hedström files with xylene (Group 1); ProFile® alone (Group 2) and combination of both (Group 3). Time required to remove the gutta-percha was recorded. Postoperative radiographs were taken. Specimens were split longitudinally and photographed. Amount of gutta-percha left at coronal, middle and apical thirds was calculated by computer (QWIN software) and the photographs were also evaluated visually by two endodontists. Results showed that the combined technique was fastest in removing gutta-percha. Radiographically, more residual was left in Group 2. Although computer analysis also showed more residual was left in Group 2, they were in a small percentage and there were no significant differences (P>0.05, SPSS paired-samples T test) among groups. Although there were significant differences between the two evaluators in their scoring, both generally agreed (Kappa’s analysis= 0.64) there was more guttapercha residual in Group 2 compared to Group 3 in the apical thirds. Although the differences in efficacy of guttapercha removal among these techniques were not significant, the use of ProFile® increased the speed of the procedure. The combined technique showed the most superior efficacy in gutta-percha removal.
    Matched MeSH terms: Root Canal Obturation
  7. Tan JM, Parolia A, Pau AK
    BMC Oral Health, 2013;13:52.
    PMID: 24098931 DOI: 10.1186/1472-6831-13-52
    This study compared the effectiveness of a Specially Designed Paste Carrier technique with the Syringe-Spreader technique and the Syringe-Lentulo spiral technique in the intracanal placement of calcium hydroxide.
    Matched MeSH terms: Root Canal Obturation/instrumentation*; Root Canal Obturation/methods*
  8. Raj PKT, Mudrakola DP, Baby D, Govindankutty RK, Davis D, Sasikumar TP, et al.
    J Contemp Dent Pract, 2018 Jun 01;19(6):726-731.
    PMID: 29959303
    AIM: To determine the effectiveness of two different endodontic retreatment systems for the removal of laterally compacted gutta-percha (GP).

    MATERIALS AND METHODS: Sixty-three freshly extracted human maxillary central incisors were used for the study. The teeth were instrumented with K-flex files and obturated using lateral condensation technique with GP and AH Plus sealer. The teeth were divided into three retreatment groups, each group consisting of 21 teeth. Group I: D-RaCe desobturation files (D-RaCe); group II: ProTaper Universal retreatment files (PTUR); group III: Hedstrom files (H-file). After removal of GP, the teeth were split longitudinally and divided into three equal parts: Cervical, middle, and apical third. The middle and apical thirds of all root halves were examined using scanning electron microscope (SEM). The total surface area covered by the residual debris was evaluated using Motic Image plus 2.0 software. Statistical analysis was done by one-way analysis of variance (ANOVA) test with a p-value <0.05 used to determine significance and Tukey's multiple post hoc tests used for comparison between the groups, and 't' test was done for comparison between the thirds within the same group.

    RESULTS: The PTUR retreatment files showed overall better performance compared with D-RaCe files and H-files. The PTUR files performed better at middle third compared with others. The PTUR files and D-RaCe files performed equally at apical third better than H-files.

    CONCLUSION: ProTaper retreatment files are better compared with D-RaCe files and H-files for the retreatment of the previously endodontically treated teeth.

    CLINICAL SIGNIFICANCE: Highest efficacy for the removal of GP was shown by ProTaper Universal System followed by D-RaCe and H-file.

    Matched MeSH terms: Root Canal Obturation/instrumentation*; Root Canal Obturation/methods
  9. Elenjikal MJ, Latheef AA, Kader MAM, Ganapathy S, Mohamed AB, Sainudeen SS, et al.
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S450-S456.
    PMID: 31198386 DOI: 10.4103/JPBS.JPBS_75_19
    Background: Root resorption is the loss of dental hard tissues as a result of clastic activities. It might be broadly classified into external or internal resorption by the location of the resorption in relation to the root surface. the various techniques used these days for filling internal resorption include warm condensation, vertical condensation, core techniques, thermoplasticized gutta-percha, warm vertical compaction, and cold lateral condensation.

    Objectives: The aims and objectives of this study were to compare the quality of root fillings in artificially created internal resorption cavities filled with warm vertical compaction, lateral condensation, Obtura II along with System B, E and Q plus along with System B, and Thermafil, and to calculate the percentage of gutta-percha, sealer, and voids using an ImageJ software.

    Results: Results between the warm vertical compaction (group I), lateral condensation (group II), Obtura II with System B (group III), E and Q plus with System B (group IV), and Thermafil (group V), group III showed the highest percentage of gutta-percha plus sealer and gutta-percha, and least number of voids, which was statistically significant (P < 0.000).

    Conclusion: It can be concluded that Obtura II along with System B was found to be the most suitable obturation technique for the management of teeth exhibiting internal resorption. Thermafil was found to give the poorest obturation quality when used to fill the teeth with internal resorption. Similarly, lateral condensation technique was observed to show maximum sealer and hence was not ideal for the management of internal resorptive cavities.

    Matched MeSH terms: Root Canal Obturation
  10. Yap WY, Che Ab Aziz ZA, Azami NH, Al-Haddad AY, Khan AA
    Med Princ Pract, 2017;26(5):464-469.
    PMID: 28934753 DOI: 10.1159/000481623
    OBJECTIVE: To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha.

    MATERIALS AND METHODS: A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation.

    RESULTS: The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p < 0.05) at both 2 weeks (G1: 1.46 ± 0.29 MPa, G2: 1.74 ± 0.43 MPa, G3: 1.74 ± 0.43 MPa, G4: 0.66 ± 0.31 MPa, G5: 0.74 ± 0.47 MPa) and 3 months after obturation (G1: 1.70 ± 1.05 MPa, G2: 3.69 ± 1.20 MPa, G3: 2.84 ± 0.83 MPa, G4: 0.14 ± 0.05 MPa, G5: 0.24 ± 0.10 MPa). The mean push-out bond strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa).

    CONCLUSION: The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time.

    Matched MeSH terms: Root Canal Obturation/methods*
  11. Gupta R, Kewalramani R
    J Oral Biol Craniofac Res, 2021 03 10;11(2):330-333.
    PMID: 33786296 DOI: 10.1016/j.jobcr.2021.03.001
    Aim: To evaluate the microleakage of newer bioceramic root-end filling materials.

    Material and method: Sixty freshly extracted human single-rooted mandibular premolar teeth were selected for the study. Teeth with fractured root, cracks, anddilacerations were rejected. All teeth were cleaned with ultrasonic scalers. Standard access opening was done and root canal treatment was performed with rotary files followed by obturation. After storing in saline for a week apical 3 ​mm of the root was resected at 900 angles to the long axis of the root. Retro cavity preparation was done with ultrasonic tips. The teeth were divided into four groups of 15 specimens each. Group I - Biodentin, GroupII-Bioaggregate, Group III - MTA Plus, and Group IV - MTA. After the restoration of retro cavities of all the teeth as per manufacture instructions, two coats of nail varnish were applied to leave apical 3 ​mm. All teeth were stored in 2% methylene blue for 72 ​h followed by emersion in 65% nitric acid for the next 72 ​h for Dye extraction. The obtained supernatant solution was then centrifuged and optical density or absorbance was measured with a UV spectrophotometer.

    Result: Microleakage was found to be increasing in this order: Biodentin ​ ​0.01).

    Conclusion: All materials exhibit some amount of microleakage. Biodentin shows the least microleakage among all the bioceramic material groups. Hence, Biodentin and bioaggregate are better material of choice for the retrograde filling to prevent microleakage.

    Matched MeSH terms: Root Canal Obturation
  12. Karobari MI, Khijmatgar S, Noorani TY, Assiry A, Alharbi T
    J Conserv Dent, 2021 02 10;23(5):518-521.
    PMID: 33911363 DOI: 10.4103/JCD.JCD_220_19
    Objective: The aim of this study is to determine the role of clinical audit in improving endodontic treatment outcomes.

    Materials and Methods: An audit at the department of endodontics at dental specialty centre kingdom of Saudi Arabia was carried out. The audit was conducted by developing endodontics treatment and success predictors based on evidence, that can be measured for endodontic care. A total of 12 months' data was examined from the previous dental records. Ten clinical cards were which included root canal treatment were selected. The audit was carried out for a minimum of 50 teeth and a maximum of 200 teeth. The radiographs of record cards were studied and a single dentist completed the audit tool.

    Results: The vitality test was performed in 1.98% cases, intra-canal medicament was used and named in 3.96% cases, 3.96% the teeth were extracted due to endodontic failure. Further, in 6.93% of the cases that were identified had certain spaces but overall root canal filling was evaluated as satisfactory.

    Conclusion: The vitality test, type of intracanal medicament, and assessment of root canal filling were not done, but there was an overall performance of predictors for endodontic treatment.

    Matched MeSH terms: Root Canal Obturation
  13. Ong TK
    Eur Endod J, 2019;4(3):145-149.
    PMID: 32161902 DOI: 10.14744/eej.2019.03016
    A 27-year-old male patient complained of dental pain on previously root-treated tooth #17. Intentional replantation (IR) was performed. However, the symptoms returned at 10 months of follow-up, and a sinus tract was detected on the buccal gingiva of tooth #17. The patient refused extraction of the tooth and tooth was scheduled for non-surgical retreatment. Root canal retreatment was initiated with the removal of the previous root filling material while leaving the retrograde filling in situ. After 1 month of intracanal medication, the tooth became asymptomatic with complete healing of the sinus tract and the root canal filling was completed. Clinical and radiographic examination at 1 year follow-up revealed endodontic success with complete resolution of periapical radiolucency. This case report shows that non-surgical retreatment could be a viable alternative for failed IR.
    Matched MeSH terms: Root Canal Obturation
  14. Lin GSS, Singbal KP, Noorani TY, Penukonda R
    Odontology, 2022 Jan;110(1):106-112.
    PMID: 34269933 DOI: 10.1007/s10266-021-00643-y
    To compare the vertical root fracture (VRF) resistance of root canal-treated teeth instrumented with four different nickel-titanium (NiTi) rotary file systems and examine the dentinal crack pattern and direction using a new classification. Eighty mature mandibular premolars were selected and decoronated, leaving 13 mm of the root. The root samples were mounted in acrylic resin and divided randomly into five groups of different NiTi file systems: Group 1-control, Group 2-T-Pro, Group 3-HyFlex CM, Group 4-TG6 and lastly Group 5-ZenFlex. Samples in Group 2 and Group 3 were instrumented up to size 25/0.04, whereas Group 4 and Group 5 were instrumented up to size 25/0.06. Obturation was performed with AH Plus sealer and gutta-percha using single cone technique. Subsequently, all samples were subjected to occlusal compressive force until they were fractured. The force (N) needed to cause root fracture was recorded. The crack patterns and directions were also inspected under magnification and classified using a new and simple classification. The highest (VRF) resistance was noted in the control group (453.15 ± 92.23 N), followed by T-Pro (387.43 ± 76.81 N), HyFlex CM (381.88 ± 52.73 N), ZenFlex (369.15 ± 89.41 N) and finally TG6 (346.05 ± 72.08 N), but there was no significant difference between T-Pro and HyFlex (P = 0.438). A significantly higher prevalence (P = 0.001) of Type 1 crack pattern was observed, especially in samples instrumented with TG6. Majority of the cracks ran buccolingually except in some samples instrumented with ZenFlex (P = 0.898). Smaller file taper increased the VRF resistance of root canal-treated teeth. Majority of the dentinal crack exhibited Type 1 pattern and ran buccolingually.
    Matched MeSH terms: Root Canal Obturation
  15. Ismail, N.M., Ismail, A.R., Wan Nor Syuhada, W.A.R.
    MyJurnal
    Root canal treatment (RCT) requires high level of technical skills of the dentist. Its outcome is an important part of evidence-based practice and become the basis of treatment planning and prognostic considerations. Adequate removal of micro-organisms and prevention of recolonization of residual micro-organisms through the placement of root filling with satisfactory coronal seal ensures success. This retrospective record review study aimed to investigate the practices of RCT in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic, Kota Bharu, Kelantan. It involved 333 randomly selected patient records at the HUSM Record Unit. Data was obtained by careful analyses of daily treatment progress sheets and analyzed using SPSS version 12.0. A total of 2996 RCT cases were seen and 59.8% of patients were females. The age range of patients varied from 14 to 64 years. The maxillary anterior teeth were most commonly treated (52.6%). Most operators (99.1%) used step-back technique and 97.6% used files to prepare root canals. The most commonly used material for obturation and sealing was gutta-percha and epoxy resin-based sealer (AH26). About 82.9% used calcium hydroxide as intra-canal medication. About 25.5% of cases had no periapical pathology, 65.8% with pre-existing periapical radiolucencies healed in 1-3 months whereas 2.1% of cases with periapical pathology eventually healed after a year. About 6.9% cases failed after retreatment. The number of radiographs taken was two to four pieces. RCT is a useful intervention to maintain longevity of teeth. Decision making and current updates of methods and materials are essential among practitioners as well as administrators to ensure success.
    Matched MeSH terms: Root Canal Obturation
  16. Saini, D., Nadig, G., Saini, R.
    MyJurnal
    The main objective of a root end filling material is to provide an apical seal that prevents the movement of bacteria and the diffusion of bacterial products from the root canal system into periapical tissues. The aim of this study was to compare the microleakage of three root end filling materials Mineral trioxide aggregate (MTA), Glass ionomer cement (GIC) and Silver GIC (Miracle Mix) using dye penetration technique under stereomicroscope. Forty-five extracted human maxillary central incisors were instrumented and obturated with gutta percha using lateral compaction technique. Following this, the teeth were stored in saline. After one week, teeth were apically resected at an angle of 90ï° to the long axis of the root and root end cavities were prepared. The teeth were divided into three groups of fifteen specimens each and were filled with Group I -MTA, Group II - GIC and Group III - Miracle Mix. The samples were coated with varnish and after drying, they were immersed in 1% methylene blue dye for 72 hours. The teeth were then rinsed, sectioned longitudinally and observed under stereomicroscope. The depth of dye penetration was measured in millimeters. Microleakage was found to be significantly less in MTA (0.83 mm) when compared to GIC (1.32 mm) (p < 0.001) and with Miracle Mix (1.39 mm) (p < 0.001) No significant difference was found when microleakage in Miracle Mix was compared to that of GIC (p = 0.752). Thus we concluded that MTA is a better material as root end filling material to prevent microleakage, in comparison to GIC and Miracle Mix.
    Matched MeSH terms: Root Canal Obturation
  17. Chong LE, Jow TK
    Dent J Malaysia Singapore, 1967 Oct;7(2):44-51.
    PMID: 5247441
    Matched MeSH terms: Root Canal Obturation
  18. Farea M, Masudi S, Wan Bakar WZ
    Aust Endod J, 2010 Aug;36(2):48-53.
    PMID: 20666748 DOI: 10.1111/j.1747-4477.2009.00187.x
    The aim of this study was to evaluate in vitro the apical sealing ability of cold lateral and system B root filling techniques using dye penetration. Eighty-six extracted single-rooted human teeth were prepared and randomly divided into two experimental groups to be obturated by cold lateral condensation (n = 33) and system B (n = 33). The remaining 20 teeth served as positive and negative controls. The roots were embedded for 72 h in methylene blue dye solution and sectioned transversely for dye penetration evaluation using stereomicroscope. The results of this study showed that cold lateral condensation leaked significantly more (P < 0.001) than system B technique.
    Matched MeSH terms: Root Canal Obturation/methods*
  19. Thong YL, Messer HH, Zain RB, Saw LH, Yoong LT
    Dent Traumatol, 2009 Aug;25(4):386-93.
    PMID: 19459923 DOI: 10.1111/j.1600-9657.2008.00631.x
    Progressive replacement resorption following delayed replantation of avulsed teeth has proved to be an intractable clinical problem. A wide variety of therapeutic approaches have failed to result in the predictable arrest of resorption, with a good long-term prognosis for tooth survival. Bisphosphonates are used in the medical management of a range of bone disorders and topically applied bisphosphonate has been reported to inhibit root resorption in dogs. This study evaluated the effectiveness of a bisphosphonate (etidronate disodium) as an intracanal medicament in the root canals of avulsed monkey teeth, placed before replantation after 1 h of extraoral dry storage. Incisors of six Macaca fascicularis monkeys were extracted and stored dry for 1 h. Teeth were then replanted after canal contamination with dental plaque (negative control) or after root canal debridement and placement of etidronate sealed in the canal space. A positive control of calcium hydroxide placed 8-9 days after replantation was also included. All monkeys were sacrificed 8 weeks later and block sections were prepared for histomorphometric assessment of root resorption and periodontal ligament status. Untreated teeth showed the greatest extent of root resorption (46% of the root surface), which was predominantly inflammatory in nature. Calcium hydroxide treated teeth showed the lowest overall level of resorption (<30% of the root surface), while the bisphosphonate-treated group was intermediate (39%). Ankylosis, defined as the extent of the root surface demonstrating direct bony union to both intact and resorbed root surface, was the lowest in the untreated control group (15% of the root surface), intermediate in the calcium hydroxide group (27%) and the highest in the bisphosphonate group (41%). Bony attachment to the tooth root was divided approximately equally between attachment to intact cementum and to previously resorbed dentin. Overall, bisphosphonate resulted in a worse outcome than calcium hydroxide in terms of both root resorption and ankylosis.
    Matched MeSH terms: Root Canal Obturation/methods
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