A practitioner's guide to gutta-percha removal during endodontic retreatment

Abstract

Endodontic retreatment can be a challenging task that can result in many complications if not approached cautiously. Many of these difficulties revolve around regaining access to the pulp chamber through extensive coronal restorations and removing residual root filling material, the commonest being gutta-percha (GP), from within obturated canals. This can often be an untidy, time consuming process that places teeth at a greater risk of iatrogenic injury and inhibits the operator achieving the necessary chemical disinfection required to eliminate the persistent apical disease. Therefore the following article aims to aid practitioners, particularly those who are unfamiliar, with accessing and removing GP from endodontically treated teeth. The outlined systematic approach is accessible in general practice, where the vast majority of endodontic treatment is conducted, requires basic equipment and with the correct experience can be applied to both straight and curved canals. By overcoming this initial stage of retreatment, subsequent chemical disinfection, which is critical to success, can be carried out to a higher standard reducing risks of re-infection.

Endodontic retreatment of curved root canals using the dual wavelength erbium, chromium:yttrium, scandium, gallium, garnet, and diode 940-nm lasers and the XP-Endoshaper/finisher technique

“…This has been associated with one or more factors, including inadequate canal debridement, inadequate obturation, and complicated canal anatomy, all in turn result in the persistence of bacterial infection inside the root canal [2][3][4]. Traditionally, endodontic retreatment is performed by first removing the obturating material and sealer, followed by repeated canal preparation and irrigation with a suitable antimicrobial solution such as NaOCl, which is reported to remove bacteria and promote healing in retreatment cases [5]. Another widely used endodontic irrigant is ethylenediaminetetraacetic acid (EDTA) which is capable of removing the inorganic component of the smear layer [6].…”

Endodontic Retreatment Using a Single Instrument from four Nickel-Titanium Systems - A Micro-CT Study

“…The removal of the previous obturation materials during non-surgical endodontic retreatment is essential to gain access to the root canals and disinfect them (1,2). The ability of an instrument or technique to remove filling materials from the root canals has been evaluated by different methods (3,7,17,18); however, micro-CT is considered as the most accurate method owing to possibility of performing 3D sequential qualitative and quantitative evaluations (4,6,(8)(9)(10)15,16,(19)(20)(21)(22)(23)(24).…”

“…The permanence of filling materials in the root canal can compromise the success of an endodontic retreatment procedure because the remaining filling materials that adhere to the dentin walls can shelter microorganisms and necrotic remains leading to the development of intraradicular infection, which can interfere with the adhesion of new filling materials to the walls (1,2).…”

Terpenoids as Potential Geroprotectors

“…Some plants produce polyisoprene, in which the double bond is in trans-conformation, this is gutta-percha. This class of terpenoids does not have geroprotectors properties, but these compounds are widely used materials because they have low toxicity [ 398 , 399 , 400 , 401 ].…”