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J Am Dent Assoc, Vol 140, No 6, 680-688. © 2009 American Dental Association

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JADA Continuing Education

A Comparison of Rotary File Systems and Re-treatment Agents

Background. The authors conducted a study to compare the effectiveness and working time of two rotary instrumentation file systems with two solvents for the removal of gutta-percha (GP) (ProTaper Universal, Dentsply Tulsa Dental, Tulsa, Okla.) or resin-based composite (RBC) (RealSeal 1 Bonded Obturator, SybronEndo, Orange, Calif.) endodontic obturation materials.

Methods. The authors instrumented 88 human extracted teeth and obturated the root canals of 80 of the teeth with either GP with AH Plus root canal sealer (Dentsply Maillefer, Tulsa, Okla.) or RBC with adhesive according to the manufacturers’ instructions. They re-treated each tooth by using one of two rotary instrumentation file systems. They assessed each file system by using chloroform or orange solvent re-treatment agents. The authors measured the time needed to remove the obturation material from each tooth. They processed the teeth for scanning electron microscopy, and two blinded reviewers categorized the micrographs according to several criteria.

Results. The authors observed more RBC remnants on the root canal surfaces compared with GP remnants after re-treatment. The re-treatment solvents and file systems were equally effective in removing the obturation materials.

Conclusion. The study results show that the quickest root canal retreatment can be accomplished by using EndoSequence rotary files (Brasseler, Savannah, Ga.) and orange solvent to remove RBC obturation material.

Clinical Implications. Re-treatment with EndoSequence rotary files was quicker than re-treatment with ProTaper Universal re-treatment files (Dentsply Tulsa Dental). However, in this study, the file systems were similarly effective in removing GP and RBC. Orange solvent was as effective as chloroform in removing obturation materials, but its use is less time-consuming.

Key Words: Endodontic files; endodontic therapy; obturation; root canal; dental materials

Abbreviations: C: Chloroform. • EDTA: Ethyl-enediaminetetraacetic acid. • ES: EndoSequence rotary files (Brasseler, Savannah, Ga.). • GP: Gutta-percha. • OS: Orange solvent. • PT: ProTaper Universal retreatment files (Dentsply Tulsa Dental, Tulsa, Okla.). • RBC: Resin-based composite. • SEM: Scanning electron microscopy.