Original Article

CBCT Evaluation of Gutta-Percha Removal Using ProTaper and Mtwo Retreatment Files, WaveOne, and Hedstrom Files: An Ex Vivo Study


Objectives: This study aimed to evaluate the efficacy of ProTaper, Mtwo, and WaveOne retreatment files and Hedstrom files for removal of gutta-percha from the straight root canals using cone-beam computed tomography (CBCT).
Materials and Methods: Forty freshly extracted single-rooted and single-canal teeth were selected for this study. The teeth were decoronated, and biomechanical preparation was performed up to #30 K-file. The root canals were obturated using lateral compaction technique with gutta-percha and Resilon sealer. The teeth were then randomly divided into 4 groups, and CBCT images were obtained. All the canals were then retreated with either ProTaper retreatment files, Mtwo retreatment files, WaveOne files, or Hedstrom files. The surface area of the remaining filling material after the retreatment procedure was quantified by CBCT. Statistical analysis was performed via one-way ANOVA and the Tukey-Kramer multiple comparisons test.
Results: None of the file systems could completely remove the filling material from the canals. Data analysis revealed significant differences between the groups in the apical and middle thirds (P<0.05).
Conclusion: All the file systems left some filling material in the canals. Mtwo retreatment files had maximum efficacy for removal of filling materials in comparison with other files. WaveOne files can also be used for root canal retreatment.

Giuliani V, Cocchetti R, Pagavino G. Efficacy of ProTaper universal retreatment files in removing filling materials duringroot canal retreatment. J Endod. 2008;34(11):1381-4.

Lin LM, Skribner JE, Gaengler P. Factors associated with endodontic treatment failures. J Endod. 1992;18(12):625-7.

Hammad M, Qualtrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentationfor retreatment of canals filled with different materials. J Endod. 2008;34(11):1370-3.

Imura N, Zuolo ML, Ferreira MO, Novo NF. Effectiveness of the Canal Finder and hand instrumentation in removal of guttapercha root fillings during root canal retreatment. Int Endod J. 1996;29(6):382-6.

Keles A, Koseoglu M. Dissolution of root canal sealers in EDTA and NaOCl solutions. J Am Dent Assoc. 2009;140(1):74-9; quiz 113.

Pinto de Oliveira D, Vicente BaroniBarbizam J, Trope M, Teixeira FB. Comparison between gutta-percha and resilion removal using two different techniques in endodontic retreatment. J Endod. 2006;32(4):362-4.

Ring J, Murray PE, Namerow KN, Moldauer BI, Garcia- Godoy F. Removing root canal obturation materials: acomparison of rotary file systems and re-treatment agents. J Am Dent Assoc. 2009;140(6):680-8.

Schirrmeister JF, Wrbas KT, Schneider FH, Altenburger MJ, Hellwig E. Effectiveness of a hand file and three nickeltitanium rotary instruments for removing gutta-percha in curved root canals during retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(4):542-7

Yadav P et al.An in vitro CT Comparison of Gutta-Percha Removal with Two Rotary Systems and Hedstrom Files.Iran Endod J2013;8(2):59-64.

Prichard J. Rotation or reciprocation: A contemporary look at NiTi instruments. Br Dent J 2012;212:345-6.

Koçak MM,Koçak M, Türker S,Sağlam BC.Cleaning efficacy of reciprocal and rotary systems.in the removal of root canal filling material. J Cons Dent. 2016 ;19(2).

Alapati SB, Brantley WA, Iijma M, Clark WA, Kovarik L, Buie C, et al. Metallurgical characterization of a new nickel-titanium wire for rotaryendodontic instruments. J Endod 2009;35:1589-93.

Gutmann JL, Gao Y. Alteration in the inherent metallic and surface properties of nickel-titanium root canal instruments to enhance performance, durability and safety: A focussed review. Int Endod J 2012;45:113-28.

Kim S. Endodontic application of cone-beam computed tomography in South Korea. J Endod. 2012;38(2):153-7.

Nair PNR, Sjögren U, Krey G, Kahnberg K-E, SundqvistG. Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study. J Endod;16:580–8.

Khedmat S,Azari A ,Shamshiri AR,Fadae M,Fakhar HB. Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals. Iran Endod J 2016;11(3): 184-187

Evaluation of efficiency of three NiTi instruments in removing gutta-percha from root canal during retreatment - An in vitro study. ENDODONTOLOGY.

K. Marfisi, M. Mercade, G. Plotino, F. Duran-Sindreu, R. Bueno, M. Roig. Efficacy of three different rotary files to remove gutta-percha and Resilon from root canals.Int. Endod. J.2010;43:1022-28.

Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J. 2008;41(4):288-95.

Silva EJN, Orlowsky NB, Herrera DR, Machado R.,Countinhofilho RL.Effectiveness of rotatory and reciprocating movements in root canal filling material removal.Braz Oral Res.2015;29(1):1-6

IssueVolume 18 (IN PROGRESS) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v18i19.6326
Gutta-Percha Resilon Sealer Cone-Beam Computed Tomography Root Canal Preparation Root Canal Therapy

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How to Cite
Madhu K, Karade P, Chopade R, Jadhav Y, Chodankar K, Alane U. CBCT Evaluation of Gutta-Percha Removal Using ProTaper and Mtwo Retreatment Files, WaveOne, and Hedstrom Files: An Ex Vivo Study. Front Dent. 18.