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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1682-1685  

A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of gutta percha from the root canal


1 Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Sangli, Maharashtra, India
2 Department of Dentistry, Jawaharlal Nehru Medical College and Hospital, Bihar, India
3 Department of Conservative Dentistry and Endodontics, Shaheed Kartar Singh Sarabha Dental College and Hospital, Ludhiana, Punjab, India
4 Department of Conservative Dentistry and Endodontics, Dr RRK Dental College, Akola, Maharashtra, India
5 Department of Conservative Dentistry and Endodontics, Dr HSRSM Dental College and Hospital, Hingoli, Maharashtra, India
6 Department of Conservative Dentistry and Endodontics, Desh Bhagat Dental College, Mandi Gobindgarh, Punjab, India

Date of Submission17-May-2021
Date of Decision22-May-2021
Date of Acceptance28-May-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Shweta V Sagare
Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Sangli, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_406_21

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   Abstract 


Background: Teeth with apical periodontitis that either persisted or developed after initial root canal treatment is most often indicated for retreatment procedure. The present study was conducted to compare the WaveOne and NeoEndo retreatment file system for the removal of gutta-percha from the root canal. Materials and Methods: Fifty extracted mandibular first premolars with single straight roots were divided into two groups, Group I-WaveOne and Group II-NeoEndo. All samples were scanned with cone-beam computed tomography after the root filling and retreatment procedures. The decrease in the volume of filling material after each retreatment protocol was measured. Results: The mean volume of gutta-percha in Group I before retreatment was 5.6 and in Group II was 5.3, after retreatment in Group I was 2.7, and in Group II was 4.2. The mean percentage reduction in Group I was 45.2% and in Group II was 23.8%. The difference was significant (P < 0.05). Conclusion: Both systems failed to completely remove gutta-percha. WaveOne was significantly more effective than the NeoEndo retreatment system.

Keywords: NeoEndo, retreatment system, WaveOne


How to cite this article:
Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of gutta percha from the root canal. J Pharm Bioall Sci 2021;13, Suppl S2:1682-5

How to cite this URL:
Sagare SV, Chandra P, Kaur T, Ganorkar O, Khade A, Mehta SD. A comparative study of the efficacy of WaveOne and NeoEndo retreatment file system for the removal of gutta percha from the root canal. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Oct 6];13, Suppl S2:1682-5. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1682/330133




   Introduction Top


A procedure to remove root canal filling materials from the tooth, revise the shape, and obturate the canals; usually accomplished because the original treatment appears inadequate or has failed or because the root canal has been contaminated by prolonged exposure to the oral environment. This definition is very limited because it does not take into consideration all the situations where there is no previous filling material to be removed, nevertheless, the case is failing and needs to be “retreated.”[1]

The leading cause of posttreatment disease after root canal treatment is persistent secondary intraradicular infection.[2] Teeth with apical periodontitis that either persisted or developed after initial root canal treatment are most often indicated for retreatment procedures. Another most common indication for retreatment is failed root canal treatment due to incomplete cleaning and disinfection of root canals, inadequate filling of root canals (unfilled, overfilled, or incomplete filling), and unsatisfactory or untimely coronal tooth restoration.[3]

The use of rotary instruments could reduce the fatigue and time of endodontic retreatments in comparison with hand files. Rotary nickel–titanium instruments are efficient than hand files.[4] Advantages of rotary files are maintenance of canal shape and shorter working time, whereas disadvantages are the higher incidence of file fracture and more remaining filling material after retreatment. A single-file reciprocating technique utilizing unequal clockwise and counterclockwise angles is four times safer and almost three times faster than using multiple rotary files to achieve the same final shape.[5] The present study was conducted to compared WaveOne and NeoEndo retreatment file system for the removal of gutta-percha from the root canal.


   Materials and Methods Top


The present in vitro study comprised fifty extracted mandibular first premolars with single straight roots. Higher authorities were approached for obtaining consent for the study.

All tooth root canals were instrumented with the ProTaper system up to the F3 file and filled with gutta-percha and epoxy resin-based sealer using the cold lateral condensation technique. After 1 month, the samples were divided into two groups based on retreatment system used: Group I-WaveOne and Group II-NeoEndo. All samples were scanned with cone-beam computed tomography after the root filling and retreatment procedures. The decrease in the volume of filling material after each retreatment protocol was measured. The results were clubbed and entered in MS excel sheet for correct statistical inference where P value was set statistically significant <0.05.


   Results Top


[Table 1] shows that each group comprised 25 teeth.
Table 1: Distribution of specimens

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[Table 2], [Graph 1] shows that the mean volume of gutta-percha in Group I before retreatment was 5.6 and in Group 2 was 5.3, after retreatment in Group I was 2.7, and in Group II was 4.2. The difference was statistically significant (P < 0.05).
Table 2: Mean volume of gutta-percha before and after retreatment

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[Table 3], [Graph 2] shows that the mean percentage reduction in Group I was 45.2% and in Group II was 23.8%. The difference was statistically significant (P < 0.05).
Table 3: Percentage reduction in the volume of gutta-percha after retreatment

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   Discussion Top


Retreatment is common in endodontics. The clinical success of endodontic retreatment seems to depend on whether alterations in the natural course of the root canals were caused by previous root canal treatment.[6] Few authors related their outcomes to microbiological problems to discriminate root canal retreatment. The clinical rate of success of retreatment has been estimated to vary between 50% and 90%. The ultimate goal of nonsurgical root canal retreatment is to re-establish healthy periapical tissues. There are many causes of failure of initial endodontic therapy.[7] These include iatrogenic procedural error, untreated canal, canals that are poorly cleaned and obturated, complication of instrumentation (ledges, perforation, etc.) and overextension of root filling material and sometimes by self-styled expert. Such “failures” are most often caused by microorganisms that have either survived the conventional treatment procedures or invaded the root canal system at later stages through coronal leakage.[8] To combat the infection, the root canal has to be renegotiated using either an orthograde or a retrograde route of entry. The selection of retreatment procedures primarily has to be based on case-specific factors, such as the technical quality of the root filling and the personal evaluation of risks and monetary costs.[9]

There are different techniques currently in use for the removal of filling materials. These are the use of endodontic hand files, automated devices, solvents, ultrasonics, and lasers. Earlier endodontic retreatments were challenging as well as time-consuming.[10] The present study was conducted to compared WaveOne and NeoEndo retreatment file system for the removal of gutta-percha from the root canal.

In the present study, the mean volume of gutta-percha in Group I before retreatment was 5.6 and in Group II was 5.3, after retreatment in Group I was 2.7 and in Group II was 4.2. Wahane et al.[11] compared the NeoEndo and WaveOne retreatment systems concerning the effective removal of epoxy resin-based sealer and gutta-percha during the retreatment of straight root canals. Sixty extracted, human mandibular first premolars were randomly divided into two groups (n = 30) according to the retreatment system used: NeoEndo and WaveOne. There were no statistically significant differences in the initial filling volume of the filling material among the samples (P > 0.05). The amount of filling material in the root canals decreased after two retreatment protocols. However, none of the protocols succeeded in complete removal of the material from any root canal. The WaveOne system was more effective than the NeoEndo retreatment system during the removal of filling material.

We found that the mean percentage reduction in Group I was 45.2% and in Group II was 23.8%. The difference was statistically significant (P < 0.05). Sundqvist et al.[12] for example, reported an overall success rate of 74% of 50 cases examined after retreatment. They found that the success rate in bacteria-free canals was almost 80%; whereas in teeth with particular bacteria species the outcome was significantly lower (66%). In a study by Sjogren et al.[13] similar results were achieved and further considerations were made regarding the size of the lesions: The greater the lesion, the lower the success rate. During the diagnostic phase, only clinical signs and symptoms are available for dentists.

The removal of filling materials during retreatment procedures enables instruments and irrigants to reach all areas of the root canal system, which results in more effective intracanal cleaning and disinfection. According to a review, no existing retreatment protocol can completely remove root filling materials.[14] The mean percentage of residual material ranges from 45.4% to 0.02%. Kvist and Reit[15] compared the results of surgical and nonsurgical retreatment. After 1 year, the surgically treated cases had healed more quickly, but after 4 years the slower healing of the nonsurgical cases had “caught up” and there were some failures in the surgical group, resulting in no difference.


   Conclusion Top


Authors found that both systems failed to completely remove gutta-percha. WaveOne was significantly more effective than the NeoEndo retreatment system.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Barkhordar RA, Stewart GG. The potential of periodontal pocket formation associated with untreated accessory root canals. Oral Surg Oral Med Oral Pathol 1990;70:769-72.  Back to cited text no. 1
    
2.
De Deus QD. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod 1975;1:361-6.  Back to cited text no. 2
    
3.
Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967;12:723-44.  Back to cited text no. 3
    
4.
Stabholz A, Friedman S, Tamse A. Endodontic failures and retreatment. In: Cohen S, Burns RC, editors. Pathways of the Pulp. Vol 6. St Louis: Mosby Yearbook Co; 1994. p. 690-727.  Back to cited text no. 4
    
5.
Tewari RK, Mishra SK, Sharma S, Kharade P. Nonsurgical endodontic retreatment: A case of dental quackery. Int J Exper Dent Sci 2012;1:34-6.  Back to cited text no. 5
    
6.
Koçak MM, Koçak S, Türker SA, Sağlam BC. Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material. J Conserv Dent 2016;19:184-8.  Back to cited text no. 6
    
7.
Sharma P, Goel M, Verma S. Entering a new era in endodontics with single file systems: A comprehensive review. EC Dent Sci 2016;5:1100-22.  Back to cited text no. 7
    
8.
Yılmaz F, Koç C, Kamburoğlu K, Ocak M, Geneci F, Uzuner MB, et al. Evaluation of 3 different retreatment techniques in maxillary molar teeth by using micro-computed tomography. J Endod 2018;44:480-4.  Back to cited text no. 8
    
9.
Pawar AM, Thakur B, Metzger Z, Kfir A, Pawar M. The efficacy of the Self-Adjusting File versus WaveOne in removal of root filling residue that remains in oval canals after the use of ProTaper retreatment files: A cone-beam computed tomography study. J Conserv Dent 2016;19:72-6.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Colombo AP, Fontana CE, Godoy A, De Martin AS, Kato AS, Rocha DG, et al. Efectiveness of the waveone and ProTaper D systems for removing gutta-percha with or without a solvent. Acta Odontol Latinoam 2016;29:262-7.  Back to cited text no. 10
    
11.
Wahane KD, Kulkarni SS, Daokar S, Patil K, Patel K, Thorat T. An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study. Endodontology 2021;33:20-4.  Back to cited text no. 11
  [Full text]  
12.
Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:86-93.  Back to cited text no. 12
    
13.
Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod 1990;16:498-504.  Back to cited text no. 13
    
14.
Friedman S. Management of post-treatment endodontic disease: A current concept of case selection. Aust Endod J 2000;26:104-9.  Back to cited text no. 14
    
15.
Kvist T, Reit C. Results of endodontic retreatment: A randomized clinical study comparing surgical and nonsurgical procedures. J Endod 1999;25:814-7.  Back to cited text no. 15
    



 
 
    Tables

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