Full counterclockwise rotary motion kinematics enhances the removal of gutta-percha and bioceramic sealer from root canals: A computed tomographic study

J Conserv Dent. 2022 Nov-Dec;25(6):672-677. doi: 10.4103/jcd.jcd_352_22. Epub 2022 Oct 13.

Abstract

Background and aim: Complete removal of gutta-percha and sealer is an important step during retreatment. The aim of this study was to assess the efficacy and time taken by full counterclockwise rotary motion of a reciprocating file in the removal of gutta-percha and BioRoot™ RCS bioceramic sealer.

Materials and methods: Thirty-six extracted human mandibular premolars were instrumented with Mtwo rotary files and obturated using lateral condensation technique with gutta-percha and BioRoot™ RCS bioceramic sealer. The teeth were divided into three retreatment groups (n = 12) based on the kinematics used: Group I, Mtwo retreatment (Mtwo-R) files; Group II, Reciproc files used in reciprocation mode (Reciproc-R); and Group III, Reciproc files used in full counterclockwise motion (Reciproc-CCW). The efficacy of gutta-percha and bioceramic sealer removal was assessed by volume of gutta-percha removed using cone-beam computed tomography and area of remaining gutta-percha and bioceramic sealer using ImageJ software after longitudinal sectioning. Statistical analysis was done by one-way analysis of variance test and Tukey's multiple post hoc tests.

Results: Reciproc-CCW motion was significantly efficient in the removal of gutta-percha and bioceramic sealer in comparison to Mtwo-R files and Reciproc-R. The time taken for gutta-percha and sealer removal was least for Reciproc-R (325.5 ± 101.68 seconds) and was statistically significant in comparison to the other groups.

Conclusion: Within the limitations of the study, Reciproc-CCW was an effective method of removal of gutta-percha and bioceramic sealer during retreatment.

Keywords: Gutta-percha; reciprocation; removal; retreatment; sealer.