Optimizing Non-surgical Endodontic Retreatment: A 3D CBCT Quantification of Root Canal Bioceramic Filling Material Removal

Abstract

Objective This study aims to quantify and compare the volume of residual bioceramic root canal filling material after different non-surgical endodontic retreatment procedures. Methods Fifty single-rooted teeth underwent primary root canal treatment using the ProTaper system and BioRoot RCS. Non-surgical retreatment employs ProTaper files D1, D2, D3, F3 (n=50). For Group A (n=10), retreatment procedures conclude on the X3 file and additional ultrasonic energy (Group B, n=10), the Self-Adjusting File (SAF) system (Group C, n=10), endodontic solvents (Group D, n=10), and chelator (Group E, n=10). Detailed procedures outline each group's retreatment protocol. Residual root canal filling material volumes are precisely evaluated in mm3 using 3D CBCT and specific software. Results Significant variations in residual material volume are observed among the groups, with ultrasonic energy demonstrating superior efficacy. Statistical analyses affirm the impact of different methodologies on material removal. The SAF system also shows promise, although limited literature addresses its impact on Bioceramic Sealers. Conversely, no significant advantage is observed with endodontic solvents or chelators. Conclusion This in vitro study underscores the efficiency of ultrasonic energy in material removal, supported by the existing literature. The SAF system exhibits promise, contributing to the evolving landscape of endodontic practice. However, endodontic solvents and chelators show limited efficacy in bioceramic sealer removal. The study advocates for the integration of 3D CBCT in endodontic research, offering precise measurements and insights into bioceramic material removal techniques.