Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth with Simulated Apical Root Resorption: An in Vitro Study

Abstract

Background: This study was conducted for Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth With Simulated Apical Root Resorption.

Material and methods: A study was conducted utilizing an in vitro approach on the root canals of 90 mandibular premolar teeth that were extracted. These teeth were prepped using a ProTaper Gold rotary file and filled with gutta-percha and an AH Plus sealer, employing a cold lateral compaction technique. A sample of 45 mandibular premolar teeth was allocated randomly into three control groups: the ProTaper Universal retreatment file group, the Neo Endo retreatment files group, and the Endo ReStart file group. These groups were used to assess the efficacy of root canal filling material removal. The remaining 45 teeth were designated as the experimental group, where the apical portion was modified to simulate apical root resorption. The teeth of the experimental group were randomly allocated into three subgroups, mirroring the three approaches employed in the control groups for the purpose of removing root canal filling materials. The debris that was extruded apically was gathered and placed into borosilicate glass tubes that had been pre-weighed. Subsequently, the collected debris was subjected to a drying process. The average weight of the debris that was extruded apically was evaluated by employing an analytical balance with a precision of 10-4 g. Additionally, the data were subjected to statistical analysis using the Kruskal-Wallis test followed by Tukey's post hoc test.

Results: Significantly more debris extrusion was seen in the groups with simulated apical root resorption when compared to the groups without simulated root resorption (p < 0.05) for all file systems. The ProTaper Universal retreatment file demonstrated the lowest weight of apically extruded debris (p < 0.05) in both the control and experimental groups. The Neo Endo file and the Endo ReStart file followed, exhibiting higher amounts of extruded debris.

Conclusion: The teeth exhibiting simulated apical root resorption demonstrated a considerably higher quantity of apically extruded debris compared to the teeth lacking this simulated condition. Moreover, in the process of eliminating the root canal filling materials, it was seen that Endo ReStart retreatment file resulted in a considerably higher amount of debris being extruded apically across all groups.