Skip to main content Skip to main navigation menu Skip to site footer
Review
Published: 2022-05-13

Major clinical findings of endodontic retreatment: a concise systematic review

UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
Endodontic treatment Endodontic retreatment techniques Clinical trials

Abstract

Introduction: In the endodontic treatment and retreatment scenario, the primary objective is to eliminate necrotic tissue and infectious bacteria, especially cleaning and shaping. Endodontic retraction is a procedure performed on a tooth that has received a previous attempt at a definitive treatment that has resulted in a condition that requires further endodontic treatment to achieve a successful outcome. The main cause of treatment failure is insufficient cleaning and inadequate filling. Objective: The present study carried out a concise systematic review to evaluate the main findings of clinical studies on endodontic retreatments, showing the main techniques, efficacy, and safety. Methods: The rules of the Systematic Review-PRISMA Platform. The research was carried out from December 2021 to March 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 124 articles were found. A total of 74 articles were evaluated in full and 17 were included and evaluated in the present study. Studies have demonstrated the effectiveness of rotational systems in endodontic retreatment but never producing completely obturator-free root canals. Reciproc instruments were associated with significantly higher cyclic fatigue strength than WaveOne instruments. The persistent infection microbiota is polymicrobial with a predominance of E. faecalis and P. gingivalis in all stages of endodontic retreatment, regardless of the method used for microbial identification. A higher bacterial load and lower lipoteichoic acid level were found in the 2-visit group after the retreatment protocol. Postoperative pain was significantly reduced at 48 and 72 hours after the application of nano-silver and nano-calcium hydroxide alone. Conclusion: The results of clinical trials showed that the root canal instrumentation system with rotary files maintains the quality of the root preparation and reduces the number of files needed to obtain a canal, which would consequently reduce the operative time and also considerably reduce the risk of torsion fracture within the root canal, allowing successful endodontic retreatment. Also, a condition for successful endodontic retreatment is the adequate cleaning of the root canals, therefore, special attention must be given to the technique used to remove the filling material.

References

  1. Azarpazhooh A, Khazaei S, Jafarzadeh H, Malkhassian G, Sgro A, Elbarbary M, Cardoso E, Oren A, Kishen A, Shah PS. A Scoping Review of Four Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies: Part 3-A Proposed Framework for Standardized Data Collection and Reporting of Endodontic Outcome Studies. J Endod. 2022 Jan;48(1):40-54. doi: 10.1016/j.joen.2021.09.017. Epub 2021 Oct 22. PMID: 34688792.
  2. Abbott PV. Present status and future directions: Managing endodontic emergencies. Int Endod J. 2021 Dec 27. doi: 10.1111/iej.13678. Epub ahead of print. PMID: 34958512.
  3. Alghamdi F, Alhaddad AJ, Abuzinadah S. Healing of Periapical Lesions After Surgical Endodontic Retreatment: A Systematic Review. Cureus. 2020 Feb 7;12(2):e6916. doi: 10.7759/cureus.6916. PMID: 32190471; PMCID: PMC7061768.
  4. Kim BN, Son SA, Park JK. Endodontic retreatment of a calcified anterior tooth using a 3D-printed endodontic guide. Int J Comput Dent. 2021 Dec 21;24(4):419-427. PMID: 34931777.
  5. Imura N, Kato AS, Hata GI, Uemura M, Toda T, Weine F. A comparison of the relative efficacies of four hand and rotary instrumentation techniques during endodontic retreatment. Int Endod J, 2000, v. 33, n. 4, p. 361-6.
  6. Carr, G.B. Endodontics at the crossroads. J Calif Dent Assoc, v. 24, n. 12, p. 20-6, 1996.
  7. Abou-Rass, M. Evaluation and clinical management of previous endodontic therapy. Journal of Prosthetic Dentistry, 1982,v.47, p. 528–34.
  8. De-Deus, G. et al. Extended cyclic fatigue life of F2 ProTaper instruments used in reciprocating movement. Int Endodontic, 2010, v. 43, p. 1063-1068.
  9. Imura, N.; Zuolo, M.L.; Ferreira, M.O.F.; Novo, N.F. Effectiveness of the Canal Finder and hand instrumentation in removal of gutta-percha root fillings during root canal retreatment. Int Endod J, 1996, v. 29, p.382-6.
  10. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n71
  11. H Balshem H, Grade guidelines: 3 ratng the quality of evidence. Journal of Clinical Epidemiology, Maryland Heights, 64 (4) (2011) 401-406.
  12. Higgins, S Green, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.
  13. Schirrmeister JF, Wrbas KT, Meyer KM, Altenburger MJ, Hellwig E. Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment. J Endod 2006; 32(5): 469-472.
  14. Tasdemir T Er K, Yildirim T, Çelik D Efficacy of three rotary NiTi instruments in removing gutta-percha from root canals. Int Endodon J 2008, 41,191- 196.
  15. Gu LS, Ling JQ, Wei X, Huang XY. Efficacy of Protaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endodon J. 2007;41:288-295.
  16. Gergi R, Sabbagh C. Effectiveness of two nickeltitanium rotary instruments and a hand file for removing gutta-percha in severely curved root canals during retreatment: an ex vivo study. Int Endod J. 2007;40(7):532-7.
  17. Plotino, G. et al. Cyclic fatigue of Reciproc and WaveOne reciprocating instruments. International Endodontic Journal, v. 45, n. 7, p. 614-618, 2012.
  18. Barbosa-Ribeiro M, Arruda-Vasconcelos R, Louzada LM, Dos Santos DG, Andreote FD, Gomes BPFA. Microbiological analysis of endodontically treated teeth with apical periodontitis before and after endodontic retreatment. Clin Oral Investig. 2021 Apr;25(4):2017-2027. doi: 10.1007/s00784-020-03510-2. Epub 2020 Aug 28. PMID: 32860137.
  19. Toia CC, Khoury RD, Corazza BJM, Orozco EIF, Valera MC. Effectiveness of 1-Visit and 2-Visit Endodontic Retreatment of Teeth with Persistent/Secondary Endodontic Infection: A Randomized Clinical Trial with 18 Months of Follow-up. J Endod. 2022 Jan;48(1):4-14. doi: 10.1016/j.joen.2021.09.004. Epub 2021 Sep 20. PMID: 34555421.
  20. Fahim MM, Saber SEM, Elkhatib WF, Nagy MM, Schafer E. The antibacterial effect and the incidence of post-operative pain after the application of nano-based intracanal medications during endodontic retreatment: a randomized controlled clinical trial. Clin Oral Investig. 2022 Feb;26(2):2155-2163. doi: 10.1007/s00784-021-04196-w. Epub 2021 Oct 25. PMID: 34697657.

How to Cite

Luccas, M. A., Silva, I. V., & Castro, F. P. L. de. (2022). Major clinical findings of endodontic retreatment: a concise systematic review. MedNEXT Journal of Medical and Health Sciences, 3(S3). https://doi.org/10.54448/mdnt22S308