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Detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographs--an ex vivo study.

Schirrmeister JF, Hermanns P, Meyer KM, Goetz F, Hellwig E

Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany. joerg.schirrmeister@uniklinik-freiburg.de

AIM: To compare the detectability of residual Epiphany and gutta-percha after root canal retreatment using a dental operating microscope and radiographic examination with the residual area measured after rendering the roots transparent. METHODOLOGY: Sixty extracted single-rooted maxillary central incisor teeth were enlarged to apical size 40. Thirty canals were filled using vertically compacted Epiphany, the remainder were filled with vertically compacted gutta-percha and AH Plus sealer. After re-instrumentation to apical size 50, radiographs of the roots were taken in buccolingual and mesiodistal direction. Residual filling material was categorized by three observers using the radiographs and a dental operating microscope. The area of remaining material that was made visible by radiographs was measured with the aid of a computer image analysis programme. After clearing the roots, areas of residual filling material on the root canal wall were measured using a microscope. RESULTS: Computer image analysis of the radiographs showed significantly smaller areas of remaining gutta-percha and Epiphany compared with the analysis of the transparent teeth that revealed only one absolutely clean root (Epiphany). Especially in the gutta-percha group, the scores determined by the observers using radiographic examination gave an over-optimistic impression of cleanliness compared with the scores determined by the visualization through the microscope. CONCLUSION: Especially for remaining gutta-percha, the operating microscopes provided better detection of residual root filling material in retreated maxillary incisor teeth.

Published 16 June 2006 in Int Endod J, 39(7): 558-65.
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