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Removal of gutta-percha and root canal sealer: a literature review and an audit comparing current practice in dental schools M-L Good A McCammon Dental Update 2024 39:10, 707-709.
Consultant, Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, Grosvenor Road, Belfast, BT12 6BP, Northern Ireland
Endodontic failures often require non-surgical retreatment. The most common root canal obturating material is gutta-percha (GP), used in conjunction with various sealers. GP removal can be undertaken thermally and/or mechanically with or without solvents, however, no published guidelines exist. Following a literature review, an audit was undertaken comparing current endodontic practice in Belfast Dental School with the other dental schools across the UK and Republic of Ireland. From the findings, Belfast Dental School decided to introduce rotary files and chloroform to its Conservation Clinic with restrictions for use of the latter, although solvent use is not recommended in every case.
Clinical Relevance: Efficiency in removing both gutta-percha and root canal sealer would maximize the ability to disinfect the root canal system and therefore increase the likelihood of a successful outcome.
Article
The aim of endodontic treatment, or retreatment, is to reduce the microbial load within the root canal system sufficiently to enable the host response to favour periapical healing.1 According to Peters et al,2 50% of canal walls remain untouched by endodontic instruments following canal preparation.
A study undertaken in 1994 in Washington reported a 95% success rate of root treated teeth.3 Despite the recent improvements in endodontic instruments and techniques, Friedman and Mor showed a relatively similar incidence of endodontic failure between 2% and 14%.4 Ng et al, in a systematic review, found success of primary treatments to range from 68–85%.5 On the other hand, success rates for retreatment cases range from 40–100% in the literature.6
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