References

Sjogren U, Hagglund B, Sundqvist G, Wing K Factors affecting the long-term results of endodontic treatment. J Endod. 1990; 16:498-504 https://doi.org/10.1016/S0099-2399(07)80180-4
Gunraj M Dental root resorption. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88:647-653
Del Fabbro M, Corbella S, Sequeira-Byron P Endodontic procedures for retreatment of peri-apical lesions. Cochrane Database Syst Rev. 2016; 10:(10) https://doi.org/10.1002/14651858.CD005511.pub3
Li BY, Gong QM [Research progress in clinical prognosis of apical overfilling of root canal obturation]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2021; 56:210-215 https://doi.org/10.3760/cma.j.cn112144-20200226-00088
Tandon J, Taneja S, Bhalla VK, Jain A Evaluation of bacterial reduction at various stages of endodontic retreatment after use of different disinfection regimens: an in vivo study. Eur Endod J. 2022; 7:210-216
Dotto L, Sarkis-Onofre R, Bacchi A, Pereira GKR The use of solvents for gutta percha dissolution/removal during endodontic retreatments: a scoping review. J Biomed Mater Res B Appl Biomater. 2021; 109:890-901 https://doi.org/10.1002/jbm.b.34753
Good ML, McCammon A An removal of gutta percha and root canal sealer: a literature review and an audit comparing current practice in dental schools. Dent Update. 2012; 39:703-708
Martos J, Gastal MT, Sommer L Dissolving efficacy of organic solvents on root canal sealers. Clin Oral Investig. 2006; 10:50-54
Oyama KO, Siqueira EL, Santos MD In vitro study of effect of solvent on root canal retreatment. Braz Dent J. 2002; 13:208-211
Ferreira I, Grenho L, Gomes P Efficacy and cytotoxicity of binary mixtures as root canal filling solvents. Materials. 2020; 13
Ribeiro DA, Matsumoto MA, Marques ME, Salvadori DM Biocompatibility of guttapercha solvents using in vitro mammalian test-system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103:106-109
Wennberg A Biological evaluation of root canal sealers using in vitro and in vivo methods. J Endod. 1980; 6:784-787
Chang YC, Chou MY Cytotoxicity of halothane on human gingival fibroblast cultures in vitro. J Endod. 2001; 27:82-84
Vajrabhaya LO, Suwannawong SK, Kamolroongwarakul R, Pewklieng L Cytotoxicity evaluation of gutta percha solvents: chloroform and GP-Solvent (limonene). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98:756-759
Zaccaro Scelza MF, Lima Oliveira LR, Carvalho FB In vitro evaluation of macrophage viability after incubation in orange oil, eucalyptol, and chloroform. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102:e24-27

Orange oil technique for gutta percha removal near open apices in root canal re-treatment

From Volume 51, Issue 6, June 2024 | Pages 443-446

Authors

M Ali M Tello

BDS, MFDS

Senior Resident in Endodontology, Postgraduate Studies, College of Dentistry, Ajman University, Ajman City, UAE

Articles by M Ali M Tello

Firas Elmsmari

DDS, MSc, PhD

Division Lead and Assistant Professor in Endodontics, Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, UAE; Visiting Faculty, Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain

Articles by Firas Elmsmari

Abdul Rahman M Saleh

DMD, MSD, PhD

Associate Professor in Endodontics, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE

Articles by Abdul Rahman M Saleh

Kelvin I Afrashtehfar

DDS, MDent, MSc, Dr med dent, PhD, FCGDent, FRCD(C), FDS RCS, ITI Fellow

Affiliate Clinical Faculty, College of Dentistry, Ajman University, Ajman City, UAE; Adjunct Research Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland

Articles by Kelvin I Afrashtehfar

Email Kelvin I Afrashtehfar

Abstract

This clinical recommendation introduces a practical approach for the removal of gutta percha remnants near open apices in root canal retreatment using orange oil. This advice discusses the rationale for the technique, provides a step-by-step description, and outlines its advantages and limitations. This minimally invasive cost-effective approach offers dental practitioners greater effectiveness and safety in addressing the challenge of gutta percha removal near open apices.

CPD/Clinical Relevance: A minimally invasive cost-effective approach that offers effectiveness and safety when removing gutta percha near open apices is described.

Article

Apical lesions in root canal-treated mature teeth, especially in cases with suboptimal root canal treatment,1 are of concern as these lesions can progress into apical inflammatory root resorption, which in turn can lead to the formation of an open apex.2 When faced with such clinical scenarios, the choice of retreatment becomes crucial.3 This decision is driven by the need to prevent an unfavourable crown–root ratio and promote the healing process to preserve the integrity of the natural tooth and avoid an extraction.

Removing gutta percha from irregular root canals of root canal-treated teeth (RCTT) can be challenging, particularly when conventional methods using retreatment files may prove to be less effective. The inefficiency of these methods can potentially lead to excessive dentine removal, resulting in root weakening, canal transportation, or strip perforation. Moreover, there is a risk of extruding gutta percha beyond the open apex, which can trigger a foreign body reaction, potentially delaying or impeding the healing process or causing a flare-up that may necessitate apical surgery or lead to post-operative discomfort.4

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available