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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


M Ali M Tello


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

Articles by M Ali M Tello

Firas Elmsmari


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


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


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.


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

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