Abstract
Background: During endodontic retreatment, complete removal of root canal filling material is essential for effective cleaning and disinfection of the root canal system. Various methods have been proposed for gutta-percha removal, including the rotary instruments, which is recommended because it is safe, effective, and less time-consuming.
Objective: Comparison of gutta-percha removal efficiency in endodontic retreatment between the Protaper retreatment system (Dentsply Sirona) and R-Endo system (Micro Mega).
Methods: The present in vitro study was conducted on 60 mandibular premolars extracted for orthodontic purposes; after initial endodontic treatment, root canal filling with gutta-percha and zinc oxide eugenol cement, the teeth were randomly divided into four groups, each group of 15 teeth. The groups were as follows: The group using the Protaper retreatment system, the group using the R-Endo system, the group using the Protaper retreatment system combined with the solvent, and the group using the R-Endo system combined with a solvent to remove gutta-percha. The time taken to remove gutta-percha was recorded. Roots were grooved into two halves, observed under a microscope, taken pictures, and evaluated with ImageJ 1.53v software, recording the amount of gutta-percha remaining on the root canal wall.
Results: The study showed no significant difference in the effectiveness of gutta-percha removal between the Protaper retreatment system and the R-Endo system; all groups left gutta-percha on the canal wall. The Protaper retreatment system or R-Endo system combined with solvent left more gutta-percha on the canal wall than using only the Protaper retreatment system or R-Endo system. The amount of gutta-percha remaining on the canal wall at the cervical third, middle third, and apical third regions between the study groups did not have a statistically significant difference. The average time to remove gutta-percha showed a statistically significant difference between the study groups (p < 0.05).
Conclusion: There was no difference in the efficiency of gutta-percha removal between the Protaper retreatment system and the R-Endo system in endodontic retreatment.
| Published | 2025-09-12 | |
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| Issue | Vol. 15 No. 4 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.4.20 | |
| Keywords | Protaper retreatment system, R-Endo system, endodontic retreatment, gutta-percha removal |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
Purba R, Sonarkar SS, Podar R, et al. Comparative evaluation of retreatment techniques by using different file systems from oval-shaped canals. J Conserv Dent. 2020;23(1):91-96.
Gu LS, Ling JQ, Wei X, et al. Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals. Int Endod J. 2008;41(4):288-295.
Slowey RR. Root canal anatomy. Road map to successful endodontics. Dent Clin North Am. 1979;23(4):555-573.
Bhagavaldas MC, Diwan A, Kusumvalli S, et al. Efficacy of two rotary retreatment systems in removing gutta-percha and sealer during endodontic retreatment with or without solvent: a comparative in vitro study. J Conserv Dent. 2017;20(1):12-16.
Kasam S, Mariswamy AB. Efficacy of different methods for removing root canal filling material in retreatment: An in vitro study. J Clin Diagn Res. 2016;10(6):6-10.
Yang R, Han Y, Liu Z, et al. Comparison of the efficacy of laser-activated and ultrasonic-activated techniques for the removal of tricalcium silicate-based sealers and gutta-percha in root canal retreatment: a microtomography and scanning electron microscopy study. BMC Oral Health. 2021;21(1):275.
Buranade AT, Algarni YA, Alobaid ASN, et al. Comparative evaluation of efficacy of Protaper Universal Retreatment system, R-Endo system and Hedstrom file in gutta-percha removal during root canal retreatment: An in vitro study. J Pharm Bioallied Sci. 2022;14(1):507-510.
Tiwari R, Nikhade P, Chandak M. Efficacy of Protaper Universal, R Endo, Peezo Reamer on gutta-percha removal: A stereomicroscopic analysis. IOSR J Dent Med Sci. 2014;13(8):65-70.
Dinh Thi Khanh Van, Pham Van Khoa. Efficacy of endodontic retreatment methods. Ho Chi Minh City Med. 2013;17(2):157-160.
Dentsply Sirona. ProTaper Universal Retreatment Files step-by-step guide [Internet]. Available from: https://www.dentsplysirona.com/content/dam/master/regions-countries/north-america/product-procedure-brand/endodontics/product-categories/restoration/retreatment-files/documents/END-Step-By-Step-ProTaper-Universal-Retreatment-Files-EN.pdf. Accessed 2022 Oct 10.
Venturi M. R-Endo Retreatment: the solution [Internet]. Available from: http://www.endodonpziamauroventuri.it/Preparazione%20rotante%20Ni-Ti/R-Endo%20Livret.pdf. Accessed 2022 Oct 10.
Hussne RP, Braga LC, Berbert FL, et al. Flexibility and torsional resistance of three nickel-titanium retreatment instrument systems. Int Endod J. 2011;44(8):731-738.
Al-Haddad A, Che Z, Aziz Z, et al. Efficacy of R-Endo and ProTaper retreatment systems in removal of RealSeal. Aust J Basic Appl Sci. 2011;5(3):108-113.
Amal F, Aswathy Y, Jenaki EV, et al. Efficacy of various rotary retreatment instruments for gutta-percha removal: An in vitro study. Int J Appl Dent Sci. 2020;6(4):242-246.
Subbiya A, Venkatesh A, Malathi Suresh SM, et al. Efficiency of Protaper retreatment files after each use with and without solvent: An in vitro study. J Crit Rev. 2020;7(14):3415-3422.
Horvath SD, Altenburger MJ, Naumann M, et al. Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: A scanning electron microscopic study. Int Endod J. 2009;42(11):1032-1038.
Gokturk H, Yucel AC, Sisman A. Effectiveness of four rotary retreatment instruments during root canal retreatment. Cumhuriyet Dent J. 2015;18(1):25-36..
Nasiri K, Wrbas KT. Comparison of the efficacy of different Ni-Ti instruments in the removal of gutta-percha and sealer in root canal retreatment. Indian J Dent Res. 2020;31(4):579-584.
Aly A, Abdallah A, Elbackly R. Efficacy of three different retreatment file systems for gutta-percha removal using cone beam computed tomography. Alexandria Dent J. 2020;45(3):23-28.
Beshr K, Mohammad S, Rokaya M, et al. Retreatment efficacy of three rotary Ni-Ti systems using computed tomography. Oral Health Dent Manag. 2015;14(2):115-119.
Colombo AP, Fontana CE, Godoy A, et al. Effectiveness of the WaveOne and ProTaper D systems for removing gutta-percha with or without a solvent. Acta Odontol Latinoam. 2016;29(3):262-267.
Kfir A, Tsesis I, Yakirevich E, et al. The efficacy of five techniques for removing root filling material: microscopic versus radiographic evaluation. Int Endod J. 2012;45(1):35-41.
Takahashi CM, Cunha RS, de Martin AS, et al. In vitro evaluation of the effectiveness of ProTaper Universal rotary retreatment system for gutta-percha removal with or without a solvent. J Endod. 2009;35(11):1580-1583.