How To Remove Gutta Percha

How to remove Eugenate-based cements and gutta-percha

29/06/2020

The removal of gutta-percha and sealer from endodontically treated root canals is the first step of whatever retreatment of teeth obturated with these materials. Gutta-percha is the nigh common obturation material, used in conjunction with diverse sealers.

The removal of gutta-percha from root-filled teeth is required not only for the retreatments, but too to prepare a space for placement of a post and to build-upward the chamber.

To reach this goal, the literature describes a number of techniques,includingtheemployofstainlesssteelmittfiles, nickel-titanium (NiTi) rotary instruments, rut-bearing instruments and ultrasonics. In improver, the use of a solvent is recommended to facilitate the removal of gutta-percha by softening it. Some of the virtually used solvents, among which chloroform, xylene and halothane are virtually equally efficient. On the other hand, all these solvents leave some droppings of gutta-percha and sealer in the root canals; in addition, chloroform might be a potential carcinogen. Other solvents have been tested: eucalyptol and turpentine oil are boring dissolvers, while orange oil and limonene are promising.

The choice of a solvent is co-determined by factors such as its toxicity.
Solvents use increase the deposit of gutta-percha and sealer remnants on root canal walls and within dentinal tubules. Since the complete removal of filling cloth and sealer is a requirement for success in retreatments, a combination of methods may be required to remove them effectively.
Clinical recommendations based on current evidence are included.

Fig. 1

Fig ane shows the chamber earlier (Left) and later cleaning (right). I of the virtually important steps after root canal treatment is to build-up the tooth using adhesive procedures. To avoid problems with bonding it is imperative to ensure that all remnants of root filling fabric and sealer have been properly removed. All of this (Eugenol, gutta-percha and filling materials) alters the penetration of dentin bonding agents.

Fig. 2

Effigy 2 (left) shows a chamber after root culvert handling using warm vertical compaction and eugenol-based sealer. All the materials staining the pulp chamber should be completely removed. Fig 2 (correct): the chamber has been cleaned using Eugenate Desobturator ands is set for the adhesive procedures.

Fig. iii

A new product made by Produits Dentaires SA, PD™ Eugenate Desobturator, was introduced in the market specifically for retreatments. Information technology is a softening solution fabricated of orange oil that helps removing eugenate-based sealers and gutta-percha from the root canals. The softening power is an culling to the mechanical action of instruments during desobturation. The softening solution tin can be used when retreating gutta-percha filled teeth, in combination with hand or rotary files.

Fig. four

The protocol is simple: one drop of Eugenate Desobturator, followed by one minute of activation, softens the material. The plastic pipettes help to innovate the product drop-by-drop direct into the canal.
Eugenate Desobturator has a natural orangish scent for patient and user comfort too.

Fig. five

The same product can be used easily after root canal obturation to make clean the chamber and to remove the excess of sealer (eugenate base cements) and gutta-percha, so the adhesive build-up process is not compromised.

Fig. vi

Here is a clinical case.

The patient was referred to retreat the upper right first molar.

The PA shows an incomplete root canal obturation and the presence of apical radiolucent area.

The molar was tender to percussion and in that location as well was a fistula on the buccal side between DB and MB root.

Fig. 7

The CBCT Browse shows on cantankerous exclusive view, a large Mesio-Buccal root. It is also like shooting fish in a barrel to appreciate on the axial view the presence of additional MB2 and MB3 canals.

The video shows the retreatment phases

Fig. viii

The CBCT Scan taken 6 months after shows a good healing of the apical lesion.

The cantankerous exclusive view shows MB1, MB2 and MB3 obturated separately. It is also piece of cake to capeesh on the axial view the presence of MB1, MB2 and MB3 canals.

Conclusions

When nonsurgical retreatment is indicated, an efficient removal of the filling materialfromtherootculvertsystemisessentialtoensureafavorableoutcome of the therapy.
Several techniques can be used to remove the gutta-percha, including the use of stainless steel mitt files or rotary instruments. The apply of a solvent is recommended to facilitate the removal of gutta-percha by softening it. Softened gutta-percha is less resistant and easier to be penetrated and removed.

Eugenate Desobturator is a softening solution fabricated of orange oil that helps removing eugenate based cements and gutta-percha. The softening solution can be used during retreatments of gutta-percha filled teeth and to clean the chamber earlier the build-up restoration with no contraindication.

Bibliography

- S D Horvath, M J Altenburger, M Naumann, M Wolkewitz, J F Schirrmeister."Cleanliness of Dentinal Tubules Following Gutta-Percha Removal With and Without Solvents: A Scanning Electron Microscopic Study" Int Endod J. November 42(eleven):1032-eight; 2009

- Gordon MPJ. "The removal of gutta-percha and root canal sealer from roots". North Z Dent J Jun;101(two):44-52, 2005

- Khedmat South, Hashemi A, Dibaji F, Kharrazifard MJ. "Effect of chloroform, eucalyptol and orangish oil solvents on the mictohardness of human being root dentin". J Dent (Tehran). Jan;12(ane):25-30. 2022

- 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". Paring Update Dec ;39(ten):703-viii. 2022

- Çanakçi BC, Er O, Dincer A. "Do the Sealer Solvents Used Affect Apically Extruded Debris in Retreatment?" J Endod 2022 Sep;41(9):1507-9

- Barbosa SV, Burkard DH, Spångberg, LSW. "Cytotoxic effects of gutta-percha solvents" J Endod 1994 January;xx(i):6-8

ABOUT THE Author