Retreatment case of roots with RetreatAll® rotary files of Zarc4Endo
Retreatment cases are often complicated and that is the reason why requires great skills on the part of the profesional. Purificación Varela, endodontist in Bahillo Policlínica Dental shows us a case report of a chronic apical periodontitis in 3.6 portrayed with RetreatAll® files.
Nowadays, simple endodontic cases are very difficult to be received by an exclusive endodontist. Most of the time, complex cases come to our hands and among them, in a good proportion, endodontic retreatments.
There are several causes of endodontic failure although every time we find a higher percentage of successes: fracture of instruments, canals with incomplete filling or simply, forgotten canals or with a cleaning deficit.
Definitely, failure, in most cases, is caused by microorganisms that survive conventional root canal treatment or have subsequently invaded it, either coronally or apically.
Retreatment cases are often complicated by either being reconstructed with prostheses or the canals may be obstructed by posts, filling materials, or fractured instruments in the canal. That is why retreatment requires great skill on the part of the professional and appropriate instruments for it.
Case report: retreatment with RetreatAll® files
In this article of Purificación Varela (Bahillo Policlínica Dental) we present a clinical case which was portrayed with RetreatAll® files 1 and 2 (ZARC4endo) (Fig.1), as well as with the BlueShaper® file system, to finish shaping the canals and driven by the E-Connect S® (Eighteeth) endodontic motor, which also has an integrated apex locator.
These new files, RetreatAll®, have special characteristics that make them extremely effective for gutta-percha removing:
- R1 diameter 30, 6% taper and 21 mm length.
- R2 diameter 25, 6% taper and 25 mm length.
Radial Land section that increases friction and therefore softening of the gutta-percha. The same as the speed and torque of 500 rpm and 4 Ncm.
The semi-active tip penetrates easily through the obturator material of the canal.
Patient came to the office with pain in the molar area, left hemimandible. Once the X-ray was performed, it was diagnosed as chronic apical periodontitis due to incomplete filling of the two mesial canals in tooth 3.6 (Fig. 1).
Fig. 1: Preoperative X-ray.
The composite filling is removed and with the help of the ultrasonic device we extract the threaded post from the distal canal.
To remove the gutta-percha, we first soften it and remove it from the entrance of the canals with an ultrasound tip, then with the rotary RetreatAll® files (ZARC4endo) Zr1 (30.04 of 21 mm) and Zr2 (25.04 of 25 mm), and E-Connect S® endodontic motor (Eighteeth), at 500rpm and 4Ncm, we removed the gutta-percha from the canals.
Without the need for the application of solvents that generates a paste that is difficult to remove later. We finished the shaping of the canals with the files of the BlueShaper® system (Zarc4Endo, Gijón-Spain). The instrumentation is completed by irrigating profusely, for the elimination of the residues that are generated and cleaning of the canals (Fig. 2).
Fig. 2: Root of deobturation canals.
The conometry X-ray is performed (Fig. 3) and the hypochlorite (5.25%) and EDTA (17%) are activated with the Ultra X® ultrasonic activator and X-Blue tip (flexible).
Finally, the canal filling with continuous wave using the Fast Pack vertical condensation system for the apical third and the Fast Fill gun to fill the coronal third (Fig 4).
Fig. 3 y 4: Conometry X-ray & Root filling X-ray.
Dr. Purificación Varela
PhD in Medicine and Surgery by University of Santiago de Compostela. Endodontics Master’s director in Medicine and Dentistry College of University of Santiago de Compostela. Member of Spanish Society of Conservative Dentistry. President of EFAM. Endodontics speaker and autor of several communications over the world. Exclusive practice of endodontics in Bahillo Policlínica Dental.
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