Root canal filling removal during endodontic retreatment - a survey of Ghanaian dentists

Abstract

Background : Endodontic treatment aims to thoroughly clean and shape the root canal system to rid it of any infected pulpal tissue or bacteria and to provide a three-dimensional hermetic seal to the root canal system to prevent re-infection. Despite the high rates of success of endodontic treatment, failures do occur, and these may be attributed to the persistence of bacteria in the root canal system, lack of a hermetic seal during obturation, inadequate condensation of gutta-percha, inadequate cleaning and shaping of the canal, coronal leakage or the presence of unidentified accessory canals.
For successful endodontic retreatment to occur, all traces of the root filling material (gutta-percha and the sealant) must be removed from the canal walls to enable access to the apical third of the root canal system to be regained. Removal of gutta-percha can be carried out by thermal, laser, chemical, and mechanical techniques or a combination of the above.
General Aim : To determine which instruments and solvents Ghanaian dentists use to remove gutta-percha during endodontic retreatment.
Methodology : A cross-sectional study was done by giving out a structured questionnaire at a Continuous Professional Development (CPD) event held for dentists. Simple descriptive statistics were used together with Chi-square (χ2) and one-way Analysis of Variance (ANOVA) tests. The chosen level of significance was set at p < 0.05. Unanswered questions were treated as missing values.
Results : A total of 64 dental practitioners were surveyed in this study. 32 out of 63(50.8%) respondents performed 2-4 root canal treatments (RCTs) per week, and 49 out of 62(79.0%) performed 0-1% of re-RCTs per week. 59 out of 62(95.2%) practitioners used hand files during root canal treatment. 44 out of 57(77.2 %) practitioners used hand files in combination with solvents, Gates Glidden burs, and barbed broaches during endodontic retreatment. Eucalyptol was the most used solvent during endodontic retreatment, accounting for 31 out of 39(79.5%) positive responses by practitioners.
Conclusion : Most Ghanaian dentists use hand files (K-files-54.3%) with solvents (Eucalyptol-79.5%) in the removal of gutta-percha during endodontic retreatment.