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A Fluorescence-based Method to Reaccess Root Canals in Endodontically Treated Teeth: A Micro-Computed Tomography
Iago Ramirez1, Lautaro Gallardo Altube1, Rafael Verardino Camargo1
1Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Journal of Endodontics
|July 22, 2024
Summary
Using fluorescence and magnification aids, such as the REVEAL device, significantly reduced remnant restorative material and dentin removal during endodontic retreatment. This innovative approach improves the efficiency and safety of removing coronal restorations and cervical barriers.
Area of Science:
- Endodontics
- Restorative Dentistry
- Dental Materials
Background:
- Evaluation of restorative material removal and dentin preservation is crucial in endodontic retreatment.
- Different magnification methods may influence the efficiency and safety of removing coronal restorations and cervical barriers.
Purpose of the Study:
- To compare the efficacy of different magnification methods (naked eye, operative microscope, REVEAL device) in removing esthetic restorative materials and cervical barriers from endodontically treated mandibular molars.
- To quantify the volume of dentin removed and the volume of remnant restorative material using 3-dimensional (3D) micro-computed tomographic (micro-CT) analysis.
Main Methods:
- 30 endodontically treated mandibular molars were restored with a single-cone technique, cervical barriers (glass ionomer cement with fluorescein), and resin composites.
- Specimens underwent simulated aging (20,000 thermocycles) and were divided into three groups for restoration removal: naked eye, operative microscope, and REVEAL device.
- 3D micro-CT scanning and morphometric analysis were performed to assess remnant material volume and dentin removal volume.
Main Results:
- The REVEAL device group exhibited the lowest volume of remnant material (3.17 ± 1.65 mm³) and the smallest percentage of dentin removal (2.56 ± 1.34%).
- The operative microscope group showed comparable dentin removal to the REVEAL group but similar remnant material to the naked eye group (9.63 ± 4.33 mm³).
- The naked eye group demonstrated the highest volume of remnant material (7.60 ± 2.68 mm³) and the greatest percentage of dentin removal (6.60 ± 3.70%).
Conclusions:
- The combination of fluorescence and magnification, particularly with the REVEAL device, significantly enhances the removal of restorative materials and minimizes dentin removal.
- This approach offers a promising solution for the challenges associated with endodontic retreatment, improving predictability and reducing procedural risks.
