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Updated: Jan 22, 2026

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Cleaning Efficacy, Debris Extrusion, and Instrument Separation during Root Canal Filling Removal using Continuous

Tarek Abboud1, Mouhammad Al-Tayyan2, Hassan Achour1

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|January 20, 2026
PubMed
Summary

Optimum Torque Reverse (OTR) motion increases the risk of separating instruments during root canal retreatment compared to continuous rotational motion (CRM) and reciprocating motion (RM). However, no significant differences were found in debris extrusion or residual material removal effectiveness among the tested motions.

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Area of Science:

  • Endodontics
  • Dental Materials Science

Background:

  • Root canal retreatment aims to remove obturation materials and sealer.
  • Different file motion kinematics, including Continuous Rotational Motion (CRM), Reciprocating Motion (RM), and Optimum Torque Reverse (OTR) motion, are used for retreatment.
  • Understanding the efficacy and complications associated with each motion is crucial for clinical success.

Purpose of the Study:

  • To compare the efficacy of OTR motion versus CRM and RM in removing root canal filling materials.
  • To evaluate the amount of apically extruded debris during retreatment with different motion types.
  • To assess the incidence of separating instruments (SI) as a complication.

Main Methods:

  • 45 decoronated mandibular first premolars were obturated and then divided into three groups for retreatment using CRM, RM, or OTR motion.
  • Apically extruded debris was weighed, and residual obturation material was quantified using ImageJ analysis.
  • The incidence of separating instruments was recorded and statistically analyzed.

Main Results:

  • The OTR motion group exhibited a significantly higher incidence of separating instruments compared to CRM and RM groups (p=0.001).
  • No significant differences were observed among the three groups regarding the amount of apically extruded debris.
  • The percentage of residual obturation material was also not significantly different across the motion types.

Conclusions:

  • The choice of motion (OTR, CRM, or RM) does not significantly impact the effectiveness of root canal obturation material removal or the amount of apically extruded debris.
  • OTR motion is associated with a higher risk of instrument separation during root canal retreatment.
  • Clinicians should consider the increased risk of separating instruments when opting for OTR motion in retreatment procedures.