A retreatment can represent an issue for every practitioner. It is always unpredictable due to many unforeseen elements like intracanal obstacles, iatrogenic errors and complicated anatomies. Recently the Retreaty Kit has been launched: it consists in a sequence of files made with the idea of providing the clinician with a predictable sequence to follow since the the first steps of a retreatment, as in this upper second molar.
Fig. 1
A symptomatic upper second molar, with:
Apical lesion
Incomplete treatment
Missed MB2
Coronal leakage
Poor shaping
Objectives:
Clean, shape and 3d fill the full anatomy
Solve the symptomatology
One visit session
The first step is always to refine the access cavity and if the pretreatment has been already performed, it is suggested to remove part of it if coronal interferences are present.
Ultrasounds are the ideal tool for doing and also for removing interferences at the MB2 orifice level
Fig. 2
The use of Bull(Y) is extremely suggested as first file. It is able to remove gutta-percha in an easily way without any solvent. It can rotate in rotary motion or in reciprocating motion.
Bull-y must work just inside gutta-percha, for this reason it has been used in palatal and mb1 canal
Fig. 3
Considering that patency has been reached immediately after the Bull(Y) use, as second file has been used immediately ShapY 1. The gold alloy is extremely effective and bendable, the reason why it has been used also manually for bypassing a ledge in the palatal canal.
After that it reached manually the apex it has been immediately connected to the end motor for shaping the ledge. Shap(Y) 1 worked well also in distal and MB1
Fig. 4
Shap(Y) 2, gold alloy in a 25/05 shape. A real nice shaper, with an amazing balance between cutting efficacy and bendability
Shap(Y) 2 in action
Fig. 5
Shap(Y) 3 in blue alloy for refining the apex. 30/05 in palatal, MB1 and distal
Shap(Y) 3 in action
Mb2 shaping with Shap(Y) 1. The tip design and the alloy can make this instrument amazing for penetrating also in a virgin canal. MB2 merged with MB1 after 16mm.
After shaping, Cleaning procedure has been performed.
Fig. 6
the canal was 3d filled with single cone technique and BC sealer.
Conclusions
Retreaty kit is an amazing solution for the endodontist who wants approach the retreatment in a predictable and repeatable way. Five files designed for disobturating first and shaping after any kind of canal. In case of bigger diameters, the operator can easily refine the apical region just with MG3 blue.
Bibliography
Trope, M. Flare-up rate of single-visit endodontics. International Endodontic JournalVolume 24, Issue 1 First published: January 1991
Betül Aycan Uysal, Burçin Arıcan. Comparison of the dentin tubule penetration of AH Plus, WellRoot ST, and MTA BioSeal after obturation, retreatment, and re-shaping of the root canals Microscopy Research and TechniqueVolume 87, Issue 1 First published: 15 September 2023
Bergenholtz, G, Lekholm, U., Milton, R. Heden, G., Ödesjö, B., Engström, B. Retreatment of endodontics fillings. Eur J Or Sci, 1979, 87, 3
Park, E. Ultrasonics in endodontics. Endod Topics, 2013, 29(1)
Gulabivala, K., Ng, Y.L. Factors that affect the outcome of root canal treatment and retreatment - A reframing of the principles. Int Endo J, 2023;56(52)
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