Frequency of aggravation in cases of endodontic retreatment with different length of obturation

Abstract

Introduction: complete removal of filling materials and contaminated dentin from the root canal during endodontic retreatment may influence the appearance of an endodontic flare-up. Objective: to determine the frequency of endodontic flare-ups after endodontic retreatment of upper anterior teeth with different lengths of apical filling. Material and methods: thirty-three cases of endodontic failure were chosen for this study. According to the apical length of the initial filling, the subjects were divided into 2 groups: cases closed between 0.0 and 2.0 mm from the radiographic apex (RA) were placed in group A (n = 23) and group B (n = 10) corresponded to cases closed between 2.1 to 6 mm short to RA. Gutta-percha fillings were removed with ProTaper retreatment instruments D1 to D3 (Dentsply-Sirona, Ballaigues, Switzerland) plus chloroform. Subsequently, the root canals were instrumented with K-flexofile files. The reinstrumented cases were filled with Gutta-percha (Higyenic, Coltene Whaledent) and Sealapex (Kerr Sybronendo, WA) during the same appointment. Patients received 400 mg of ibuprofen every 8 hours for 72 hours and recorded postoperative pain at 8, 24, 48, and 72 hours. Flare-up was defined as the appearance of severe pain (pain on the Heft-Parker scale from 114) and/or inflammation. Percentages of positive cases upon palpation and percussion at 72 hours were determined for both groups. Results: two patients presented exacerbation (6%), both of them in group A. Postoperative pain was 21.2% for group A at 8 hours and 9.1% at 48 hours. No statistically significant differences were found in the presence of exacerbation between groups (p > 0.05). Conclusions: the aggravation of endodontic retreatment cases is 6%. The obturation length of cases indicated for endodontic retreatment does not influence the frequency of postoperative aggravation.