Comparison of efficiency of the retreatment procedure between Wave One Gold and Wave One systems by Micro-CT and confocal microscopy: an in vitro study.

Introduction: To compare, by Micro-CT and confocal laser scanning microscopy (CLSM), the ability of the Wave One Gold and Wave One systems to remove filling material from mesial canals of mandibular molars, effective time spent; quantity of extruded material, and percentage of sealer in the dentinal tubules after retreatment and re-obturation procedures.

Materials And Methods: Ten first mandibular molars (n = 20 mesial canals) were prepared and filled with gutta-percha and Endofill sealer mixed with Rhodamine B dye using the single cone technique. After 7 days, the canals were scanned using a high-definition micro-computer tomography with 19-mm voxel size and divided into two groups (n = 10) according to the system used in retreatment: group 1, Wave One (WO), and group 2, Wave One Gold (WG). After removing filling material with the primary file of each system, the WO 40/.08 and WG 35/.06 files were used. After using each file, a new scanning was performed and the residual filling material and extruded filling material were measured. The effective time spent to remove the canal filling was measured after each instrument. After retreatment, the teeth were re-obturated with gutta-percha and AH Plus sealer mixed with fluorescein dye using the single-cone technique. The roots were sectioned at 2, 4 and 6 mm and analysed by CLSM to measure the percentage of remaining sealer and the sealer of the new root canal filling. The data were statistically compared (P < 0.05).

Results: Both systems presented a similar volume of filling material remaining in the canals after the use of the two instruments, similar residual and new material in the dentinal tubules, and similar extrusion of material (P > 0.05). When using WO 25, the operator spent significantly less effective time than when using WG 25 (P < 0.05); however, use of WG 35 and WO 40 required a similar time to remove filling material from the canals (P > 0.05).

Conclusions: Neither of the two systems removed all the filling material. The WG system presented similar ability in removing filling and extruded material in comparison with WO system. The effective time spent was shorter for WO 25 than for WG 25.

Clinical Relevance: Wave One Gold can be an alternative to perform retreatment considering that in comparison with Wave One, there was no difference in filling material removal capacity and extruded materials. There was only difference in the effective time spent, in which the operator spent more time with WG 25 than with WO 25.