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Journal List J Conserv Dent v.15(2); Apr-Jun 2012 PMC3339008

J Conserv Dent. 2012 Apr-Jun; 15(2): 141145.

doi: 10.4103/0972-0707.94584

PMCID: PMC3339008

Dissolving efficacy of different organic solvents on

gutta-percha and resilon root canal obturating

materials at different immersion time intervals

Mubashir Mushtaq, Riyaz Farooq, Mohammed Ibrahim, and Fayiza Yaqoob

Khan

Author information Article notes Copyright and License information

Abstract

Background Aim:

The purpose of this study was to compare and evaluate the

dissolving capability of various endodontic solvents used during

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The dissolving ability of different organic

solvents on three different root canal

[Iran Endod J. 2012]

Dissolving efficacy of some organic solvents

on gutta-percha. [Braz Oral Res. 2007]

Effectiveness of three solvents and two

associations of solvents on gutta-percha and

[Braz Dent J. 2011]

A comparison of the effectiveness ofchloroform in dissolving resilon and gutta-

[J Dent (Tehran). 2011]

Push-out bond strengths: the Epiphany-

Resilon endodontic obturation system

[Int Endod J. 2006]

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endodontic retreatment on resilon and gutta-percha at different

immersion time intervals.

Materials and Methods:

160 ISO no. 40 cones (0.06 taper), 80 each of resilon and gutta-

percha were taken as samples for the study. Both resilon and gutta-

percha were divided into eight experimental groups of 20 cones

(four groups each of resilon and gutta-percha) for immersion in

xylene, tetrachloroethylene, refined orange oil and distilled water.

Each group was further divided into two equal subgroups (n=10)

for 2- and 5-minute immersion time intervals at room temperature

to investigate the potential of these solvents for clinical use in

dissolving resilon and gutta-percha. Each sample was weighed

initially before immersing in the solvent on a digital analytical

scale. Distilled water served as a control. Samples were removed

from the respective solvents after the specified immersion period

and washed in 100 ml of distilled water and allowed to dry for 24 h

at 37C in a humidifier. The samples were then again w eighed after

immersion in the specific solvent on a digital analytical scale. The

extent of gutta-percha or resilon removed from the specimen was

calculated from the difference between the original weight of gutta-

percha or resilon sample and its final weight. Means and standard

deviations of percentage loss of weight were calculated at each time

interval for each group of specimens. The values were compared by

statistical parametric tests using SPSS 16.0 Software. The data was

subjected to paired t test, independent t test, one-way ANOVA test

and multiple comparisons with Scheffe's test.

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Dissolving efficacy of different organic

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Results:

There was no significance in the amount of gutta-percha dissolved

at 2- and 5-minute immersion time intervals in all groups (P>0.05)

except the tetrachloroethylene group (P=0.00). There was a very

high significance in the amount of resilon dissolved at 2- and 5-

minute immersion time intervals in all groups (P=0.00) except the

xylene and distilled water (Control) groups (P>0.05).

Conclusion:

The results showed that xylene, refined orange oil and

tetrachloroethylene can be used for softening gutta-percha/resilon

during retreatment with various techniques- xylene being the best

solvent both for gutta-percha and resilon.

Keywords: Endodontic retreatment, gutta-percha, resilon,

solvents

INTRODUCTION

Non surgical endodontic retreatment is an attempt to re-establish

healthy periapical tissues after inefficient treatment or reinfectionof an obturated root canal system because of coronal or apical

leakage. It requires regaining access to the entire root canal system

through removal of the defective root canal filling, further cleaning

and shaping if required and reobturation.[1] Success rate of

endodontically treated teeth ranges from 86 to 95%[2] and

retreatment should be done for failure of root canal treated teeth.

Endodontic retreatment--case selection

and technique. Part 2: Treatment planning

[J Endod. 1988]

Leakage of different root canal sealants.

[Oral Surg Oral Med Oral Pathol. 1976]
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For over 100 years, gutta-percha has been the most commonly

used material to obturate the root canal system. One of the

disadvantages of gutta-percha as an obturating material is the lack

of an effective seal.[3] However, when the coronal restoration is

defective or absent, contamination with saliva may cause root

canal sealer dissolution, thus providing a space for bacterial

penetration that may contribute to the failure of the treatment.[4]

Resilon is a thermoplastic synthetic polymer based root canal filling

material containing bioactive glass and radiopaque fillers.[5] The

manufacturer claims that its handling characteristics are similar to

gutta-percha. The significant improvement of resilon when

compared to gutta-percha is claimed to be its bonding to the dentin

walls when used in conjunction with its sealer, and forms a

monoblock within the canal.[6] Preliminary studies have shown

that resilon has less microleakage when compared to gutta-

percha.[5,79] Because of its acclaimed superior characteristics,

resilon is emerging as a promising alternative to gutta-percha. The

number of teeth obturated with resilon is expected to rise

significantly in the near future. Although the long-term success

rate of this new system is unknown, a number of reasons will

necessitate retreatment of resilon-filled teeth. A recent study

demonstrated the susceptibility of biodegradation of resilon by

bacterial/salivary enzymes.[10] In such cases nonsurgical

endodontic retreatment would be indicated to clean and shape the

previously root treated tooth.

Gutta-percha is the most popular core material used for

An evaluation of microbial leakage in roots

filled with a thermoplastic synthetic

[J Endod. 2004]

Fracture resistance of roots

endodontically treated with a new resin

[J Am Dent Assoc. 2004]

Periapical inflammation after coronal

microbial inoculation of dog roots filled

[J Endod. 2005]

An in vitro assessment of apical

microleakage in root canals obturated with

[J Conserv Dent. 2011]

Susceptibility of a polycaprolactone-based

root canal filling material to degradation. I.

[J Endod. 2005]

Endodontic retreatment: evaluation of
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obturation.[11] Removal of gutta-percha can be done with several

techniques. These include rotary files, ultrasonic instruments, and

hand files in combination with heat or chemicals.[12] Solvents

have been used in the past to soften and dissolve gutta-percha.[13]

However, all solvents are known to be toxic to the periapical tissues

and should be used with caution.[13] In clinical practice, refined

orange oil, tetrachloroethylene and xylene are used for softeningthe gutta-percha during nonsurgical endodontic retreatment. There

are no studies using above solvents to remove synthetic polymer

based root canal filling material.

Hence the purpose of this study was to compare and evaluate the

dissolving capability of various endodontic solvents such as xylene,

tetrachloroethylene and refined orange oil on resilon and gutta-

percha at different immersion time intervals.

MATERIALS AND METHODS

160 ISO no. 40 cones (0.06 taper), 80 each of resilon (SybronEndo,

USA) and gutta-percha (SureEndo, Korea) were taken as samples

for the study. Both resilon and gutta-percha were divided into eight

experimental groups of 20 cones (four groups each of resilon andgutta-percha) for immersion in xylene (Fischer Scientific, Mumbai,

India), tetrachloroethylene (Ammdent, India), refined orange oil

(Nipponshika, Yakuhin Co. Ltd, Shimonoseki, Japan) and distilled

water (Milli-Q w ater system, Millipore Corporation, Bedford, MA,

USA). Each group was further divided into two equal subgroups

(n=10) for 2- and 5-minute immersion time intervals at room

gutta-percha and sealer removal and canal[J Endod. 1987]

Gutta-percha solvents--a comparative

study. [J Endod. 1986]
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temperature to investigate the potential of these solvents for clinical

use in dissolving resilon and gutta-percha. Each sample was

weighed initially before immersing in the solvent on a digital

analytical scale (Shimadzu Electronic Weighing Machine, Japan,

Model: AEL-200). Distilled water served as a control.

The samples of solvents were prepared by taking 5 ml of each

solvent in a glass vial. Immediately after the gutta-percha/resilon

cone was immersed in the solvent, timing was started with a stop

watch and the lid of the screw top bottle was replaced. If the gutta-

percha/resilon sample stuck to the glass vial during testing, it was

dislodged with vibrations on vortex shaker to prevent clumping of

partially dissolved gutta-percha/resilon, respectively. Samples were

removed from the glass vial after the specified immersion period

and washed in 100 ml of distilled water and allowed to dry for 24 h

at 37C in a humidifier. The samples were then again w eighed after

immersion in the specific solvent on a digital analytical scale

(Shimadzu Electronic Weighing Machine, Japan, Model: AEL-

200).

The extent of gutta-percha or resilon removed from the specimen

was calculated from the difference between the original weight ofgutta-percha or resilon and its final weight using the following

equation:

M=M M

Where:

2 1
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M =post-immersion weight.

M =pre-immersion weight.

Means and standard deviations of percentage loss of weight were

calculated at each time interval for each group of specimens. The

values were compared by statistical parametric tests using SPSS

16.0 Software. The data was subjected to paired t test, independentt test, one-way ANOVA test and multiple comparisons with

Scheffe's test.

RESULTS

The weight loss of gutta-percha in different solvents as a function

of time [Figure 1a] showed that there was no significance in the

amount of material dissolved at 2- and 5-minute immersion timeintervals in all groups (P>0.05) except the tetrachloroethylene

group (P=0.00).

Figure 1a

Weight loss of gutta-percha in

different solvents as a function of

time

The weight loss of resilon in different solvents as a function of time

[Figure 1b] showed that there was a very high significance in the

amount of material dissolved at 2- and 5-minute immersion time

intervals in all groups (P=0.00) except the xylene and distilled

water (Control) groups (P>0.05).

2

1
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Figure 1b

Weight loss of resilon in different

solvents as a function of time

Comparison of solubility- effect of different solvents on gutta-

percha and resilon at 2-minute immersion time interval [Figure 2a

] showed that there was a very highly significant difference in the

amount of gutta-percha and resilon dissolved in all the solvents

(P=0.00) except the distilled water (Control) groups (P>0.05).

Xylene exhibited the best dissolving capacity both for gutta-percha

and resilon followed by refined orange oil and the least dissolving

capacity was seen with tetrachloroethylene as is evident from the

graph. All the solvents tested displayed a better dissolving capacity

in dissolving gutta-percha as compared to resilon (P=0.00).

Figure 2a

Comparison of solubility effect of

different solvents on gutta-percha and

resilon at 2-minute immersion time

interval

Comparison of solubility- effect of different solvents on gutta-

percha and resilon at 5-minute immersion time interval [Figure 2b

] showed that there was a very highly significant difference in the

amount of gutta-percha and resilon dissolved in all the solvents
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(P=0.00) except the distilled water (Control) groups (P>0.05). For

gutta-percha, xylene exhibited the best dissolving capacity followed

by refined orange oil and the least dissolving capacity was seen

with tetrachloroethylene as is evident from the graph. For resilon,

the test solvents displayed no significant difference in dissolving

resilon. Xylene displayed a better dissolving capacity in dissolving

gutta-percha as compared to resilon (P=0.00). Refined orange oiland tetrachloroethylene did not show a statistically significant

difference in dissolving gutta-percha as compared to resilon

(P>0.05).

Figure 2b

Comparison of solubility effect of

different solvents on gutta-percha andresilon at 5-minute immersion time

interval

DISCUSSION

The basic aim of nonsurgical endodontic retreatment is to re-

establish healthy periapical tissues after inefficient treatment or

reinfection of an obturated root canal system because of coronal orapical leakage. The procedure involves regaining access to the

entire root canal system through removal of the original root canal

filling, further cleaning and reobturation.[1] Removing as much

sealer and filling material as possible from inadequately prepared

and filled root canal is critical to uncover remnants of necrotic

Endodontic retreatment--case selection

and technique. Part 2: Treatment planning

[J Endod. 1988]

Comparison between gutta-percha and

resilon removal using two different

[J Endod. 2006]
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tissue or bacteria that may be responsible for periapical

inflammation or failure.[14]

Removal of gutta-percha can be done with several techniques.

Removal of coronal portion of the gutta-percha can be achieved

with heat carriers such as Touch N. Heat or System B. Gates-

Glidden burs also are quite effective in the removal of the coronal

portion of the filling material.[15] Recent studies have

demonstrated the successful use of Nickel Titanium rotary files as

well.[15] Solvents have been used in the past to soften and dissolve

gutta-percha. Solvents available for dissolution of gutta-percha

filling material are as follows; chloroform, eucalyptol oil, xylene,

halothane, turpentine oil and pine needle oil.[15] When small,

underprepared and curved canals need negotiation, solvents and

small K-type files are best suited. The sequential technique involves

refilling the created reservoir in the canal orifice with drops of

solvent and picking into the dissolving gutta-percha while filing

with a size 10, 15 and 20 stainless steel files. This is continued until

the terminals is negotiated after which all the solvents should be

discontinued. Sequentially larger K-type files are then inserted into

the canal until all the gutta-percha mass is removed. In many

cases combined use of different techniques may be the most

efficient and time-saving method.[15]

Resilon is a recent advance in root canal filling materials and

chemically it is a thermoplastic synthetic polymer based root canal

filling material containing bioactive glass and radiopaque fillers.[5]

The manufacturer claims that its handling characteristics are

Review Conventional endodontic failure

and retreatment.[Dent Clin North Am. 2004]

An evaluation of microbial leakage in roots

filled with a thermoplastic synthetic

[J Endod. 2004]

Fracture resistance of roots
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similar to gutta-percha. The significant improvement in resilon

when compared to gutta-percha is claimed to be its bonding to the

dentinal walls when used in conjunction with its sealer. Epiphany

root canal sealer forms a monoblock with the canal.[6] Because of

its acclaimed superior characteristics; resilon is emerging as a

promising alternative to gutta-percha. The number of teeth

obturated with resilon in expected to rise significantly in the nearfuture. Although the long-term success rate of this new system is

unknown a number of reasons will necessitate retreatment of

resilon-filled teeth.

So, we conducted a study in our department to comparatively

evaluate the dissolving capability of various endodontic solvents

such as xylene, tetrachloroethylene and refined orange oil on

resilon and gutta-percha at different immersion time intervals.

In clinical practice chloroform is the most effective and most

widely used solvent for gutta-percha. Other solvents include refined

orange oil, halothane, tetrachloroethylene and xylene. There are no

studies reported using above solvents to remove synthetic polymer

based root canal filling material (resilon). Tamse et al. found that

chloroform was the most effective solvent for all brands of gutta-percha tested. They also reported a difference in solubility between

various brands of gutta-percha.[13] The strongest and most

commonly used of the solvents, it is quickly effective. Its rapid

evaporation also makes it a useful chair side material.[13]

However, it has been identified as a potential carcinogen. Because

of concerns of carcinogenicity of chloroform clinicians and

en o on ca y rea e w a new res n

m en ssoc.



Alternative solvents to chloroform for gutta-

percha removal. [J Endod. 1990]

Risk assessment of the toxicity of

solvents of gutta-percha used in

[J Endod. 1998]
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researchers have developed a renewed interest in finding alternative

solvents.[16] Of the possible alternative solvents to chloroform is

halothane, a fluorinated hydrocarbon used for induction anesthesia

seems to be the most promising due to its biocompatibility. It is

nearly as effective as chloroform in dissolving gutta-percha.[16]

Halothane, however, is not without any drawbacks. Idiosyncratic

hepatic necrosis is a potential side effect following repeated use ofhalothane-induced anesthesia. Idiosyncratic toxicities are a major

concern because they are difficult to predict and are usually not

present until the patient has been previously exposed to the agent.

They are host-dependent and dose-dependent.[17] The incidence of

halothane hepatitis is in the order of one in 10,000 exposures.

Other chlorine containing solvents like tetrachloroethylene are not

hepatotoxic.[18] So tetrachloroethylene can be considered as aquite safe alternative to chloroform as compared to halothane.

The dissolution of gutta-percha in xylene is considered poorer than

in chloroform. For this reason and because of its slow evaporation,

xylene is impractical for use at the chair side. However, chloroform

tends to be messy and inconvenient in such procedures as it

dissolves rather than softens the gutta-percha, leaving residues on

the walls of the pulp chamber. It is fast evaporating makes it

essential to add more and more solvent as soon as it evaporates.

Xylene on the other hand dissolves the gutta-percha more slowly

thus allowing a better control and removal of softened rather than

liquefied gutta-percha. Softening and mechanical removal of gutta-

percha rather than dissolving it may prove to be not only efficient

Gutta-percha softening: "Hemo-De" as a

xylene substitute. [J Endod. 2000]

In vitro study of effect of solvent on root

canal retreatment. [Braz Dent J. 2002]

Cytotoxicity evaluation of gutta-percha

solvents: Chloroform and GP-Solvent Med Oral Pathol Oral Radiol Endod. 2004]
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but also a biologically safer procedure.[19] This can be

accomplished by a cotton pellet moistened with a solvent in the

chamber and removing the root canal filling at the following

appointment. Because the aged root canal filing tender to become

harder and more difficult to remove, such a procedure is of

potential importance because it softens the root canal filling slowly

before any attempt is done to remove it.[19] Essential oil extractedfrom the peel of sweet orange, Citrus aurantium, is easy to obtain

and suitable for rapid opening of the root canal, mainly in zinc-

oxide cement root fillings associated or not with gutta-percha

cones. Orange oil is an excellent alternative solvent as compared to

potentially toxic solvents, being used either on zinc-oxide eugenol

cement or to soften and dissolve gutta-percha.[20] d-Limonene

(refined orange oil) is found widely in citrus and many other plantspecies and is a major constituent of many essential oils. It is used

extensively as a component for flavorings and fragrances, as a

chemical intermediate, and in insect repellants. The use of essential

oils in endodontics is growing because of their proved safety,

biocompatibility and noncarcinogenicity.[21]

In this study I SO no.40 (0.06 taper) gutta-percha and resilon

cones were used for checking their dissolution in the respective

solvents and did consider the weight of gutta-percha/resilon

dissolved although it varied from the specimens in the same lot

because the solvent contacts only part of the gutta-percha (surface

area); there by dissolving it slowly. Evaluation criteria for the

amount of material dissolved was according to Tamse et al.[13] In



d l hibi d h b di l i i b h f
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our study, xylene exhibited the best dissolving capacity both for

gutta-percha and resilon followed by refined orange oil and

tetrachloroethylene in descending order at 2-minute immersion

time interval. However, at 2-minute immersion time interval all of

the solvents included in the study showed a better efficacy in

dissolving gutta-percha as compared to resilon. At 5-minute

immersion time interval, xylene displayed the best dissolvingefficacy in dissolving gutta-percha followed by refined orange oil

and tetrachloroethylene in descending order. At 5-minute

immersion time interval, all of the test solvents exhibited the same

dissolving capacity in dissolving resilon. At 5-minute immersion

time interval, only xylene showed a better dissolving capacity in

dissolving gutta-percha as compared to resilon whereas rest of the

solvents dissolved the two obturating materials to the same extent.

The finding in this study indicates that xylene is more effective in

dissolving gutta-percha compared to other commonly used solvents

such as; refined orange oil as in most other studies.[20] In our

study there is significant difference between the dissolution of

gutta-percha and resilon in different solvents. The reason might be

difference in chemical composition of gutta-percha which contains

17% of gutta-percha, with zinc oxide; zinc silicate forms most of its

weight[13] whereas resilon has thermoplastic synthetic polymer

based (polyester) root canal core material containing bioactive

glass, bismuth oxy-chlorides and barium-sulfate. The filler content

is approximately 65% by weight.[5]

In vitro study of effect of solvent on root

canal retreatment. [Braz Dent J. 2002]



An evaluation of microbial leakage in rootsfilled with a thermoplastic synthetic

[J Endod. 2004]

G tCONCLUSIONS
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Go to:

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CONCLUSIONS

Within the limitations imposed by this in vitro investigation, the

present study suggests that xylene, refined orange oil and

tetrachloroethylene can be used for softening gutta-percha/resilon

during retreatment with various techniques. Xylene being the best

solvent both for gutta-percha and resilon.

For gutta-percha, none of the solvents except for the

tetrachloroethylene showed any significant increase in dissolving

capacity as the immersion time was increased from 2 minutes to 5

minutes.

For resilon all of the solvents except xylene and distilled water

(control) showed a significant increased dissolving capacity as the

immersion time was increased from 2 to 5 minutes.

Footnotes

Source of Support: Nil,

Conflict of Interest: None declared.

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pp. 74768.

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Conserv Dent. 2011;14:1737. [PMC free article] [PubMed]

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18. Hepatitis.org[Internet]. Strasbourg: Hepatitis and

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