EXACT Retreatment

Are you retreating a minimally
invasive prep and want more flexibility?

Are you retreating a larger
canal or prefer a Stiffer file?

CLINICAL CASE

41 year old male presents with a chief complaint of increasing pain associated with the lower left first molar. The tooth was initially treated endodontically by his dentist 12 years ago. Clinical examination confirmed tooth #19 having sensitivity to percussion. Palpation was wnl. Probing depths wnl. Case provided by Dr. Reza Farshey.

After discussion with patient, decision was made to obtain a CBCT of the tooth. a small FOV cbct of the area was obtained. Additional findings obtained from CBCT alone:

1. DL canal joins the DB canal in the apical region.
   Diagnosis
   Previously Treated with Symptomatic Apical Periodontitis
   Treatment Plan
   Selective non-surgical retreatment, leaving the DB canal (with the threaded post intact) so as to minimize iatrogenic mishaps that can negatively affect the prognosis.
   Treatment
   Access created and refined using Piranha round diamond to remove porcelain, followed by Great White # 701 to remove the underlying alloy, and finally the Endo Safe End Bur to refine and smooth the access
   A small amount of chloroform is used as solvent in the chamber to soften the existing gutta-percha. The EXACT RETREATMENT™ series (D1-D3) was used ,sequentially starting with D1. A light pecking motion, repeated 3-5 times per pass is a safe way to utilize these files efficiently. This sequence was repeated three times until most of the GP was removed from the canal spaces.
   The EXACTTaper^™H DC size F1, F2 and F3 were used to remove any stray gutta-percha off of the walls, and to complete the shaping protocol. Triton irrigation solution was used for irrigation throughout the procedure, laser activated using the Biolase.
   Obturation made with vertical compaction of warm gutta-percha and Bioceramic sealer.

WATCH THE VIDEO

The EXACT RETREATMENT™ technique is a specialized dental procedure that is used to treat failed root canal therapy. It involves the removal of the previous filling materials and thorough cleaning of the root canal system to allow for the placement of new filling materials.

RETREATMENT TIPS

EXACT RETREATMENT ™ Files are available in 3 lengths, 3 progressive tapers and 3 apical diameters and are designed to remove root canal obturating material such as gutta-percha, carrier-based obturators, and fillers from coronal, middle and apical thirds of root canal prior to canal reshaping.

• Always begin with a well-angulated set of radiographs.
• Understand the specific anatomy is critical to success.
• Obtain straight-line access to the canal.
• Assess the obturation material.
• Heat and friction will help remove the obturation material.
• Throughout the procedure, remove the instruments, inspect and clean the flutes. Then, re-insert and continue to auger material out of the canal.
• Recommended speed for EXACT RETREATMENT™ Files is 500-700 RPM for gutta-percha and carrier based obturators. Use 300 PRM to remove paste fillers.
• EXACT RETREATMENT™ Files are single use devices.

Designed to remove materials like gutta-percha, carrier and paste fillers, prior to reshaping procedures. The technique for removing a carrier core obturator or gutta-percha alone is the same.