Retreaty Kit, for easier and predictable retreatments
28/02/2023
Riccardo Tonini
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The reason why we designed and developed ReTreaty kit, is because we felt the need to make the reatreatment procedure more predictable and easier. As StyleItaliano Endodontics we already shared the concept that a primary treatment should start since the beginning with rotary files for avoiding iatrogenic errors created by hand files. We transferred now the same concept in retreatment procedure and Retreaty kit represents the ultimate choice for doing it with confidence.
Nowadays retreatment therapies are increasing if compared to primary treatment. That’s why we decided to create a specific kit to perform endodontic disassembling in a minimal invasive way, following the Style Italiano Endodontics philosophy. Five instruments, three different alloys, two rotary motions (Bull-Y) and one cross section. We also decided to create for each instrument an Avatar, that is commonly used for better and quicker recognition of a user as an additional cognitive sign next to his name. Many times, when a kit of rotary files is introduced, the end user find difficult to remember the sequences and the names of files. No more codes or letters in ReTreaty, but names and Avatars.
Fig. 1
Before starting a Retreatment, is mandatory a pre op X ray for evaluating where the previous treatment stopped and why it failed. It’s also important to consider if any obstacles like post or broken file are present for avoiding further complications.
Fig. 2
If the gutta-percha is present since the coronal level continuing for middle third or in case until the apex it means the it’s time tu use ReaTreaty kit. The primary concept is measuring the length of GP inside canal, because is suggested to bypass last 2 mm with manual files. Instead until the last 2 mm and after, rotary motion is extremely suggested for preparing and finalizing the ReTreatment.
Fig. 3
25/07, gold heat treated alloy, 21mm long with a semi active tip; this is Bull-Y, the most efficient GP remover.
Introduce Bull -Y at the orifice level in touch with gutta-percha in clockwise or in reciprocating motion setting in this case angles 30° anticlockwise/150° clockwise. Remove Guttapercha at orifice and third coronal level without pushing if a passive penetration is not reached. No Solvent is required for this procedure. The tactile sensation is unique especially if OTR or ATR mode is activated on your endo motor.
Fig. 4
Bull-Y in action
Fig. 5
24/04, no heat treatment, 25mm semi active tip for removing the Gp at mid level of the root canal system. It is able to remove Guttapercha making the instrument advance of 1-3 mm with gentle movements in and out the root canal. We designed it in 04 taper for not overshare the canal in the coronal mid part of the root. The feeling is absolutely great, because the progression inside the canal is fast and safe.
Fig. 6
Skinn-Y in action
Fig. 7
After that patency has been reached with a K-file, it’s time now for reshaping the canal. We absolutely trust in a conservative retreatment, because an over shaping of the canal cannot ensure a better outcome, or better can only produce further complication like stripping, zipping of the apex and alteration of the original anatomy. 20/05 for Shap-Y1 and 25/05 for Shap Y2, gold heat treated alloy for both files. Intruduce Shap-Y1 at the working length followed by Shap -Y2, without doing a brushing motion. Files will reach the WL and will just print their shape without modifying the original anatomy
Fig. 8
Primary shaping with Shap-Y1
Fig. 9
Secondary shaping with Shap-Y2
Fig. 10
If it’s required to enlarge more just the apical region, there is the chance to introduce Shap-Y3. Blue alloy for an incredible flexibility, 30/04 and 25mm of length. With this file the operator will just shape the apical region following the anatomy in a conservative way without any transportation. Just kiss the apex and get it out of the canal.
Fig. 11
Final shaping with Shap-Y3
Fig. 12
Conservative retreatment shaped until Shap-Y2
The ReTreaty kit in action
Conclusions
ReTreaty is an easy and effective system to retreat teeth in a conservative way
Bibliography
- Cardinali F, et al., La risoluzione delle complessitè nei ritrattamenti. Dental Cadmos, 2014. 82(10): p. 690-712.
- Friedman S, Considerations and concepts of case selection in the management of post-treatment
endodontic disease (treatment failure). Endodontic Topics, 2002. 5(1): p. 54-78. - Haapasalo MSY, Ricucci D, Reasons for persistent and emerging post-treatment endodontic disease.
Endodontic Topics, 2011. 18(1): p. 31-50. - Abbott P, Diagnosis and management planning for root-filled teeth with persisting or new apical pathosis.
Endodontic Topics, 2008. 19(1): p. 1-21. - Dofour DL, V Leung, Levesque, CM, Bacterial biofilm: structure, function, and antimicrobial resistance.
Endodontic Topics, 2010. 22(1): p. 2-16.
