Fig. 1

Pre operative X-ray: the upper right central incisor has an endodontic lesion, while the upper left incisor has an incomplete treatment.

This article will focus on the upper right incisor.

Fig. 2

Screw disassembling using ultrasonic tips

Fig. 3

The tip works in counterclockwise direction around the post in order to remove it.

Fig. 4

This technique allows unscrewing the post with maximum preservation of the dental tissue.

Fig. 5

The post is finally removed

Fig. 6

Once removed the post, it is time to focus on removing the existing endodontic obturation.

Fig. 7

Thanks to its sharp tip and the grooves, ExtEndo penetrates inside the material and with a light lateral pressure it removes gutta-percha in different pieces

Fig. 8

The removal of the gutta percha with this technique is effective and quick

Fig. 9

The action is easy, moreover it takes few time and leaves the root canal clean, with no debris on the canal walls

Fig. 10

Deep cleaning with sodium hypochlorite

Fig. 11

A little piece of gutta-percha is beyond the apex 

Fig. 12

All the material has been removed , the foramen is empty and we can proceed in the final step of the treatment

Fig. 13

Using PREXO , a new plugger by Styleitaliano Endodontics , we packed collagen foam in the foramen, creating extra apical barrier useful to obtain a stop for the MTA that will be used for the apical obturation. 

Fig. 14

The MTA is positioned with a dedicated carrier and compacted with PREXO.

Fig. 15

The smooth ends of PREXO allow us to press MTA in the best way

Fig. 16

The apical obturation with MTA

Fig. 17

Post operative x-ray

Conclusions

Thanks to its length and sharpness, ExtEndo can be useful also in non surgical retreatments to remove gutta percha.

Bibliography

Virdee SS, Thomas MB. A practitioner's guide to gutta-percha removal during endodontic retreatment. Br Dent J. 2017 Feb 24;222(4):251-257. doi: 10.1038/sj.bdj.2017.166. PMID: 28232689.

Gordon MP. The removal of gutta-percha and root canal sealers from root canals. N Z Dent J. 2005 Jun;101(2):44-52. PMID: 16011309.

Agrawal P, Ramanna PK, Arora S, Sivarajan S, Jayan A, Sangeetha KM. Evaluation of Efficacy of Different Instrumentation for Removal of Gutta-percha and Sealers in Endodontic Retreatment: An In Vitro Study. J Contemp Dent Pract. 2019 Nov 1;20(11):1269-1273. PMID: 31892677.