ReRCT UR1: Difficulty in removing GP
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Strategies for Removing Gutta-Percha in Wide Anterior Canals
Overview
In this video, we have a challenging case involving a maxillary central incisor requiring re-treatment. We explore mechanical and chemical techniques for thorough gutta-percha removal in wide canals where traditional instrumentation may leave remnants on the canal walls.
The Case & History
A 36-year-old male presented with a history of localised pain and a previous episode of swelling in the upper right quadrant, which was managed with antibiotics. Clinical examination revealed the upper right central incisor (UR1) had a well-fitting crown and an active buccal draining sinus. The patient reported that the original root canal treatment was performed over 15 years ago. Radiographic evidence suggests the tooth may have suffered historical trauma, resulting in a wide, slightly short canal development.
The Clinical Problem
The clinician achieved patency and noted the healing of the sinus tract, yet significant gutta-percha remnants remain visible on the 3D imaging. Despite using Reciproc Blue (up to R40), Hedstrom files, and an XP Shaper, the wide dimensions of the canal have made it difficult to engage all the material. The clinician is specifically concerned about the canal width (gauging between 35 and 40) and whether using solvents will cause excessive smearing on the canal walls.