Reciproc and XP-endo Shaper Outperform WaveOne Gold in Apical Debris Removal: A Micro-CT Study in 3D-Printed Molars

Abstract

Objective

Complete removal of filling material from complex anatomies such as the mesiobuccal isthmus remains a challenge in endodontic retreatment. This study aimed to compare the efficacy of XP-endo Shaper (XPS), Reciproc (REC), and WaveOne Gold (WOG) in removing root canal filling material during the retreatment of 3D-printed maxillary first molars, as quantified by micro-CT.

Methods

Fifteen standardized 3D-printed resin teeth with Vertucci type II mesiobuccal canals were prepared, obturated, and randomly assigned to retreatment using XPS, REC, or WOG (n = 5 per group). Micro-CT scans were acquired before and after retreatment to analyze residual filling material volume in the coronal, middle, and apical thirds. Statistical analysis was performed using the Kruskal‒Wallis H test with post hoc Mann‒Whitney U tests (Bonferroni corrected).

Results

While all the systems achieved near-complete coronal debridement (> 97%), REC demonstrated significantly greater removal in the middle third (99% ± 1% vs. 97% WOG and 94% XPS; P < 0.05). Crucially, in the apical isthmus region, both XPS (95% ± 3%) and REC (90% ± 7%) significantly outperformed WOG (76% ± 3%) (P < 0.05). No significant difference was detected between XPS and REC in the apical third.

Conclusion

Residual filling material persisted in all the samples. REC showed the highest overall efficiency, whereas XPS achieved comparable apical debridement to REC. These quantitative, region-specific findings support the preferential use of XPS or REC over WOG for retreatment cases involving complex apical anatomy or isthmus configurations.

Keywords

Root canal retreatment / Nickel-titanium instruments / X-ray microtomography / Gutta-percha / Dental pulp cavity / Isthmus / 3D printing / Reciproc / WaveOne gold

References

[1] Adıgüzel M, Capar ID. Comparison of cyclic fatigue resistance of WaveOne and WaveOne gold small, primary, and large instruments. J Endod., 2017, 43(4): 623-627.

[2] Alsubait S, Alhathlool N, Alqedairi A, et al.. A micro-computed tomographic evaluation of retreatability of BioRoot RCS in comparison with AH Plus. Aust Endod J., 2023, 49(2): 459.

[3] Aksel H, Küçükkaya Eren S, Askerbeyli Örs S, et al.. Micro-CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP-Endo Finisher file. Int Endod J., 2019, 52(7): 1070-1076.

[4] Azim AA, Wang HH, Tarrosh M, et al.. Comparison between single-file rotary systems: part 1—efficiency, effectiveness, and adverse effects in endodontic retreatment. J Endod., 2018, 44(11): 1720-1724.

[5] Bago I, Suk M, Katić M, et al.. Comparison of the effectiveness of various rotary and reciprocating systems with different surface treatments to remove gutta-percha and an epoxy resin-based sealer from straight root canals. Int Endod J., 2019, 52(1): 105-113.

[6] Bukhary SM. Retreatability of calcium silicate-based sealers based on micro-computed tomographic evaluation - A systematic review. Saudi Dent J., 2024, 36(10): 1278-1294.

[7] Bürklein S, Hinschitza K, Dammaschke T, et al.. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J., 2012, 45(5): 449-461.

[8] Byun C, Kim C, Cho S, et al.. Endodontic treatment of an anomalous anterior tooth with the aid of a 3-dimensional printed physical tooth model. J Endod., 2015, 41(6): 961-965.

[9] Copelli FA, Oda LY, Leal RMS, et al.. Influence of the filling technique on endodontic retreatment in curved mesial canals of mandibular molars: an in vitro study. J Endod., 2025, 51(6): 755-760.

[10] Crozeta BM, Silva-Sousa YT, Leoni GB, et al.. Micro-computed tomography study of filling material removal from oval-shaped canals by using rotary, reciprocating, and adaptive motion systems. J Endod., 2016, 42(5): 793-797.

[11] Cui Z, Wei Z, Du M, et al.. Shaping ability of protaper next compared with waveone in late-model three-dimensional printed teeth. BMC Oral Health., 2018, 18(1): 115.

[12] De-Deus G, Belladonna FG, de Siqueira Zuolo A, et al.. 3-dimensional ability assessment in removing root filling material from pair-matched oval-shaped canals using thermal-treated instruments. J Endod., 2019, 45(9): 1135-1141.

[13] Derby B. Printing and prototyping of tissues and scaffolds. Science., 2012, 338(6109): 921-926.

[14] Elnaghy AM, Elsaka SE. Cyclic fatigue resistance of one curve, 2Shape, ProFile vortex, vortex blue, and RaCe nickel-titanium rotary instruments in single and double curvature canals. J Endod., 2018, 44(11): 1725-1730.

[15] Estrela C, Rabelo LEG, de Souza JB, et al.. Frequency of root canal isthmi in human permanent teeth determined by cone-beam computed tomography. J Endod., 2015, 41(9): 1535-1539.

[16] Fischer BV, Santos Goulart T, Vitali FC, et al.. Supplementary methods for filling material removal: a systematic review and meta-analysis of micro-CT imaging studies. J Dent., 2024, 151. ArticleID: 105445

[17] Fruchi LDEC, Ordinola-Zapata R, Cavenago BC, et al.. Efficacy of reciprocating instruments for removing filling material in curved canals obturated with a single-cone technique: a micro-computed tomographic analysis. J Endod., 2014, 40(7): 1000-1004.

[18] Gavini G, Caldeira CL, Akisue E, et al.. Resistance to flexural fatigue of Reciproc R25 files under continuous rotation and reciprocating movement. J Endod., 2012, 38(5): 684-687.

[19] Gomes NN, De Carvalho GM, Júnior ECS, et al.. Filling material removal with reciprocating and rotary systems associated with passive ultrasonic irrigation. Eur Endod J., 2017, 2(1): 6.

[20] Haghanifar S, Moudi E, Moudi E, et al.. Evaluation of the Prevalence of Complete Isthmii in Permanent Teeth Using Cone-Beam Computed Tomography. Iran Endod J., 2017, 12(4): 426-431

[21] Kiraz G, Kaya BÜ, Ocak M, et al.. Micro-CT evaluation of the removal of root fillings using rotary and reciprocating systems supplemented by XP-Endo Finisher, the Self-Adjusting File, or Er, Cr: YSGG laser. Restor Dent Endod., 2023, 48(4. ArticleID: e36

[22] Helvacioglu-Yigit D, Yilmaz A, Kiziltas-Sendur G, et al.. Efficacy of reciprocating and rotary systems for removing root filling material: a micro-computed tomography study. Scanning., 2014, 36(6): 576-581.

[23] Kırıcı D, Demirbuga S, Karataş E. Micro-computed tomographic assessment of the residual filling volume, apical transportation, and crack formation after retreatment with reciproc and reciproc blue systems in curved root canals. J Endod., 2020, 46(2): 238-243.

[24] Lacerda MFLS, Marceliano-Alves MF, Pérez AR, et al.. Cleaning and shaping oval canals with 3 instrumentation systems: a correlative micro–computed tomographic and histologic study. J Endod., 2017, 43(11): 1878-1884.

[25] Machado AG, Guilherme BPS, Provenzano JC, et al.. Effects of preparation with the Self-Adjusting File, TRUShape and XP-endo Shaper systems, and a supplementary step with XP-endo Finisher R on filling material removal during retreatment of mandibular molar canals. Int Endod J., 2019, 52(5): 709-715.

[26] Ordinola-Zapata R, Bramante CM, Duarte MAH, et al.. Shaping ability of Reciproc and TF Adaptive systems in severely curved canals of rapid microCT-based prototyping molar replicas. J Appl Oral Sci., 2014, 22(6): 509-515.

[27] Rödig T, Reicherts P, Konietschke F, et al.. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J., 2014, 47(10): 942-948.

[28] Silva EJ, Orlowsky NB, Herrera DR, et al.. Effectiveness of rotatory and reciprocating movements in root canal filling material removal. Braz Oral Res., 2015, 29: 1-6

[29] Silveira SB, Alves FRF, Marceliano-Alves MF, et al.. Removal of root canal fillings in curved canals using either mani GPR or HyFlex NT followed by passive ultrasonic irrigation. J Endod., 2018, 44(2): 299-303.e1.

[30] Sinsareekul C, Hiran-us S. Comparison of the efficacy of three different supplementary cleaning protocols in root-filled teeth with a bioceramic sealer after retreatment—a micro-computed tomographic study. Clin Oral Investig., 2022, 26(4): 3515-3521.

[31] Sutharoj T, Dewi A, Phumpatrakom P, et al.. Comparative evaluation of root canal retreatment techniques and the effect of supplementary cleaning on curved canals obturated with premixed bioceramic sealer. J Endod., 2025, 51(10): 1464-1470.

[32] Zuolo AS, Mello JEJr, Cunha RS, et al.. Efficacy of reciprocating and rotary techniques for removing filling material during root canal retreatment. Int Endod J., 2013, 46(10): 947-953.

Funding

Natural Science Foundation of Hubei Province(2020CFB844)

National Natural Science Foundation of China(81802973)

RIGHTS & PERMISSIONS

The Author(s), under exclusive licence to the Huazhong University of Science and Technology