The effect of different file systems used in retreatment on the release of inflammatory mediators

Aim: The aim of this thesis study is to evaluate the effect of ProTaper Universal Retreatment (PTUR), Reciproc blue and XP-endo Finisher R file systems, which are used in the removal of root canal filling materials during retreatment with different motion kinetics on the release of Substance P, CGRP (Calcitonin Gene-Related Peptide), IL-6 and IL-10 inflammatory mediators in the periapical region. Methodology: Seventy-five patients with asymptomatic and chronic apical periodontitis teeth with retreatment indication were included in the study. Patients were randomly divided into three groups according to the file system used to remove root canal filling materials (n = 25): ProTaper Universal Retreatment, Reciproc blue and XP-endo Finisher R. After the removal of the previous root canal filling materials, reshaping and disinfection of the root canals, periapical fluid samples were taken from the root tip of the teeth in all three groups. The amount of Substance P, CGRP, IL-6 and IL-10 mediators that cause pain, swelling and flare-up in periapical fluid samples were measured by ELISA test. The Kruskal Wallis test was used to compare the values of non-normally distributed inflammatory mediators. Mann-Whitney U test was used to compare data that were not normally distributed according to paired groups. The level of significance was determined as p<0.05. Results: When evaluated in terms of Substance P and CGRP, no statistically significant difference was found among file systems (p>0.05). When evaluated in terms of IL-6 and IL-10 release, a statistically significant difference was found among file systems (p<0.05). IL-6 values of Reciproc blue group were significantly higher than those of the XP-endo Finisher R group (p = 0.024). Conclusion: While the effect of files with different motion kinematics on Substance P and CGRP release was not observed, Reciproc blue file working with reciprocating motion increased IL-6 release. Keywords: Retreatment, Substance P, CGRP, IL-6, IL-10, ProTaper Universal Retreatment, Reciproc blue, XP-endo Finisher R, ELISA.