The effect of ultrasonic removal of various root-end filling materials

To compare residual root-end filling material in apical root-end cavities following their removal with ultrasonic retrotips.

Thirty single-rooted teeth were filled with Thermafil and AH Plus sealer. Root-ends were resected at 90 degrees, 3 mm from the apex. Root-end cavities were prepared with diamond burs and ultrasonic retrotips and filled with one of three filling materials: group I: Retro-TC (calcium silicate-based cement), group II: IRM (Dentsply, Germany), group III: Vitrebond (3M ESPE, USA). After 30 days of storage, ultrasonic retrotips were used to remove materials from the root-end cavities. The ultrasonic application time was fixed at 60 s. Polyether impressions and replicas of the root-ends were made. Root apices and replicas were examined by one operator under a scanning electron microscope. Remnants of residual materials were evaluated using a four-level scoring system; fractures, smear layer and exposed dentinal tubules were also examined.

Forty per cent of the specimens filled with Retro-TC revealed complete removal of the material with exposure of dentinal tubules, whilst 60% contained residual cement. Twenty per cent of specimens filled with IRM were completely devoid of material, whereas 80% had retained material. Ten per cent of specimens filled with Vitrebond retained a moderate amount of material whilst 90% had substantial retention of the material. Statistically significant differences were found (P < 0.05) amongst the three groups of materials.

Retro-TC was successfully removed in 40% of cases using ultrasonics retrotips for 60 s, whereas IRM and Vitrebond specimens had evidence of retained material in 80% and 90% of all specimens respectively.