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The efficacy of different cleaning protocols for the sealer-contaminated access cavity
Stéphanie Devroey1, Filip Calberson1, Maarten Meire2
1Department of Oral Health Sciences, Section of Endodontology, Ghent University, C. Heymanslaan 10/P8, B, 9000, Ghent, Belgium.
Objectives:
Sealer remnants in the access cavity may negatively affect coronal seal and cause tooth discoloration. This study sought to evaluate the efficacy of different cleaning protocols for the sealer-contaminated access cavity.
Materials And Methods:
Sixty extracted human molars were accessed, chemomechanically prepared and warm vertically obturated with gutta-percha and epoxy resin sealer. Teeth were randomly assigned to one control (air/water spray) and five test groups (n = 10): scrubbing with an ethanol-saturated cotton pellet (CP), scrubbing with an ethanol-saturated microbrush (MB), air polishing (ProphyFlex, KaVo), MB + air polishing and cleaning with a round bur. Each tooth was split sagittally, and the sealer-covered access cavity area (SCA) before and after cleaning was determined using image analysis software and compared pre- and post-operatively and across groups using paired samples t test and one-way ANOVA.
Results:
The SCA was significantly reduced in all test groups (P < 0.05), but not in the control group (P > 0.05). Highest epoxy resin sealer reductions were observed for MB (92%) and MB + air polishing (94%), yielding a significantly better SCA reduction than that of ethanol-saturated cotton pellet (58%), bur cleaning (69%) or air polishing alone (64%).
Conclusions:
All cleaning protocols except air/water spray reduced the amount of epoxy resin sealer in the access cavity, but none of them completely removed the sealer. Cleaning with the ethanol-saturated microbrush, with or without air polishing, performed better than the other methods.
Clinical Relevance:
Scrubbing with an ethanol-saturated microbrush, with or without air polishing, was the most efficient method for cleaning the epoxy resin sealer-contaminated molar access cavity.
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