Effectiveness of Two Endodontic Instruments in Calcium Silicate-Based Sealer Retreatment

Area of Science:

• Endodontics
• Dental Materials Science
• Restorative Dentistry

Background:

• Calcium silicate-based sealers are increasingly used in root canal therapy.
• Effective removal of these sealers during retreatment is crucial for successful outcomes.
• Limited data exists on the efficacy of current rotary retreatment systems for these specific sealers.

Purpose of the Study:

• To compare the effectiveness and time efficiency of two rotary retreatment systems in removing calcium silicate-based sealer.
• To evaluate the impact of an additional finishing instrument on sealer removal.
• To assess the nature and location of residual sealer material.

Main Methods:

• Sixty extracted premolars were obturated with calcium silicate sealer.
• Four groups were tested: D-Race, D-Race + XP-Endo Finisher R, Protaper Universal Retreatment, and Protaper Universal Retreatment + XP-Endo Finisher R.
• Cone beam computed tomography (CBCT), digital microscopy, and scanning electron microscopy (SEM) were used for evaluation; time was recorded.

Main Results:

• No statistically significant difference in sealer removal between D-Race and Protaper Universal Retreatment alone.
• XP-Endo Finisher R significantly enhanced sealer removal when used adjunctively.
• Protaper Universal Retreatment groups took significantly longer to reach working length.
• No system completely removed sealer; residual material was observed on canal walls and in dentinal tubules.

Conclusions:

• Current rotary retreatment systems, even with XP-Endo Finisher R, do not completely remove calcium silicate-based sealers.
• The mineral deposition of these sealers into dentinal tubules may necessitate alternative removal agents.
• Further research into specialized irrigants or techniques is required to facilitate easier and more complete retreatment.