Efficacy of Post-Endodontic Access Cavity Cleaning Techniques: A Randomized Clinical Study

Area of Science:

• Endodontics
• Dental Materials Science
• Restorative Dentistry

Background:

• Residual epoxy resin-based sealer on the pulp chamber floor can complicate postendodontic procedures.
• Effective cleaning of the access cavity is essential for successful postendodontic treatment outcomes.

Purpose of the Study:

• To compare the efficacy of various postendodontic access cavity cleaning techniques.
• To evaluate the removal of residual epoxy resin-based sealer from the pulp chamber floor.

Main Methods:

• A randomized clinical study involving 70 patients undergoing root canal treatment in maxillary first molars.
• Seven groups were assigned to different cleaning protocols: dry cotton pellet, ethanol-saturated cotton pellet (5s or clinically acceptable cleanliness), ethanol-saturated cotton pellet with air polishing, ethanol-saturated microbrush (5s or clinically acceptable cleanliness), and air abrasion.
• Sealer-covered area (SCA) was quantified using pixel analysis of standardized photographs before and after cleaning.

Main Results:

• All tested cleaning protocols significantly reduced SCA compared to baseline.
• Air abrasion (96.1%), ethanol-saturated microbrush (clinically acceptable cleanliness) (93.9%), and ethanol-saturated cotton pellet with air polishing (92.8%) showed the highest SCA reductions.
• These superior methods demonstrated significantly greater cleaning efficacy than dry cotton pellet or short-duration ethanol applications.

Conclusions:

• Air abrasion, ethanol-saturated microbrush (clinically acceptable cleanliness), and ethanol-saturated cotton pellet with air polishing are highly effective in removing residual sealer.
• Mechanically assisted techniques, including air polishing and air abrasion, represent reliable and effective clinical strategies for access cavity cleaning.