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Effect of a Calcium Silicate-Specific Solvent on Filling Material Removal during Retreatment and Subsequent
Gavin Raddall1, Bettina Basrani1, Gustavo De-Deus2
1Graduate Endodontics Program, University of Toronto, Faculty of Dentistry, Toronto, Ontario, Canada.
Introduction:
Complete removal of calcium silicate-based sealers (CSS) during retreatment remains challenging. This study evaluated the effect of a calcium silicate-specific solvent on filling-material removal during retreatment and during subsequent multisonic irrigation.
Methods:
Twenty-four mesial roots of mandibular molars were pair-matched by root canal configuration and allocated to CSS-solvent or No CSS-solvent groups according to solvent use during retreatment (n = 12/group). Filling-material volume and percentage reduction were quantified by micro-CT after obturation, retreatment, and supplementary irrigation with the GentleWave system, including the additional percentage reduction relative to the post-retreatment volume. Between-group effects were expressed as mean differences or Hodges-Lehmann shifts (95% CIs). Longitudinal changes were analyzed using generalized estimating equations (α = 0.05).
Results:
Filling-material volume did not differ between groups at any stage, nor did the percentage reduction during retreatment (P > 0.05 and P = 0.312, respectively). The additional reduction during supplementary irrigation, relative to the post-retreatment volume, was greater in the CSS-solvent group (43.64% vs. 13.86%; Hodges-Lehmann difference, 22.51 percentage points; 95% CI, 9.59-33.72; P = 0.003), with no significant group-by-stage interaction (P = 0.063). In the apical third, no significant between-group differences were detected at any stage, including this additional reduction (Hodges-Lehmann difference, -5.35 percentage points; 95% CI, -39.51 to 18.79; P = 0.486).
Conclusions:
The calcium silicate-specific solvent did not significantly improve filling-material removal during retreatment alone. Its use was associated with a significantly greater percentage-based reduction during subsequent multisonic irrigation in the entire root canal, although absolute volumes did not differ significantly between groups.
