Removal of Two Ready-to-Use Calcium Silicate-Based Sealers from Artificial Grooves Using a Multisonic System and...

Calcium silicate-based sealers bond to dentin and are difficult to remove during retreatment. This study compared five techniques for removing two ready-to-use calcium silicate-based sealers from artificial grooves. Grooves were cut in the apical and coronal thirds of 200 extracted maxillary central incisors and filled with CeraSeal (n = 100) or BioRoot Flow (n = 100). After 30 days, the sealer was removed using syringe needle irrigation, passive ultrasonic irrigation, a multisonic system (GentleWave G4), Er:YAG laser activation in R-SWEEPS mode, or Er,Cr:YSGG laser activation (n = 20/each group). Residual sealer was scored from 0 to 3 by two blinded observers. Scores were compared with the Kruskal-Wallis and Dunn tests, and the sealer and its interaction with the technique with the Scheirer-Ray-Hare test. The technique affected the residual score in both regions (p < 0.001), whereas no significant effect of the sealer or of the interaction was detected. GentleWave G4 produced the lowest scores and cleared the groove in up to 75% (15 of 20) of specimens, while syringe needle irrigation removed no sealer from any groove. The lasers and passive ultrasonic irrigation were intermediate, and passive ultrasonic irrigation did not differ from the needle for BioRoot Flow. Under the tested conditions, the removal of calcium silicate-based sealer from artificial grooves depended on the technique, whereas no statistically significant effect of the sealer was detected. No technique achieved complete removal.