Comparative Evaluation of Retreatability of Endodontically Treated Teeth using AH 26, Fluoride Varnish and Mineral Trioxide Aggregate-based Endodontic Sealers

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

The objective of the present in vitro work was to investigate the effectiveness and time required for the removal of calcium silicate-based sealer using two rotary retreatment systems. Sixty extracted, single-canal, lower premolars were used. After obturation using the single-cone technique with calcium silicate-based sealer, samples were divided into four groups according to the technique of desobturation: Group 1 (G1): D-Race; Group 2 (G2): D-Race followed by the use of XP-Endo Finisher R; Group 3 (G3): Protaper Universal Retreatment; and Group 4 (G4): Protaper Universal Retreatment followed by the use of XP-Endo Finisher R. Cone beam computed tomography (CBCT) images were used to calculate the remaining filling materials at the middle and apical thirds. Times required to perform each method were recorded. Scanning electron microscopy (SEM) and digital microscopy were used to evaluate the remaining filling materials. Data were statistically analyzed using the t-test and one way ANOVA on ranks tests. No statistically significant difference was found between G1 and G3 after CBCT observations (p > 0.05). Xp-Endo Finisher R significantly increased the ability to remove materials regardless of the initially used retreatment system (p < 0.05). Statistically significant longer time was found in G3 and G4 compared to G1 and G2, respectively (p < 0.05), to reach the full working length. No retreatment system was able to totally remove the calcium silicate-based sealer from the root canal at the middle and apical thirds (p > 0.05). Digital microscopy demonstrated that the residual materials were the remaining sealers on the canal walls. SEM showed the mineral depositions of calcium silicate materials onto the canal walls and into the dentinal tubules. However, that calcium silicate materials provide mineral deposition into the dentinal tubules might indicate that the traditional irrigants could not be sufficient to remove calcium silicate-based materials from the root canal, and other agents should be used to make retreatment considerably easier.

Retrievability of bioceramic-based sealers in comparison with epoxy resin-based sealer assessed using microcomputed tomography: A systematic review of laboratory-based studies

Aim:

The objective was to evaluate the retrievability of bioceramic sealers in comparison with epoxy resin-based sealers assessed using microcomputed tomography.

Materials and Methods:

Four reviewers independently conducted a systematic literature search in four electronic databases. The risk of bias was assessed using modified Joanna Briggs Institute Critical Appraisal tools for Quasi-Experimental Studies.

Results:

Ten articles were included in this review and all had a moderate risk of bias. The results across the included articles were inconsistent with some indicating easier/difficult removal of bioceramic sealers, while others indicate no difference. The studies varied in terms of the type of bioceramic sealer used, root canal anatomy, and retreatment techniques followed. Due to heterogeneity, only a qualitative analysis was performed and no meta-analysis was conducted.

Conclusion:

The quality of evidence is low and no definitive conclusion could be derived regarding the retrievability of bioceramic sealer/AH plus sealer from the root canals during retreatment procedures.