The efficacy of different cleaning protocols for the sealer-contaminated access cavity.

Abstract

Sealer remnants in the access cavity may negatively affect coronal seal and cause tooth discoloration. This study sought to evaluate the efficacy of different cleaning protocols for the sealer-contaminated access cavity. Sixty extracted human molars were accessed, chemomechanically prepared and warm vertically obturated with gutta-percha and epoxy resin sealer. Teeth were randomly assigned to one control (air/water spray) and five test groups (n = 10): scrubbing with an ethanol-saturated cotton pellet (CP), scrubbing with an ethanol-saturated microbrush (MB), air polishing (ProphyFlex, KaVo), MB + air polishing and cleaning with a round bur. Each tooth was split sagittally, and the sealer-covered access cavity area (SCA) before and after cleaning was determined using image analysis software and compared pre- and post-operatively and across groups using paired samples t test and one-way ANOVA. The SCA was significantly reduced in all test groups (P < 0.05), but not in the control group (P > 0.05). Highest epoxy resin sealer reductions were observed for MB (92%) and MB + air polishing (94%), yielding a significantly better SCA reduction than that of ethanol-saturated cotton pellet (58%), bur cleaning (69%) or air polishing alone (64%). All cleaning protocols except air/water spray reduced the amount of epoxy resin sealer in the access cavity, but none of them completely removed the sealer. Cleaning with the ethanol-saturated microbrush, with or without air polishing, performed better than the other methods. Scrubbing with an ethanol-saturated microbrush, with or without air polishing, was the most efficient method for cleaning the epoxy resin sealer-contaminated molar access cavity.