The Retrievability of Calcium Silicate-Based Sealer during Retreatment and the Effectiveness of Additional Passive Ultrasonic Irrigation: A Microcomputed Tomographic Study

Taeyeon Lee,Kyungjae Kim,Se Hoon Kahm,Sungeun Yang,Heng Bo Jiang

doi:10.1155/2022/3933305

Taeyeon Lee, Kyungjae Kim + Show 3 more

Open Access

https://doi.org/10.1155/2022/3933305

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Abstract

This study investigated the retreatability of EndoSeal MTA (Maruch, Wonju, Korea) according to the presence or absence of a canal isthmus and the additional use of passive ultrasonic irrigation (PUI) through microcomputed tomography (micro-CT) imaging. An epoxy resin sealer (AH Plus (Dentsply DeTrey, Konstanz, Germany)) was used as a reference for comparison. Forty-five artificial mandibular molars (TRUETOOTH #19, DELABS, Santa Barbara, CA) with a mesial canal with an isthmus and a distal canal without an isthmus were obturated using gutta-percha and one of the following sealers (n = 15 each): AH Plus, EndoSeal MTA, and EndoSeal MTA + PUI. Micro-CT scanning was performed to assess the void volume (as a percentage) at three root levels. After the root fillings were removed, second micro-CT scanning was conducted to evaluate the amount of remaining root filling material. The Kruskal-Wallis H test and post hoc analysis were used for between-group comparisons. The Mann–Whitney U test was used for comparisons between canals with and without an isthmus (p < 0.05). In the EndoSeal MTA group, the void volume and remaining filling materials were higher irrespective of the presence or absence of an isthmus. In apical lesions in the EndoSeal MTA group, the void ratio was significantly lower, and there was a significantly higher amount of remaining filling material. Regardless of the presence of an isthmus, the amount of remaining filling material of the EndoSeal + PUI group was reduced to a similar degree as the AH plus group. When performing retreatment for root canals filled with EndoSeal MTA, removal of the filling material can be more difficult in the apical region. The additional use of PUI can improve the efficacy of removal.

Highlights

Periapical disease might not be resolved even following root canal treatment if there is a persistent bacterial infection or if infection recurs [1, 2]
The void ratios were higher in the root canals with an isthmus in both groups (AH Plus: 6.16% vs. 0.65%, EndoSeal MTA: 16.79% vs. 2.37%)
Irrespective of the presence or absence of an isthmus, the void ratio was higher in the EndoSeal MTA group

Summary

Introduction

Periapical disease might not be resolved even following root canal treatment if there is a persistent bacterial infection or if infection recurs [1, 2]. The root canal filling is completely removed to access the apical foramen, through which the root canal system is cleaned and shaped [3, 4]. This process necessitates removing filling materials that may serve as a bacterial reservoir and providing an environment that promotes healing [5]. Materials based on calcium silicate, such as EndoSeal MTA (Maruch, Wonju, Korea), EndoSequence BC Sealer (Brasseler USA, Savannah, GA, USA), and MTA Fillapex (Angelus, Londrina, Brazil), have recently been developed These materials are minimally cytotoxic, have an appropriate

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