APICAL CLEANLINESS AFTER REMOVAL OF TOTALFILL BIOCERAMIC SEALER VERSUS AH-PLUS EPOXY-RESIN SEALER

Objectives: The aim of the present study was to evaluate the apical cleanliness following canal enlargement after removal of canal obturating material containing TotalFill bioceramic Sealer as compared to AH-Plus epoxy-resin sealer.
Materials & Methods: 40 obturated single-canal roots were divided into 2 groups; AH-Plus (Gp-I) and TotalFill (Gp-II) 15 specimen each. 5 specimens were kept as control for each group. Canal filling was removed and canals were enlarged. According to the file size used for canal enlargement, each group was divided into 3 sub-groups; A, B, and C (#30-0.04%, #35-0.04, and #35-0.04%, respectively). Roots were split and the apical third was examined under SEM. Digital image analysis was done for the photomicrographs.
Results: SEM images of the control groups revealed more condensed and widely spread particles of TotalFill in comparison to AH-Plus. In AH-Plus subgroups: The recorded means (in a descending order) of remnants for subgroups I_A, I_B, and I_C were 27.3, 24.23, and 0.94, respectively. There was a significant statistical difference (P≤0.05) between the test subgroups, except for subgroups I_A/I_B where the difference was statistically insignificant (P > 0.05). In TotalFill subgroups: The recorded means (in a descending order) of remnants for subgroups II_A, II_B, and II_C were 48.16, 39.3, and 30.42, respectively. There was a statistically insignificant difference (P > 0.05) between the test subgroups, except for subgroups II_A/II_C, where the difference was statistically significant (P≤0.05). In file #40 sub-groups: There was a statistically significant difference (P≤0.01) between the recorded amount of remnants between AH-Plus and TotalFill subgroups. TotalFill recorded higher amount of remnants.
Conclusions: Within the parameters of this study - after canal desobturation -, increasing the size of the apical preparation – within limits – improves the cleanliness of canal walls at the apical third area. TotalFill sealer leaves more remnants on the dentin surface of the apical third when compared to AH-Plus sealer. It’s better to enlarge the apical third of the canal two or three sizes larger than the master apical file (in case of desobturation of bioceramic-sealer-containing canal filling) to ensure better cleanliness of the area.