Comparison of the efficacy of laser-activated and ultrasonic-activated techniques for the removal of tricalcium silicate-based sealers and gutta-percha in root canal retreatment: a microtomography and scanning electron microscopy study

Abstract

Background Tricalcium silicate-based sealers have been usually indicated for the single-cone technique and result in more residual filling materials in root canal retreatment. Passive ultrasonic irrigation and photon-initiated photoacoustic streaming have been reported to improve the removal efficacy of root canal filling materials. However, the abilities of both techniques combined with NiTi re-instrumentation to remove residual tricalcium silicate-based sealer and gutta-percha have not been compared. The aim of this study was to evaluate the efficacy of laser-activated and ultrasonic-activated techniques in vitro for the removal of the tricalcium silicate-based sealer iRoot SP and gutta-percha after standard canal retreatment procedures with the use of nickel-titanium (NiTi) rotary instruments.

Evaluation of Dentinal Microcracks following Diode Laser- and Ultrasonic-Activated Removal of Bioceramic Material during Root Canal Retreatment

“…Photoacoustic techniques such as PIPS and SWEEPS can improve root canal filling removal during root canal retreatment [ 20 ]. Recently, laser- and ultrasonic-activated irrigation have been proposed as adjunct procedures to enhance the complete removal of the BC sealer material [ 10 , 15 , 25 , 26 ]. This study evaluated the toll that these treatments may have on the dentinal root in terms of dentinal defects that jeopardize the tooth's longevity.…”

“…Recently, adjunct methods have been suggested to enhance the efficacy of removal of BC sealer, such as the use of XP-endo finisher instruments, ultrasonic-activated irrigation, and photoacoustic streaming [9][10][11][12]. Although limited to the straight area of the canal, ultrasonic tips are an excellent adjunct technique in endodontic retreatment, particularly in cases with BC sealer [13].…”

“…Although limited to the straight area of the canal, ultrasonic tips are an excellent adjunct technique in endodontic retreatment, particularly in cases with BC sealer [ 13 ]. Ultrasonic-activated irrigation has been found to significantly increase the efficacy of sealant removal [ 10 , 11 ]. In general, ultrasonic energy has been effectively employed to clean root canals from filling materials with and without BC sealer [ 14 , 15 ].…”

“…Recent studies have shown that SWEEPS can enhance the antimicrobial effect of low-concentration sodium hypochlorite (NaOCl) [ 19 ]. Adjunct laser-activated irrigation has also greatly improved the removal of root-filling materials such as gutta percha and BC sealer during retreatment [ 10 , 15 , 20 ].…”

Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis

“…Secondly, a standardized irrigation procedure with PUI as the control group can be developed and adopted to minimize the bias and heterogeneity. Additionally, some studies assessed irrigation efficacy on filling remnant removal using micro-CT [ 88 , 89 , 90 , 91 , 92 , 93 , 94 ]. The meta-analysis of the percentage reduction in calcium hydroxide or gutta-percha after irrigation assessed by micro-CT can be performed for comprehensive evaluation of various irrigation techniques applied in different scenarios.…”