Post-endodontic Access Cavity Cleaning Techniques

Summary

Aim This study aims to evaluate the effectiveness of different post-endodontic access cavity cleaning techniques (PACCTs) in removing residual epoxy resin-based root canal sealer from the pulp chamber floor following root canal treatment. The cleaning efficacy of seven different protocols, including manual and mechanically-assisted methods, will be compared based on the reduction of sealer-covered area (SCA).

Study Design / Methodology This study is designed as a prospective, single-center, randomized clinical trial with parallel group design.

A total of 70 patients who require root canal treatment in maxillary first molars will be included in the study. Patients will be randomly assigned to seven experimental groups (n=10 per group) according to the cleaning technique used after root canal obturation with AH Plus epoxy resin-based sealer.

The cleaning protocols will be:

1. Dry cotton pellet (control group)
2. Ethanol-saturated cotton pellet (7 sec)
3. Ethanol-saturated cotton pellet (visibly clean)
4. Ethanol-saturated cotton pellet + air polishing
5. Ethanol-saturated microbrush (7 sec)
6. Ethanol-saturated microbrush (visibly clean)
7. Air abrasion Standard root canal treatment procedures will be performed in all groups using rotary instrumentation and cold lateral condensation technique for obturation.

The cleaning effectiveness will be evaluated using standardized high-resolution macro photographs taken before and after the cleaning procedures. The sealer-covered area (SCA) will be calculated using image analysis software (Adobe Photoshop) based on pixel analysis.

The primary outcome of the study is the percentage reduction of SCA after cleaning procedures.

Conditions

• Teeth With Root Canal Treatment

Interventions

OTHER

Dry cotton pellet group

The contaminated dentine surface was scrubbed with a dry cotton pellet until no visible sealer remnants were observed

OTHER

Ethanol-saturated cotton pellet 7 seconds group

The contaminated dentine surface was scrubbed with a 70% ethanol-saturated cotton pellet for 7 seconds

OTHER

Ethanol-saturated cotton pellet visibly clean group

The contaminated dentine surface was scrubbed with a 70% ethanol-saturated cotton pellet until no visible sealer remnants were observed.

DEVICE

Ethanol-saturated cotton Pellet + air polishing group

After the contaminated dentine surface scrubbing with an 70% ethanol-saturated cotton pellet until no visible sealer remnants were observed, air polishing was performed for 10 seconds using the AquaCare Twin device (Velopex, UK). Sodium bicarbonate powder (Velopex) was applied at a pressure of 2 bar, with a medium media flow and 17.5% ethanol-saturated solution (AquaSol, Velopex). The standard tip was positioned approximately 5 mm from the dentin surface and moved in a vertical (up-and-down) direction during the procedure. The application time and parameters were determined in consultation with the manufacturer due to the lack of previous clinical studies using the AquaCare device for this purpose.

OTHER

Microbrush 7 sec group

The contaminated dentine surface was scrubbed with a 70% ethanol-saturated microbrush for 7 seconds

OTHER

Microbrush visibly clean group

The contaminated dentine surface was scrubbed with a 70% ethanol-saturated microbrush until no visible sealer remnants were observed.

DEVICE

Air abrasion group

Air abrasion was performed for 10 seconds using the AquaCare Twin device (Velopex, UK). Aluminium oxide particles (53 µm, Velopex) were applied at a pressure of 2 bar, with a medium media flow and 17.5% ethanol-saturated solution (AquaSol, Velopex). The standard tip was positioned approximately 5 mm from the dentin surface and moved in a vertical (up-and-down) direction during the procedure. The application time and parameters were determined in consultation with the manufacturer due to the lack of previous clinical studies using the AquaCare device for this purpose.

Sponsors & Collaborators

• Marmara University

  lead OTHER

Principal Investigators

• ayse karadayi, asst. prof. · marmara university faculty of dentistry

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-08-19

Primary Completion

2025-04-07

Completion

2025-04-07

Countries

• Turkey (Türkiye)

Study Locations