Residual Endodontic Filling Material after Post Space Preparation: A Confocal Microscopic Study

This laboratory study assessed removability of endodontic alkaline cements and resin sealers using coronal cross-sectional slices of roots with single canals. Materials were labelled with 0.1% (w/w) sodium fluorescein prior to mixing so that confocal microscopy could be used to quantify material remaining on the walls of post spaces, to assess cleanliness. Roots of extracted teeth were prepared using rotary NiTi instruments then obturated using lateral condensation with gutta percha and epoxy resin sealers (AH-Plus™ or Zirmix™), or were filled by injecting mineral trioxide aggregate (MTA) cement (GC Nex™ MTA or MTAmix™) or a hard-setting calcium hydroxide cement (Supercal™). Brown (#3) ParaPost™ drills were used at 600 rpm with a torque setting of 3 N cm-1 for 2 min to remove 5 mm of the root filling. Roots were embedded and coronal slices examined by confocal microscopy, with the perimeter of the drill channel divided into clean, unclean and non-accessible regions. The choice of material affects cleanliness, with MTA being the most difficult and calcium hydroxide cement the easiest to remove. With epoxy resin-based sealers, almost half of the accessible canal walls remained coated with remnants of sealer after post space preparation.