Protocols for cleaning the incisor access cavity contaminated with epoxy resin sealer

This study compared different methods for cleaning the sealer‐contaminated access cavity of upper incisors. After standard endodontic access, the canals of 50 extracted maxillary incisors were chemomechanically prepared and obturated with gutta‐percha and epoxy resin sealer. Teeth were randomly assigned to one of five different pulp chamber cleaning protocols (n = 10): air/water spray, ethanol‐saturated cotton pellet (CP), ethanol‐saturated microbrush reaching the root filling (MB), MB + air polishing (PROPHYflex; KaVo), or MB + etching with 37% phosphoric acid. Each tooth was split and the sealer‐covered area of the pulp chamber was determined on images taken before and after cleaning using image analysis software. The sealer‐covered area was compared across groups using one‐way ANOVA. Greatest mean sealer‐covered area reduction was observed for MB + etching (98.0%), MB + air polishing (95.2%), and MB alone (92.8%), yielding a significantly higher sealer‐covered area reduction than after air/water spray (8.3%) and ethanol‐saturated cotton pellet (53.4%). The upper incisor access cavity is best cleaned with an ethanol‐saturated microbrush reaching up to the root filling, followed by air/water spraying and etching. The use of cotton pellets should be discouraged.