title: Apically Extruded Sealers: Fate and Influence on Treatment Outcome.
abstract: BACKGROUND
  This retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome.
  
  
  METHODS
  One hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment. Sealers included Pulp Canal Sealer (Sybron Dental, Orange, CA), PCS Extended Working Time-EWT (Sybron Dental), Tubli-Seal (Sybron Endo), Endomethasone (Septodont, Saint-Maur-des-Fossés, France), AH Plus (DeTrey GmbH, Konstanz, Germany), and Apexit (Ivoclar Vivadent, Schaan, Lichtenstein). Recall radiographs were compared with immediate postobturation films for removal of the extruded material and status of the periradicular tissues. Data were grouped as 1-, 2- and >4-year recall and statistically analyzed using the chi-square and Fisher exact tests.
  
  
  RESULTS
  As for the sealers' fate, the only statistically significant differences at the 1-year recall were observed when comparing Tubli-Seal with AH Plus, Apexit, and Endomethasone (P < .05). At both the 2- and 4-year recalls, frequency of complete removal of AH Plus and Apexit was significantly lower when compared with all the other sealers (P < .05). No other significant differences were observed between groups. As for the influence on treatment outcome, there were no statistically significant differences between sealers at all follow-up periods (P > .05). Data from the >4-year recall revealed that 79% of the teeth with apical periodontitis lesions at the time of treatment had healed in comparison with 100% of the teeth with no apical periodontitis (P < .01).
  
  
  CONCLUSIONS
  Not all extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis.
authors.affiliation: Private Practice, Cetraro, Italy. Electronic address: dricucci@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Ricucci
authors.affiliation: Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Isabela N
authors.initials: IN
authors.lastname: Rôças
authors.affiliation: Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Flávio R F
authors.initials: FR
authors.lastname: Alves
authors.affiliation: Private Practice, Cetraro, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Loghin
authors.affiliation: Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: José F
authors.initials: JF
authors.lastname: Siqueira
mesh_terms: D000328:Adult; D003763:Dental Leakage / Q000517:prevention & control*; D003786:Dental Pulp Cavity / Q000187:drug effects / Q000473:pathology; D004853:Epoxy Resins; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000628:therapy; D012189:Retrospective Studies; D012387:Root Canal Filling Materials; D012389:Root Canal Obturation; D012390:Root Canal Therapy / Q000379:methods; D019227:Tooth Apex / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement
chemical_list: D004853:Epoxy Resins; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C112894:canals sealer; C534916:epoxy resin-based root canal sealer
keywords: Endodontic sealers; endodontic treatment; overfilling; treatment outcome