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Ex vivo comparative analysis of retrievability among four calcium silicate-based sealers for regaining apical patency
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Darian Shomali, Timothy Kirkpatrick, Sang Won Kwak, , Hyeon-Cheol Kim, Ji Wook Jeong
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J Korean Acad Conserv Dent ;Published online December 8, 2025
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DOI: https://doi.org/10.5395/rde.2026.51.e3
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Abstract
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- Objectives
Efficient retrievability is a key requirement for endodontic sealers. This study evaluated the retrievability of four different calcium silicate-based sealers (CSS).
Methods A total of 153 single-rooted human teeth with straight canals were decoronated to a standardized working length of 12 mm. The canals were negotiated to working length using K files up to size 15/.02, followed by rotary instrumentation up to 35/.04, 2 mm short of working length. The teeth were randomly assigned to five groups: NeoSEALER Flo (NEO; Avalon Biomed), Ceraseal (CS; Meta Biomed), Endosequence BC Sealer (BC; Brasseler USA), AH Plus Bioceramic Sealer (AHB; Dentsply Sirona), and a negative control group. Sealer application and obturation with a 35/.04 gutta-percha cone were performed. After incubation at 37°C in 100% humidity for 7 days, retreatment was performed until apical patency was obtained, with retrievability assessed by regaining apical patency. One-way analysis of variance and Tukey contrast test were used to determine whether there was a significant difference among the four different CSS (p < 0.05).
Results Success rates in regaining apical patency were NEO (79.4%), CS (37.0%), BC (50.0%), and AHB (69.7%). NEO demonstrated the highest retrievability, while CS had the lowest (p < 0.01).
Conclusions The type of CSS used has a considerable impact on retreatment difficulty. Among the tested sealers, NeoSEALER Flo showed the highest retrievability, making it the most retrievable CSS in terms of retreatment efficacy.
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