Evaluation of apically extruded sealers and their relationship to various risk factors

The aim of this study is to evaluate the unintentionally apically extruded root canalsealers in endodontically treated teeth and to determine the possible risk factors affecting this situation.Records of 7761 teeth belonging to 5381 patients treated by a single operator during 18 years and 6 months were included. The most determining factor on extruded sealer was identified considering the patient's age, gender, diagnosis of pulpal and periapical disease, tooth type, treatment modality [primarytreatment (vital, mortal), retreatment], filling technique, sealer choice, and the number of visits. Statistical analysis was carried out by using univariate binary and multivariate logistic regression analyses. The mean age was 43.7±16.6 (years) and 2251 (41.8%) were men and 3130 (58.2%) were women. Extruded sealer was observed in 535 (6.9%) of 7761 teeth. The incidence of sealer extrusion was higher in primarily treated mortal teeth (p<0.001) and retreated teeth (p=0.002) compared to primarily treated vital teeth. The incidence of sealer extrusion was higher in solely lateral condensation (LC) and LC+vertical condensation (VC) (p=0.002) techniques compared to simple single cone or VC techniques. The use of AH 26 increased the incidence of sealer extrusion compared to AH Plus (p=0.002).It has been determined that primary treatments and retreatments performed in teeth with necrotic and/or periapical lesions, the use of LC, LC in combination with VC, and the choice of AH 26 as a sealer are risk factors in terms of sealer extrusion.