full of irrigation in canal  like as NAOCl and used rotary instruments like as turbin 

Refer to chapter cleaning & shaping dr,torabi nejad or pathway.....

First clean with ethanol or AH Plus Cleaner, then use etch-and rinse without bur / diamond, then use agoo dentin bonding and a flowable composite (eg. SDR)

You can use an ethanol pellet, followed by preparation with a water-cooled diamond bur and etch-and-rinse procedure.

ethanol or alcohol swab followed by slow speed round bur. Etch and rinse

Wipe excess sealer with a cotton pellet, remove entire gutta percha from chamber with heated instrument up to the level of orifice, then wipe with alcohol. It has been suggested that a sponge piece is more effective than cotton because cotton fibres could separate and get stuck on the cement. Will it be wise to use high speed handpiece and water spray on the exposed ends of your obturation...I doubt it. Heat and alcohol are least likely to disturb the obturation. Also, a layer of chemically bonding material such as GIC over the orifice followed by etching and bonding is the common technique we follow.

Afraid I might not suggest the use of ethanol due to the subsequent desiccation of the dentin which is not desirable. Using Miller burs without pressure or air abrasion should suffice. Hope this helps.

Propylene glycol also helps

I would suggest that total seal within the pulp chamber is not really relevant. It is the peripheral seal around the lesion that counts and that means total adhesion to either enamel and/or dentine. Sealing enamel with etching and composite resin is routine and sealing dentine through conditioning and glass-ionomer is likewise routine. Clean the pulp chamber as best possible and then ensure the margins of the lesion are treated as required to achieve adhesion and seal the lesion totally.

Use ethanol pellet, followed by preparation with a water-cooled diamond bur and etch-and-rinse procedure.

I suggest copious ulrasonic  or airsonic cleaning with water to remove all the obvious stuff -especially in the pulp cornuae and  down 2-3 mm subgingivally.

Dry the tooth chamber with a series of big  paper points  to wick the fluid out of the chamber.Mix up contrasting colour  conventional  GIC (white -not tooth coloured -e.g Ketac Cem radiopaque) to double cream thickness .Pick up that  in the back of  a syringe with a  soft wide bore bendable  needle attached at the other end .

Inject that  subgingivally as far down as the GP and as you withdraw the needle leave most  the chamber filled ,epecially on the inside of the labial surface of anterior teeth with the contrasting white colour material. Wait for it to set.

Etch the enamel and use a three bottle system and a contrasting lighter coloured composite to seal the rest of the access cavity.

That means a very good seal in two parts but  if it ever needs re-intervention e.g for inside /outside bleaching , then the  white  coloured GIC can be blasted out with airsonics or ultrasonics  allowing any one later in  to follow the internal anatomy . 

Dear Dr Kelleher,

any particular evidence to recommend GIC?

It seems like bonding in the access cavity is impacted by particles and overall contamination, which is not completely removed by alcohol or air abrasion (see Peters et al IEJ 2000, 53-55). We found glass ionomer a reasonable orifice barrier (Zakizadeh et al, JoE 2008, 871-875). This is obviously all in vitro, I have not seen any clinical studies to this point.

Dear Ove, hope this message finds you well.

Have just checked the literature you have quoted and afraid I have to ask for your guidance when intending to support the indication of GIC use as a better orifice access sealer please.

The "Zakizadeh" paper:The efficacy of amalgam, Fuji-Plus, Geristore, and mineral trioxide aggregate (MTA) as intraorifice barriers was com- pared in a simulated saliva leakage model." Using the PICO tools one encounters difficulties in matching this study to the asked question of course presuming rubber dam use and an optimized core build approach.

The "Peters" papers again seems to not cover the topic as your here investigate "Effect of eugenol-containing sealer on marginal adaptation of dentine-bonded resin fillings" and we have never discussed which sealer was used more the fact that eugenol containing sealer  do not represent the golden standard any further.

Thank you so much for your input and my best regards

Liviu

Afraid I have continued digging on the GIC myth! Came across the following paper: "Adhesion of resin-modified glass-ionomer cements may affect the integrity of tooth structure in the open sandwich technique"by Czarnecka et al.: "..The most serious inadequacy, though, was not lack of intimate contact and/or adhesive bond, but the presence of perpendicular cracks in 30% of the Fuji II LC samples which extended into the underlying dentin." This for sure can not be an intended goal in previous root canal treated teeth, isn t it? Most important to understand re the results from the study by Lin 1991 saying that:"...the highest bond strengths were obtained with light -cured GIC". Personally I have to question the use of GIC for sealing the access cavity.