Abstract
This study evaluated the efficacy of 2 types of rotary instruments employed in association with sodium hypochlorite (NaOCl) or EDTA in removing calcium hydroxide (CH) residues from root canals dentin walls. Forty-two mandibular human incisors were instrumented with the ProTaper System up to F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA and filled with a CH intracanal dressing. After 7 days, the CH dressing was removed using 4 techniques: NiTi rotary instrument size 25, 0.06 taper (K3 Endo) and irrigation with 17% EDTA (Group 1), NiTi rotary F1 instrument (ProTaper) and irrigation with 17% EDTA (Group 2), NiTi rotary instrument size 25, 0.06 taper and irrigation with 2.5% NaOCl (Group 3) and NiTi rotary F1 instrument and irrigation with 2.5% NaOCl (Group 4). Two roots without intracanal dressing were used as negative controls. Teeth were evaluated by scanning electron microscopy, in the cervical and apical canal thirds. None of the techniques removed the CH dressing completely. In the apical and cervical thirds, F1 instrument was better than instrument size 25, 0.06 taper in removing CH residues (p<0.05), regardless of the final irrigating solution. No difference was found between the irrigating solutions in the groups of F1 instrument and of instrument size 25, 0.06 taper (p>0.05). The negative controls had no CH residues on the dentin walls. In conclusion, the ProTaper F1 instrument was better than K3 Endo instrument size 25, 0.06 taper in the removal of CH intracanal medication, regardless of irrigating solution used.
Highlights
Presence of microorganisms in the root canal system plays a fundamental role in the pathogenesis of apical periodontitis [1,2]
Considering the importance of the complete removal of intracanal dressing before root canal filling, this study aimed at evaluating the efficacy of 2 types of rotary instruments, in association with NaOCl or EDTA, in removing calcium hydroxide (CH) residues from root canal dentin walls, using scanning electron microscopy (SEM)
In the apical and cervical thirds, F1 instrument was more efficient than instrument size 25, 0.06 taper in removing CH residues (p
Summary
Presence of microorganisms in the root canal system plays a fundamental role in the pathogenesis of apical periodontitis [1,2]. The use of intracanal dressing to disinfect the root canal system has been advocated to enhance the success of root canal treatment [3,4,5]. An ideal root canal dressing must have antimicrobial efficacy causing no harm to the periapical tissues. Calcium hydroxide (CH) has been considered to be the material of choice as an intracanal medicament [6]. If this medication is not completely removed, its presence on the dentin walls could compromise the endodontic treatment [7]. There is evidence that these residues may react with zinc oxide and eugenol-based cements, forming calcium eugenolate, which hinders the penetration of cement into the dentin tubules [8]
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