Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals

Abstract

To compare the efficacy of ultrasonic irrigation and RinsEndo in removing calcium hydroxide and Ledermix paste from simulated root canal irregularities. The root canals of sixty extracted single-rooted teeth were prepared using FlexMaster rotary instruments to size 60, 0.02 taper. The roots were split longitudinally, and a standardized groove was prepared in the apical part of one segment. The teeth were randomly allocated into two groups (n = 30), according to the intracanal dressing. In the first group, grooves were filled with calcium hydroxide paste (Calxyl), whereas the grooves in the second group were filled with Ledermix paste. After reassembly, the root canals were completely filled with the respective medicament using a lentulo. The removal of medicament dressing was performed after 7 days with either passive ultrasonic irrigation or RinsEndo and 1% sodium hypochlorite for 3 min. The amount of remaining medicament was evaluated under a microscope with 30 × magnification using a four-grade scoring system. A regression analysis with P ≤ 0.05 was performed. Ledermix paste removal was significantly more effective than the removal of calcium hydroxide (P < 0.0001), whereas irrigation technique was not a significant factor (P = 0.3712). The percentages of complete removal of calcium hydroxide and Ledermix paste were 11.7% and 51.7%, respectively. None of the irrigation techniques was able to completely remove the intracanal medicaments from the apical part of the root canal. Irrespective of the irrigation technique, significantly less Ledermix paste was detected compared with calcium hydroxide.