Abstract
The present study aimed to investigate the efficiency of passive ultrasonic irrigation (PUI), EndoActivator (EA), standard needle irrigation (SNI), and XP-endo Finisher files in removing pure calcium hydroxide (pCH) and injectable CH from in vitro root resorption cavities. Using a rotary system, the root canals of 116 extracted single rooted teeth were prepared. Imitated internal resorption cavities were then created in root halves. The specimens were divided into two groups according to the form of CH (n = 58): (I) pCH; (II) injectable CH. The teeth of each group were randomly divided into six subgroups: negative control (n = 5), positive control (n = 5), PUI (n = 12), XP-endo Finisher (n = 12), EA (n = 12), and SNI (n = 12). The root canals were irrigated using NaOCl and EDTA and split longitudinally, and both halves were evaluated with a stereomicroscope. Kruskal–Wallis and Mann–Whitney U tests were used to analyze data. The present results revealed that PUI completely removed pCH in 79% and injectable CH in 70.8% of the internal resorption cavities which was significantly higher than other methods (p < 0.05). There was no statically significant difference between different forms of CH in terms of CH removal (p=0.918). The PUI technique was observed as the most efficient method of P-CH and injectable CH removal from a replicated internal resorption cavity. Finally, according to the findings, different forms of CH were comparable in terms of CH removal.
Highlights
Successful removal or reduction of microorganisms and their products from root canals is the determining factor in prognosis of teeth with pulp necrosis and apical periodontitis [1, 2]
In group I, there was a significant difference between various removal methods in terms of calcium hydroxide (CH) removal (p < 0.001)
The passive ultrasonic irrigation (PUI) technique achieved complete clearance of pure calcium hydroxide paste in 70.8% of cases (0 score) which was significantly higher than other removal techniques (p < 0.05). ere was no significant difference between negative control and PUI in terms of complete CH removal (p 0.325)
Summary
Successful removal or reduction of microorganisms and their products from root canals is the determining factor in prognosis of teeth with pulp necrosis and apical periodontitis [1, 2]. Intracanal calcium hydroxide was removed by instrumenting using a master apical file and irrigating abundantly using sodium hypochlorite or ethylenediaminetetraacetic acid (EDTA) [11, 12]. The main objective of the present invitro investigation was to compare the efficacy of four removal methods of calcium hydroxide paste (passive ultrasonic irrigation, standard needle irrigation, EndoActivator, and XP-endo Finisher file) in removing different forms of CH (pure calcium hydroxide (pCH) and injectable CH) from the replicated internal root resorption. In order to standardize the specimens, 20 mm from the apex was marked by a digital calliper (Teknikel, Istanbul, Turkey) and the remaining crown was cut using diamond disks (Jota Co., Ruthi, Switzerland) under water cooling to obtain the desired root length for each tooth. Five teeth were appointed as the positive control group. ese teeth were filled with CH without any removal procedure. en the remaining 48 teeth in each group were randomly divided to four subgroups based on the CH removal technique (n 12): PUI, XP-endo Finisher, EA, and SNI
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