Abstract

AimTo evaluate the efficacy of 10% maleic acid in comparison with 17% ethylenediaminetetraacetic acid (EDTA) in the removal of intracanal medicaments from the root canal system.Materials and methodsForty-eight extracted single-rooted mandibular premolars were decoronated to standardize the length of 14 mm. Chemomechanical preparation was done using the crown-down technique with Protaper files (Dentsply‑Maillefer, Ballaigues, Switzerland) till F4, followed by irrigation with 2 ml of 5.25% sodium hypochlorite (NaOCl) after each instrument, and 5 ml of 17% EDTA was used as the final irrigating agent.Metapex (Meta Dental Corp. Ltd., Elmhurst, NY, USA) and Odontopaste (Australian Dental Manufacturing, Kenmore Hills, Qld, Australia) were the two intracanal medicaments that were used in this study.Total samples were divided into two groups based on the intracanal medicament that was placed in the canal. In group 1, Metapex was injected into the root canal until the material extruded through the apex. In group 2, Odontopaste was placed into the canal until the material extruded through the root apex. Cleaning off the excess medicament was done with a moist cotton pellet. After temporary sealing with a cotton pellet and Cavit, all the samples were stored at 37 ºC and 100% relative humidity for a period of seven days. The teeth in each group were further randomly divided into three subgroups on the basis of the irrigant used for retrieval of medicament. In groups 1A and 2A, 1ml of 17% EDTA was used; in groups 1B and 2B, 1ml of 10% maleic acid was used; in groups 1C and 2C, 1ml of 0.9% saline was used. Sonic agitation for 1 minute, followed by a final rinse of 1 ml distilled water, was used in all the groups.After the intracanal medicament was removed from the canal, the roots were longitudinally sectioned using a diamond disk (Bego, Berman, Germany). The residual medicament on each section was evaluated under a stereomicroscope (×30; Medilux, MDL-DS4-BI, Biosystems, Curitiba, PR, Brazil). The data were analyzed using SPSS version 23.0 software (IBM Corp., Armonk, NY). Kruskal-Wallis ANOVA and Mann-Whitney U test (post hoc) were applied for intergroup comparisons. A Wilcoxon signed-rank test was applied for intragroup comparisons.ResultsBoth the chelators, 17% EDTA and 10% maleic acid, removed the Odontopaste significantly better than Metapex. However, 17% EDTA was more effective in the removal of Odontopaste. 10% Maleic acid showed better results in the removal of Metapex than 17% EDTA.ConclusionNone of the chelating agents was able to totally retrieve the intracanal medicaments. When compared to Metapex, Odontopaste showed significantly better retrievability from the root canal with both 17% EDTA and 10% Maleic acid, whereas the retrievability of Metapex was significantly better with 10% Maleic acid in comparison to 17% EDTA.

Highlights

  • Root canal treatment is directed towards the control and prevention of pulpal and periradicular diseases

  • 17% ethylenediaminetetraacetic acid (EDTA) was more effective in the removal of Odontopaste. 10% Maleic acid showed better results in the removal of Metapex than 17% EDTA

  • The prognosis of root canal treatment depends on the reduction or eradication of microorganisms, as they are relevant in the progression of these lesions [1]

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Summary

Introduction

Root canal treatment is directed towards the control and prevention of pulpal and periradicular diseases. The prognosis of root canal treatment depends on the reduction or eradication of microorganisms, as they are relevant in the progression of these lesions [1]. The number of microorganisms in the infected root canal was significantly reduced by chemomechanical preparation. Intracanal dressing enhances the elimination of microorganisms from the infected root canals by preventing the recontamination and proliferation of residual strains [2]. Calcium hydroxide is the most popular intracanal medicament. It is widely used as an interappointment root canal dressing due to its well-documented antimicrobial activity against most endodontic microorganisms. Most of the bacteria are unable to survive the extremely alkaline environment provided by calcium hydroxide [3]

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