Removal Of Calcium Hydroxide Research Articles

Comparative Evaluation Of Retrievability Of Calcium Hydroxide From Apical Third Of Root Canal With Commercially Available Root Canal Irrigants: An InVitro Study

Context: Calcium hydroxide is the most widely used intracanal medicament to aid chemomechanical preparation to thoroughly clean the root canal system. However, it is important to completely remove the medicament for predictable success of the root canal treatment. Aim: This study was aimed to compare the effectiveness of irriganting solutions and irrigation methods to remove calcium hydroxide from the root canal system. Material and Methodology: Eighty extracted single rooted teeth were selected and instrumented using ProTaper Gold rotary files, followed by application of calcium hydroxide. After incubating for a week, teeth were randomly allocated into 8 groups (n=10) based on irrigating solution (17% EDTA, 1% Phytic Acid, 3% NaOCl, 70% Ethanol) and method of irrigation used (PUI and NAI). The sample teeth were then sectioned horizontally to assess the residual calcium hydroxide on the canal walls under Confocal Laser Scanning Microscope. Statistical analysis: The difference in the mean value of the two parameters was assessed by using analysis of variance (ANOVA). Tukey’s test was used for post hoc multiple comparisons between different groups. The level of significance was fixed at p<0.05. Results: None of the irrigants were able to completely remove the calcium hydroxide from the root canal. However, irrigation with 70% Ethanol presented significantly cleaner root canal walls in NAI. Conclusion: 70% Ethanol presented with least amount of residual calcium hydroxide in comparison with phytic acid and commercially available irrigants i.e., EDTA and NaOCl in both NAI and PUI.

A confocal laser scanning microscopic analysis of efficacy of different activated irrigants in the removal of calcium hydroxide medicament and subsequent penetrability of Bio-C sealer – An in vitro study

Abstract Aim: The aim of the study was to investigate the efficacy of different irrigants activated by pro-agitator tip system (PATS) Vario on the removal of calcium hydroxide medicament and subsequent penetration depth of Bio-C sealer. Materials and Methods: Fifty single-rooted mandibular premolars were selected. Access cavities were prepared; biomechanical preparation was done. Metapex that had been combined with rhodamine B dye was used to fill each sample. All the samples were divided into five groups (n = 10) – Group I: chitosan–citrate, Group II: intracanal heated sodium hypochlorite (NaOCl), Group III: phytic acid, Group IV: SmearClear, and Group V: saline. All samples were obturated using gutta-percha and Bio-C sealer (combined with fluorescein dye). Later, all samples were sectioned at 3, 6, and 9 mm from the apex and observed under a confocal microscope for residual Ca(OH)2 and sealer penetration into dentinal tubules. Results: The saline group exhibited the least amount of sealer penetration and high residual Ca(OH)2, both of which were statistically significant (P ≤ 0.05). Conclusion: The use of PATS Vario for irrigant activation enhanced the calcium hydroxide removal efficacy and penetration of Bio-C sealer into dentinal tubules. The elimination of calcium hydroxide and sealer penetration, from the apical region of the tooth, can be accelerated by intracanal heating of NaOCl.

Irrigation techniques for calcium hydroxide removal from resorption cavities

Irrigation techniques for calcium hydroxide removal from resorption cavities

Effectiveness of mechanical vs. chemomechanical methods in removing intracanal calcium hydroxide medication: a randomised trial.

To compare the mechanical and chemomechanical methods for removing calcium hydroxide medication from the root canal system. The triple-blind, randomised clinical trial was conducted at the Department of Operative Dentistry and Endodontics, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan, from December 16, 2022, to June 15, 2023, and comprised patients having necrotic teeth and chronic apical pathosis. They were randomised into groups A and B. On the initial visit, after access opening and chemomechanical preparation, calcium hydroxide paste was placed as an intracanal medication in both groups. the patients were recalled after two weeks. In Group A, calcium hydroxide was removed from the canals using a rotary master apical file, while in Group B, an endoactivator was used to sonically agitate the endodontic irrigant. Verification of placement was done by using a periapical radiograph. Data was analysed using SPSS 26. Of the 98 individuals assessed initially, 60(61.22%) were included; 34(57%) females and 26(43%) males with age ranging from 19 to 57 years. There were 27(45%) incisors, 22(36.7%) premolars and 11(18.3%) canines. There were 30(50%) patients in each of the 2 groups. The intergroup difference was not statistically significant (p=0.43). Tooth arch did not significantly correlate with the removal method (p=0.79). Both methods were found to be equally effective in removing water-based calcium hydroxide medication from the endodontic system. NCT05744661.

Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study.

This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2mm in diameter and located 8mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.

Efficacy of Different Irrigation Needles and Ultrasonic Activation on Calcium Hydroxide Removal: A Micro-CT Study Using 3D-Printed Endodontic Models

IntroductionThe aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)2 from an endodontic model that duplicated a root canal configuration of a human natural tooth. MethodsAn extracted human maxillary premolar was subjected to root canal preparation and scanned with microcomputed tomography. A 3-dimensional reconstruction model of the natural tooth was printed to endodontic models using a polyjet printer. The root canals of the models were filled with Ca(OH)2 paste and divided into 2 groups based on the irrigation protocol: conventional syringe-needle irrigation (conventional group) and passive ultrasonic irrigation (PUI) group. Each group was subdivided into 3 groups (n = 10) according to the type of needle: half-cut, side-vented, and TruNatomy irrigation needle. Microcomputed tomographyimaging was used to assess the percentage of reduction of Ca(OH)2. Data were analyzed using two-way analysis of variance test (α = .05). ResultsThe side-vented and TruNatomy irrigation needles showed significantly higher percentage reductions than the half-cut needle (P < .05) in the conventional irrigation group. The PUI group showed significantly higher percentage reductions of Ca(OH)2 than the conventional group regardless of the type of needle (P < .05). However, no significant difference was found among the needles in the PUI group. ConclusionsThe type of irrigation needle and the use of PUI influenced the removal efficacy of Ca(OH)2. PUI enhanced the removal of Ca(OH)2 regardless of the type of irrigation needle.

Comparative Effectiveness of Different Er:YAG Laser-Activated Irrigation Systems on Removing Calcium Hydroxide from Simulated Internal Root Resorption Cavities at Different Root Levels.

Objective: To investigate the effectiveness of Er:YAG laser-activated irrigation (LAI) with a short pulse duration for removing calcium hydroxide (CH) from simulated internal root resorption (IRR) cavities at three root levels. Background: Pulse duration is an important parameter during LAI, which ensures the efficiency of irradiation and the corresponding activation process. Short pulses in the range of a few microseconds enable rapid expansion and successive implosion of irrigants, resulting in distinct fluid movement. There have been few reports on CH removal efficacy from IRR cavities of different LAI systems, including those using short pulse duration. Methods: IRR cavities (1.6 mm diameter) were created at the apical, middle, and coronal root levels in 60 mandibular premolars and filled with a radiopaque CH paste. Samples were assigned to the following irrigation groups (n = 12, each): (1) LAI(P)-F, a prototype laser device that operates with short pulse duration (Morita Manufacturing) with a flat tip; (2) LAI(EA)-F, the ErwinAdverl laser device (Morita Manufacturing) with a flat tip; (3) LAI(EA)-T, the ErwinAdverl laser device with a tapered tip; (4) PIPS-T, the Lightwalker laser device (Fotona) with a tapered tip; and (5) SI, the syringe irrigation group. The laser tips were fixed at the canal entrance. The remaining CH volume and surface area were assessed in IRR cavities using micro-computed tomography and scanning electron microscopy, respectively. Data were statistically analyzed utilizing one-way analysis of variance and Tukey's test at 5% significance level. Results: The LAI(P)-F and PIPS-T groups exhibited the highest CH removal rates at three different levels (p < 0.05). The LAI(EA)-F group had a significantly better efficacy of CH removal compared with the LAI(EA)-T group at the middle level (p < 0.05). Conclusion: The LAI(P)-F and PIPS-T groups demonstrated superior efficiency in removing CH from simulated IRR cavities.

Comparative Analysis of AH Plus Bond Strength to Root Canal Dentin and Adhesive Interface Quality after Calcium Hydroxide Removal using Different Irrigation Protocols

IntroductionTo evaluate the push-out bond strength (POBS) of AH Plus sealer to root dentin and the adhesive interface quality after calcium hydroxide (Ca(OH)2) intracanal dressing removal with different final irrigation protocols. MethodAfter root canal instrumentation and irrigation, 40 root canals were filled with Ca(OH)2 and sealed. After 14 days, the specimens were randomly distributed according to the irrigation protocols for Ca(OH)2 removal (n = 10): GH2O (control) - distilled water; GNaOCl - 1% NaOCl; GEDTA - 17% EDTA; GEDTA + NaOCl - 17% EDTA + 1% NaOCl. The root canals were filled with AH Plus sealer and gutta-percha. After 7 days, the roots were sectioned into dentin slices and submitted to POBS test and analysis of the adhesive interface under scanning electron microscope. The POBS data were statistically evaluated (analysis of variance and Tukey test). The Kruskal-Wallis and Mann-Whitney tests were used to analyze the adhesive interface (α = 0.05). ResultsGH2O, GNaOCl, and GEDTA + NaOCl had similar POBS values, with higher values on the apical third, in comparison with other thirds (P < .05). A homogeneous and free-of-gaps adhesive interface was observed for GH2O, GNaOCl, and GEDTA + NaOCl, with difference between GH2O and GEDTA (P < .05). GH2O and GEDTA + NaOCl presented higher sealer tags formation (P < .05). ConclusionThe final rinse with EDTA for Ca(OH)2 dressing removal had a negative effect on the POBS of the filling material to root dentin. The use of EDTA followed by NaOCl had results similar to the distilled water, providing uniform and free-of-gaps adhesive interface, and a higher number of sealer tags.

Retrievability of Intracanal Medicament from Root Canals: An In-vitro CBCT Volumetric Analysis

Introduction: The complete removal of Calcium Hydroxide {Ca(OH)2 } using various techniques remains a challenge in root canal therapy. One of the most commonly used methods for removing calcium hydroxide is by using a Master Apical File (MAF) along with sodium hypochlorite and Ethylenediaminetetracetic Acid (EDTA). Various new modalities, like Canal Brush, NaviTip and file systems, have emerged to tackle the residual calcium hydroxide in the canal; but none of these methods have been able to completely remove it from the canal. Aim: To evaluate and compare the efficacy of H-files, NaviTip FX and Canal Brushes in removing calcium hydroxide intracanal medicament from root canals. Materials and Methods: This in-vitro study was carried out in the Department of Conservative Dentistry and Endodontics at KM Shah Dental College and Hospital, Vadodara, Gujarat, India, from December 2023 to March 2024. To standardise the length at 14 mm, 30 mandibular premolar teeth (n=30) with a single root were decoronated at the Cementoenamel Junction (CEJ). The working length was determined, followed by the cleaning and shaping of all specimens using ProTaper Rotary Files. Intracanal medicament (Metapex) was placed and the canals were sealed with Glass Ionomer Cement (GIC). The specimens were then placed at 37±1ºC and 100% relative humidity for 30 days. The medicament was subsequently removed by three different protocols: H-file, NaviTip FX and Canal Brush (n=10 each). The residual volumes in the mesial, distal and apical thirds were assessed, referring to the volume of medicament left in the canal, which was measured using Cone-beam Computed Tomography (CBCT). The recorded variables were analysed using one-way Analysis of Variance (ANOVA) post-hoc tests (p&lt;0.05). Results: The Canal Brush removed the maximum amount of Metapex in the apical third (0.108) of the roots of the premolars, followed by NaviTip FX and then H-file. In the middle third of the root, NaviTip FX removed more Metapex than the Canal Brush, followed by H-files. A comparison of retrieval between and within the groups it showed that none of the techniques were capable of removing all the Metapex from the specimens, with p&gt;0.05. Conclusion: The present study demonstrated that the Canal Brush showed superior results in retrieving Metapex from the apical third of the root and the distal side (middle third), whereas NaviTip FX removed more Metapex from the mesial side (middle third) of the root, but H-file exhibited the least efficacy in the retrieval of Metapex. Total removal of calcium hydroxide from the entire canal is not possible regardless of the technique used.

Effect of Irrigation Solution of Sodium Hypochlorite, Ethylenediamine Tetraacetic Acid, Chitosan Oligosaccharide and Agitation Techniques on Calcium Hydroxide Removal in Root Canal: In Vitro Study

Root canal treatment removes all infected pulp tissue and shapes the root canal to be appropriately filled to prevent bacteria from re-entering the root canal. Chitosan oligosaccharide is a promising irrigation solution because it has high solubility and low molecular weight, biocompatibility, good adhesion, and chelating properties.This study aims to assess the impact of various irrigation solutions, namely sodium hypochlorite, ethylenediamine tetraacetic acid, chitosan oligosaccharide, and different agitation strategies, on the efficacy of calcium hydroxide removal within the root canal. A total of 24 single-root mandibular premolars were extracted, decolonized, and root canal treated using Ca(OH)2. Examination of residual Ca(OH)2 in the channel was examined with a Scanning Electron Microscope (SEM). SEM results are assessed based on scoring with a double-blind method. Chitosan oligosaccharide irrigant with ultrasonic agitation can remove residual (Ca(OH)2) on the surface of the root canal wall, which is very good compared to the aspirator with XP Endo Finisher. The 2.5%NaOCl + 17% EDTA solution with ultrasonic agitation was better than the agitation with XP Endo Finisher. The ultrasonic agitation technique removes residue (Ca(OH)2) better than the XP endo finisher technique after being influenced by 2.5% NaOCl irrigation solution, 17% EDTA, and 2% chitosan oligosaccharides.The ultrasonic agitation technique generally removed up to 70% residue compared to the XP endo finisher agitation technique (30%) from all cervical, middle, and apical parts of the root canal:The ultrasonic agitation technique removes residue (Ca(OH)2 more than the XP Endo Finisher technique. Chitosan Oligosaccharide 2% has a better effect on removing residue (Ca(OH)2 in root canals. In comparison, 2% NaOCl irrigation solution is better than 17% EDTA in removing debris (Ca(OH)2 ).

Efficacy of 2% Paradichlorobenzene, 10% Citric Acid, 17% Ethylenediaminetetraacetic Acid, and 0.2% Chitosan at Removing Calcium Hydroxide From the Root Canals.

Chronic infections often require the use of an intracanal medicament. Calcium hydroxide is the most commonly used intracanal medicament. However, retrieval of calcium hydroxide (CH) medicaments is a challenge. This study evaluated the efficacy of 2% paradichlorobenzene, 10% citric acid, 17% ethylenediaminetetraacetic acid (EDTA), and 0.2% chitosan in removing calcium hydroxide from the root canals. Forty single-rooted mandibular premolars extracted for orthodontic reasons were selected for the study. After access opening, cleaning and shaping were performed following a standardized irrigation protocol, and the samples were pre-weighed for baseline weight. CH was placed in canals until the apex, and the specimen was incubated at 37 °C and 100% relative humidity for seven days. These samples were weighed again for quantitative analysis and subjected to cone beam computed tomography (CBCT) for volumetric analysis using ITK SNAP software (Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA). The samples were randomly divided into four groups based on the irrigant used for the removal of medicament. Group 1: 2% paradichlorobenzene; group 2: 10% citric acid; group 3: 17% EDTA; and group 4: 0.2% chitosan, all in combination with sonic agitation. After the removal of CH, weight and volumetric analyses were repeated, and the percentage difference was calculated. Statistical analysis was done using the one-way ANOVA test for both weight and volumetric assessment, and the inter-group comparison was made using the post hoc Tukey test. The maximum retrieval was observed with 2% paradichlorobenzene by both weight (96.75%) and volumetric (91.42%) assessment, with p=0.00 and p=0.01, respectively. This was followed by 0.2% chitosan, 10% citric acid, and the least, 17% EDTA. Two percent paradichlorobenzene combined with sonic agitation was most efficient in removing CH, followed by 0.2% chitosan, 10% citric acid, and 17% EDTA chitosan.

Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities

Aim: To compare the efficacy of shockwave-enhanced emission photoacoustic streaming (SWEEPS), sonic activation with EDDY, and passive ultrasonic irrigation (PUI) in the removal of calcium hydroxide medicaments from artificial internal resorption cavities. Methodology: Ninety mandibular premolars with single oval canals were prepared to size 50/0.04 and split longitudinally. Standardized cavities were prepared in the apical third of the root canal and filled with calcium hydroxide. The root halves were reassembled and divided into three groups (n = 30) according to the removal methods used. The amount of residual calcium hydroxide was evaluated using a four-grade scoring system. The differences between the groups were analyzed using the Kruskal–Wallis H test (p &lt; 0.05). Results: SWEEPS removed significantly more calcium hydroxide than PUI (p &lt; 0.003) and EDDY (p &lt; 0.035). There was no significant difference between the EDDY and PUI groups (p = 1.000). Conclusion: None of the systems tested were able to completely remove the calcium hydroxide paste from the simulated internal resorption cavities; however, SWEEPS removed more calcium hydroxide than the EDDY and PUI techniques. How to cite this article: Erkan E, Aydın RN, Falakaloğlu S, Yeniçeri Özata M, Gündoğar M. Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities. Int Dent Res 2023;13(2):48-53. https://doi.org/10.5577/idr.2023.vol13.no2.1 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation.

To evaluate the effectiveness of laser-activated irrigation (LAI) and ultrasonic irrigation (UI) in the removal of calcium hydroxide [Ca(OH)2] and modified triple antibiotic paste (MTAP) from the root canals. Root canals of freshly extracted human permanent maxillary incisors (n = 80) were prepared. The root canals of half sample (n = 40) were filled with Ca(OH)2 and the other half (n = 40) with MTAP, in which propylene glycol was used as a vehicle. After 14 days, roots were randomly assigned to four groups (n = 20) according to the irrigation technique used-group I [Ca(OH)2 with UI], group II (MTAP with UI), group III [Ca(OH)2 with LAI], group IV (MTAP with LAI). The roots were sectioned, and the intracanal medicament residues were evaluated at 25× magnification under stereomicroscope using 4-grade scoring system. One-way analysis of variance (ANOVA) and post hoc Tukey tests were performed. Laser-activated irrigation (LAI) was found to be superior compared to UI. Ca(OH)2 was better removed compared to MTAP with either of the irrigation techniques. A statistically significant difference was found between the Ca(OH)2 with LAI and MTAP with UI groups in all the regions, that is, coronal, middle, and apical thirds. Laser-activated irrigation (LAI) was superior to UI in removing Ca(OH)2 and MTAP. Ca(OH)2 was better removed than MTAP, irrespective of the technique used. However, none of the irrigation techniques could completely remove the intracanal medicament from the root canals. Swathi P, Uloopi KS, Vinay C, et al. Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation. Int J Clin Pediatr Dent 2023;16(S-1):S1-S5.

Efficiency of Different Agitation Methods for Removal of Calcium Hydroxide Intracanal Medicament Mixed with Two Different Vehicles from Canals of Mandibular Premolars: A Volumetric Analysis using Cone-beam Computed Tomography

Introduction: The purpose of this research was to use cone-beam computed tomography (CBCT) to examine the efficacy of hand and rotary files, manual dynamic agitation, and inactive ultrasonic actions in removing Ca(OH)2 from root canal surface when used in conjunction with two distinct vehicles. Materials and Methods: Using the ProTaper Gold file system, the root canals of 100 mandibular premolars were cleaned and shaped up to file F2, and then filled with either Ca(OH)2 + saline or Ca(OH)2+ camporated monochloro-phenols. After 7 days of incubation, CBCT was used to do a prevolume analysis. Several forms of agitation were used to successfully remove calcium hydroxide (K- and H-file, ProTaper Gold rotary file, passive ultrasonic irrigation (PUI), and manual dynamic agitation). CBCT was used to reevaluate the volumes after the fact, &amp; the percentage of change was determined the Post Hoc Tukey test, One-way ANOVA, &amp; the Dunn test were utilized to analyse the data statistically. Results: Saline-based Ca (OH) 2 was little simple to be separate than camporated monochloro-phenols (CMCP)- based group. When the agitation systems were compared, H-file in both the groups removed more calcium hydroxide from root canals than other systems (P &lt; 0.01). Conclusion: The H-file system and PUI were more effective than the K-file, rotary, and manual dynamic agitation methods in eliminating calcium hydroxide from root canals. However, the saline-based calcium hydroxide was easier to be removed than camphoro monochlorophosphate.

Effectiveness of calcium hydroxide removal with irrigation techniques using ProTaper and ultrasonic activation: an in vitro study

Background: Residual calcium hydroxide might adversely affect the outcome of endodontic treatment results. Calcium hydroxide affect the adhesion of endodontic sealers to the canal walls and interfere with sealing ability of endodontic sealers. To remove this intracanal medicament, there are various irrigation techniques have developed. The aim of this study was to evaluate the effectiveness of different techniques in removing calcium hydroxide from the root canal. Materials and methods: Thirty extracted single-rooted mandibular premolar were instrumented and filled with calcium hydroxide and divided into three groups (n = 10/group). After 7 days, calcium hydroxide was removed. All root canals were received 2.5% NaOCl, followed by 17% EDTA and a final flush with 2.5% NaOCl. In group I, no additional agitation of the irrigant was performed. In group II, agitation was done for 20 s between irrigants with a size of F2 ProTaper rotary file. In group III, an ultrasonic activation was delivered for 20 s between irrigants. Finally, the roots were grooved longitudinally and split in two halves. Selected half of each tooth was observed under a stereomicroscope at 30x magnification. Results: In groups needle irrigation and ProTaper technique, score of residual calcium hydroxide in apical third is higher than cervical and middle thirds (p &lt; 0.05). Needle groups demonstrated the significantly higher score of residual calcium hydroxide than ProTaper and ultrasonic groups (p &lt; 0.05). Conclusion: None of irrigation techniques could remove all calcium hydroxide completely. Ultrasonic irrigation and ProTaper irrigation was more effective in removing calcium hydroxide than needle irrigation. Key words: calcium hydroxide, irrigation solution, ultrasonic irrigation.

Efficacy of Three Irrigation Methods in Removing Calcium Hydroxide from Curved Root Canals: An In Vitro Micro-CT Study.

This in vitro study aimed to compare the efficacy of three different irrigation methods in removing calcium hydroxide from curved root canals and to estimate the amount of residual medicament using microcomputed tomography. Thirty extracted molars with curved mesial root canals, ranging from 25° to 30°, were prepared with ProTaper Next using X2 to full working length and were filled with calcium hydroxide. Teeth also were randomly divided into four groups: group 1 (n = 8)- Erbium: Yttrium-Aluminum-Garnet (Er:YAG) laser; group 2 (n = 8)-EndoActivator; group 3 (n = 8)-EndoVac; and a control group (n = 6)-negative control with no calcium hydroxide. Microcomputed tomography was used to evaluate the residual amount of filling material. Statistical analysis was performed using IBM SPSS Statistics 26, with a significance level of 0.05. Descriptive statistics, student t test, and Chi-square test were applied for data analysis. The greatest amount of residual calcium hydroxide was observed in the samples with EndoVac irrigation (0.515 mm3), followed by EndoActivator (0.381 mm3) and Er:YAG laser (0.121 mm3). However, no statistically significant difference was observed between the groups. The greatest residual amount was observed in the apical third (0.419 mm3), followed by the middle (0.050 mm3) and the coronal (0.015 mm3). No statistically significant differences were observed in the efficacy of the tested techniques for removing calcium hydroxide from curved root canals, whereas a significant difference was observed in the distribution of residual material depending on the technique used. The removal of the calcium hydroxide was more effective in the coronal and middle third of the canal. The greatest residual material was found in the apical portion of the root canal.

Efficacy of removing calcium hydroxide deposits from endodontic instruments prior to sterilization using different cleaning methods

Introduction. Endodontic instruments during root canal treatment come into contact with dentinal debris, irrigation solutions and medication agents, which reminants should be eliminated before sterilization. The aim of the study was to verify the effectiveness of different cleaning methods for removing calcium hydroxide paste residues from the surfaces of the working parts of hand instruments, as well as to propose an effective protocol for cleaning endodontic instruments before sterilization. Material and methods. Forty-two new hand endodontic instruments were used to remove calcium hydroxide paste from the filled canals of extracted teeth. After contamination with medication, they were divided into the four groups and subjected to individual decontamination methods - mechanical, chemical and ultrasonic, as well as a combined protocol. The instruments were then observed under a light microscope. The effectiveness of the methods was evaluated based on the amount of residual matter on the surface of the working parts of the instruments. Results. The combined protocol showed a statistically significant difference in the achieved level of cleanliness compared to mechanical (?2 = 12.00 p &lt; 0.05) and chemical methods (?2 = 12.00 p &lt; 0.05), but there was no statistically significant difference compared to ultrasonic cleaning in disinfectant solution (?2 = 2.4 p &gt; 0.05). By applying combined protocol, instruments with completely clean surfaces were found, as well as the lowest values of contamination at the level of the entire group of instruments (8.33%). Conclusion. The protocol that consisted of mechanical cleaning with a sponge soaked in chlorhexidine gluconate, chemical soaking in sodium hypochlorite, and ultrasonic cleaning in a disinfectant showed the best efficiency in removing calcium hydroxide residues.

Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study.

The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

Evaluation of the efficiency of brush file as irrigation agitation technique versus passive ultrasonic irrigation on biofilm eradication and calcium hydroxide removal from straight root canals: A comparative in-vitro study

Evaluation of the efficiency of brush file as irrigation agitation technique versus passive ultrasonic irrigation on biofilm eradication and calcium hydroxide removal from straight root canals: A comparative in-vitro study

The efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from root canals: an in-vitro study

BackgroundThis study aimed to compare the efficacy of EndoActivator, passive ultrasonic irrigation, and Ultra X in removing calcium hydroxide from the artificial grooves in root canal walls.MethodsThe root canals of 50 extracted human maxillary incisors were instrumented by using the ProTaper rotary system up to #F4 (size 40/0.06 ProTaper) and the teeth were split longitudinally. Lateral grooves were created in the apical and coronal parts of one half and the middle part of the other half. Calcium hydroxide paste was applied to the grooves and the root halves were reassembled. After seven days, the calcium hydroxide was removed from the canal by using one of the EndoActivator, passive ultrasonic irrigation, and Ultra X devices; one group went without irrigation (control group). The CH remnants in the grooves were scored at 20× magnification. The data were analyzed by using the Kruskal–Wallis, Dunn’s post hoc, and Friedman tests. P < 0.05 was considered to be statistically significant.ResultsNo statistically significant difference existed among the experimental groups at the coronal and middle grooves (P > 0.05). However, Ultra X was significantly more effective than passive ultrasonic irrigation at the apical grooves (P = 0.023).ConclusionWithin the limitations of this study, Ultra X can be reported to remove the calcium hydroxide from the apical third more efficiently than passive ultrasonic irrigation.