Efficacy of Ultrasonics Versus XP-endo Finisher for Removal of Intracanal Medications with Two Different Vehicles (An In-Vitro Study)

Abstract

Introduction: The ultimate goal of endodontic treatment is to eliminate bacteria from infected root canals. Intracanal medications have been thought to be an important step in reducing microorganisms. Different means were introduced for the removal of intracanal medications, so there is a need to investigate which irrigation method should be used to remove the intracanal medication to achieve a complete coronal and apical seal of the disinfected canals. Aim: To compare the effectiveness of removal of Calcium hydroxide (Ca(OH)2) and Double antibiotic paste (DAP) with Propylene glycol (PG) and Glycerol vehicles using Passive Ultrasonic irrigation (PUI) and XP-Endo Finisher. Material and methods: 80 single-rooted extracted human teeth were categorized into 4 groups (n=20) based on the intracanal medicament used GroupA1; Ca(OH) 2 + PG GroupA2; Ca(OH) 2 + Glycerol. GroupA3; DAP + PG.GroupA4; DAP + Glycerol. Samples were stored in an incubator for 3 weeks and then subdivided into two groups Subgroup B1; PUI and Subgroup B2; XP-Endo Finisher. Irrigation protocol was NaOCl 2.5% followed by 17% EDTA. Each root half’s picture was photographed using a USB digital microscope.The amount of medication still present in the canal was measured using the NIH image J V1.56 software program. One-way ANOVA and Duncan’s Multiple Range Tests were used for the statistical analysis. Results: The difference between vehicles was not significant when all groups were compared as a total using the PUI method and XP-Endo Finisher (p>0.05). However, the differences in the percentage of remaining intracanal medication between vehicles were significant at apical, middle and coronal levels of PUI and also levels of XP-Endo Finisher. Conclusion: None of the irrigation activation methods used could eliminate any of the medications. Both vehicles did not improve the elimination of the medications used from the root canals. Removal of the medications from the apical level was more difficult than the other levels.