A comparison of different irrigation/agitation methods for the removal of calcium hydroxide medicament from the root canal walls

Abstract

Aim: To compare the removal efficiency of calcium hydroxide (CH) medicament from the root canal walls with different irrigation/agitation methods. Materials and Methods: Forty human mandibular premolars were selected. Root canals of these teeth were prepared up to F4 file using ProTaper rotary system and then filled with CH. All root specimens were stored at 37΀C and 100% relative humidity for 7 days. Teeth were randomly divided into four different groups (n = 10). For the removal of the medicaments from the canal walls, roots were subjected to the final irrigation/agitation methods used as follows: Conventional syringe irrigation with side-vented needle (Group 1), passive ultrasonic irrigation (PUI; Group 2), manual dynamic agitation (Group 3), and apical negative pressure irrigation (Group 4). The negative control did not receive CH placement. The positive control received the intracanal medication, but no subsequent removal. Roots were split longitudinally into two halves. Digital images of the root canal walls were acquired by a digital camera and assessed for residual amount of medicament. Cervical, middle, and apical third of each canal was assessed by using a scoring system. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey′s multiple comparison tests, at 95% confidence interval (P < 0.05). Results: There were no statistically significant differences between all experimental groups and the negative group in each canal third (P > 0.05). However, there were statistically significant differences between the experimental groups and the positive control (P < 0.05). None of the experimental groups totally removed CH medicaments from root canal walls. Conclusions: In the limitations of this in vitro study, all experimental groups produced similar removal efficiency in terms of canal cleanliness.