Evaluating Calcium Hydroxide Removal Techniques in Endodontics: A Comparative Analysis

TL;DR

This study compares different methods for removing calcium hydroxide from root canals and finds that a Gentle Brush with a specific cleaning solution works best.

Contribution

The study introduces a novel comparative analysis of calcium hydroxide removal techniques using specific instruments and solutions in endodontic treatment.

Findings

The Gentle Brush method was most effective for calcium hydroxide removal (p < 0.01).

Ethylene-diamine-tetra-acetic acid outperformed sodium hypochlorite in cleaning (p < 0.05).

Combining Gentle Brush with ethylene-diamine-tetra-acetic acid is optimal for canal cleaning.

Abstract

Endodontic therapy plays a pivotal role in dentistry, with effective removal of intracanal medications crucial for successful treatment. The lingering presence of calcium hydroxide within dentinal walls can impede sealer adhesion and compromise treatment outcomes.

This study aimed to compare the efficacy of various methods for removing calcium hydroxide from different regions of the root canal wall.

In this in vitro randomized trial study, 108 extracted teeth underwent canal cleaning and shaping using the Dentsply Protaper Gold rotary system. Subsequently, except for the negative control group, all teeth were filled with calcium hydroxide and divided into eight groups. These groups underwent different cleaning protocols involving Gentle Brush or Gentlefile #021 files or master apical file in combination with ethylene-diamine-tetra-acetic acid or sodium hypochlorite solutions. After tooth splitting, stereomicroscopic images were taken, and Digimizer software was utilized to calculate residual calcium levels in coronal, middle, and apical regions. Mann-Whitney test was used to check the effect of the cleaning method and type of washing solution among the methods employed. All the analyses were conducted using SPSS 22.

The results indicated that the Gentle Brush method's superior efficacy in calcium hydroxide removal compared to other files,
which was statistically significant (p Value <0.01). Similarly, the ethylene-diamine-tetra-acetic acid rinse solution proved more effective than sodium hypochlorite in clearing calcium hydroxide from the canal wall (p< 0.05).

The findings suggest that a Gentle Brush combined with an ethylene-diamine-tetra-acetic acid washing solution represents the most effective method for canal cleaning and calcium hydroxide removal. This study underscores the importance of employing efficient techniques to enhance treatment quality in endodontic practice.

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