Effectiveness of the Severel Irrigation Techniques for Removal of Calcium Hydroxide-based Intracanal Medication from an Artificial Standardized Groove in the Apical Root Canal

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Background/aim: This study was aimed to evaluate the efficacy of
removal of calcium hydroxide [Ca(OH)2] with the apical negative
pressure irrigation system (EndoVac), passive ultrasonic irrigation
(PUI), and needle irrigation using sodium hypochlorite (NaOCl).
Materials and methods: The root canals of 30 freshly extracted
human mandibular premolars were used in this study. Each root
canal was prepared with nickel titanium rotary instruments. Each
root was split longitudinally through the canal. In one-half, a
standardized groove was cut in the canal wall 2–6 mm from the
apex, and filled with Ca(OH)2 paste. The roots were reassembled
with plastic bracelets. Three techniques were used for Ca(OH)2
removal: Group 1, irrigation using the EndoVac irrigation system;
Group 2, PUI; Group 3, needle irrigation; all used a total of 10 mL
of 5% NaOCl as the irrigant. The amount of residual Ca(OH)2 in
the groove was scored in accordance with previously reported
criteria. The data were analyzed with the Kruskal–Wallis and
Mann–Whitney U tests. The level of significance was set at p<
Results: No technique removed all Ca(OH)2. There were no
significant differences between Groups 1 and 2, and Groups 1 and
3 (p< 0.05). There was significant difference between Groups 2 and
3 (p> 0.05).
Conclusions: PUI was more effective in removing Ca(OH)2 paste
from artificial root canal grooves, but the efficacy of PUI did not
differ significantly from that of the EndoVac irrigation system.


Calcium hydroxide, EndoVac system, needle irrigation, passive ultrasonic irrigation, scanning electron microscopy

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