Removal efficacy of intracanal medication by different techniques and chemicals

Objective: Efficacy removal of intracanal medication (IM) is always a challenge in Endodontics, for this reason the present study compared removal ability of calcium hydroxide in combination with 2% chlorhexidine gel using different techniques.

Method: Fifty human single-rooted teeth were prepared with rotary files to a master apical file #35 and the canals were completely filled with the IM. The samples were stored at 37 °C and 100% relative humidity for 15 days and the specimens were divided according to the intracanal medication removal: C control - saline solution (SS) + apical debridement (AD); NT - SS + EDTA 17% + AD + NavTip; US – ultrasound with distilled water + AD; FX - SS + EDTA 17% + AD + NavTipFX; CA - citric acid + AD. The roots were sectioned and the apical third was quantitatively evaluated in stereomicroscope and scanning electron microscope by percentage of calcium hydroxide residue.

Result: The removal of the IM was similar among the different groups and control; it was possible to observe, by stereomicroscope, small amounts of IM in all groups. However there was significant difference between FX and CA groups (p<0.05). Summarizing the results the percentiles of open tubules can be ranked in the following order from the least to the most: CA (15.49%) < US (31.93%) < C (34.73%) < NT (40.66 %) < FX (46.61%).

Conclusion: Concluding EDTA17% using NavTipFX was the best technique, however IM removal still needs more efforts to achieve a better root dentin cleaning.