Evaluation of Different Irrigation Solutions and Activation Methods on Removing Calcium Hydroxide

Overview

Journal J Dent Sci

Specialty Dentistry

Date 2021 Apr 15

PMID 33854721

Authors

Sevan Harzivartyan

Afife Binnaz Hazar

Nevin Kartal

Zuhre Hale Cimilli

Affiliations

Soon will be listed here.

Abstract

Background/purpose: Dual Rinse HEDP is a soft chelator which can be used simultaneously with sodium hypochlorite (NaOCl). The aim of this study is to evaluate the efficacy of Dual Rinse HEDP with different irrigation systems on removing calcium hydroxide [Ca(OH)].

Materials And Methods: Eighty maxillary central incisor teeth were shaped and a standard groove on the apical third of the root canal surface was prepared. The root canals were filled with Ca(OH). Samples were divided into two groups according to the solution and these two groups were divided into three subgroups based on the activation technique. In group 1 (n = 10) Ca(OH) was removed using conventional irrigation with NaOCl whereas in group 2 (n = 10) conventional irrigation with NaOCl - Dual Rinse HEDP mixture was used. Group 3 (n = 15) and group 4 (n = 15) received sonic activation with the same irrigants as groups 1 and 2 respectively. In group 5 (n = 15) passive ultrasonic irrigation (PUI) was used with NaOCl while in group 6 (n = 15) the irrigant was the mixture. The amount of remaining Ca(OH) in the artificial grooves were evaluated under a light microscope.

Results: None of the procedures managed to completely remove the Ca(OH) from artificial grooves. There was no significant difference between the groups (p = 0.053). The scores were significantly lower in PUI group compared to the other techniques between NaOCl groups (p = 0.021).

Conclusion: Dual Rinse HEDP does not make a difference on elimination of Ca(OH). PUI is more efficient than both methods when NaOCl solution is used.

References

Deari S, Mohn D, Zehnder M . Dentine decalcification and smear layer removal by different ethylenediaminetetraacetic acid and 1-hydroxyethane-1,1-diphosphonic acid species. Int Endod J. 2018; 52(2):237-243. DOI: 10.1111/iej.12987. View

Lloyd A, Navarrete G, Marchesan M, Clement D . Removal of calcium hydroxide from Weine Type II systems using photon-induced photoacoustic streaming, passive ultrasonic, and needle irrigation: a microcomputed tomography study. J Appl Oral Sci. 2017; 24(6):543-548. PMC: 5161252. DOI: 10.1590/1678-775720160234. View

Sungur D, Aksel H, Ozturk S, Yilmaz Z, Ulubayram K . Effect of dentine conditioning with phytic acid or etidronic acid on growth factor release, dental pulp stem cell migration and viability. Int Endod J. 2018; 52(6):838-846. DOI: 10.1111/iej.13066. View

Neelakantan P, Varughese A, Sharma S, Subbarao C, Zehnder M, De-Deus G . Continuous chelation irrigation improves the adhesion of epoxy resin-based root canal sealer to root dentine. Int Endod J. 2012; 45(12):1097-102. DOI: 10.1111/j.1365-2591.2012.02073.x. View

Urban K, Donnermeyer D, Schafer E, Burklein S . Canal cleanliness using different irrigation activation systems: a SEM evaluation. Clin Oral Investig. 2017; 21(9):2681-2687. DOI: 10.1007/s00784-017-2070-x. View

van der Sluis L, Wu M, Wesselink P . A comparison between a smooth wire and a K-file in removing artificially placed dentine debris from root canals in resin blocks during ultrasonic irrigation. Int Endod J. 2005; 38(9):593-6. DOI: 10.1111/j.1365-2591.2005.00921.x. View

Hamdan R, Michetti J, Pinchon D, Diemer F, Georgelin-Gurgel M . The XP-Endo Finisher for the removal of calcium hydroxide paste from root canals and from the apical third. J Clin Exp Dent. 2017; 9(7):e855-e860. PMC: 5549582. DOI: 10.4317/jced.53962. View

Alturaiki S, Lamphon H, Edrees H, Ahlquist M . Efficacy of 3 different irrigation systems on removal of calcium hydroxide from the root canal: a scanning electron microscopic study. J Endod. 2014; 41(1):97-101. DOI: 10.1016/j.joen.2014.07.033. View

Zollinger A, Mohn D, Zeltner M, Zehnder M . Short-term storage stability of NaOCl solutions when combined with Dual Rinse HEDP. Int Endod J. 2017; 51(6):691-696. DOI: 10.1111/iej.12875. View

10.

Paulson L, Ballal N, Bhagat A . Effect of Root Dentin Conditioning on the Pushout Bond Strength of Biodentine. J Endod. 2018; 44(7):1186-1190. DOI: 10.1016/j.joen.2018.04.009. View

11.

Kirar D, Jain P, Patni P . Comparison of different irrigation and agitation methods for the removal of two types of calcium hydroxide medicaments from the root canal wall: an in-vitro study. Clujul Med. 2017; 90(3):327-332. PMC: 5536212. DOI: 10.15386/cjmed-737. View

12.

Kim S, Kim Y . Influence of calcium hydroxide intracanal medication on apical seal. Int Endod J. 2002; 35(7):623-8. DOI: 10.1046/j.1365-2591.2002.00539.x. View

13.

Chockattu S, Deepak B, Goud K . Comparison of efficiency of ethylenediaminetetraacetic acid, citric acid, and etidronate in the removal of calcium hydroxide intracanal medicament using scanning electron microscopic analysis: An study. J Conserv Dent. 2017; 20(1):6-11. PMC: 5514814. DOI: 10.4103/0972-0707.209079. View

14.

Chou K, George R, Walsh L . Effectiveness of different intracanal irrigation techniques in removing intracanal paste medicaments. Aust Endod J. 2013; 40(1):21-5. DOI: 10.1111/aej.12055. View

15.

Zehnder M, Schmidlin P, Sener B, Waltimo T . Chelation in root canal therapy reconsidered. J Endod. 2005; 31(11):817-20. DOI: 10.1097/01.don.0000158233.59316.fe. View

16.

Siqueira Jr J, Lopes H . Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J. 1999; 32(5):361-9. DOI: 10.1046/j.1365-2591.1999.00275.x. View

17.

van der Sluis L, Wu M, Wesselink P . The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J. 2007; 40(1):52-7. DOI: 10.1111/j.1365-2591.2006.01182.x. View

18.

Paque F, Rechenberg D, Zehnder M . Reduction of hard-tissue debris accumulation during rotary root canal instrumentation by etidronic acid in a sodium hypochlorite irrigant. J Endod. 2012; 38(5):692-5. DOI: 10.1016/j.joen.2011.12.019. View

19.

Kustarci A, Er K, Herguner Siso S, Aydin H, Harorli H, Arslan D . Efficacy of Laser-Activated Irrigants in Calcium Hydroxide Removal from the Artificial Grooves in Root Canals: An Ex Vivo Study. Photomed Laser Surg. 2016; 34(5):205-10. DOI: 10.1089/pho.2015.3951. View

20.

Rodig T, Vogel S, Zapf A, Hulsmann M . Efficacy of different irrigants in the removal of calcium hydroxide from root canals. Int Endod J. 2010; 43(6):519-27. DOI: 10.1111/j.1365-2591.2010.01709.x. View