Introduction:

Root canal sealing should indispensably be preceded by complete calcium hydroxide removal, otherwise the latter might prevent the penetration of the sealers into the dentinal tubules.

Objective:

Determine the effectiveness of eliminating calcium hydroxide medication from the root canal of teeth using various irrigation systems.

Methods:

Preparation was conducted of 148 straight root canals of human teeth irrigating with sodium hypochlorite. The root canals were filled with Ca(OH)2 mixed with black ink to facilitate visualization. The teeth were divided into 5 groups in compliance with the removal protocol. Apical extrusion was measured in each group during the irrigation stage using the Huang X method. After Ca(OH)2 removal they were sectioned longitudinally and placed on a slide for observation of the samples under an optical microscope. Finally the content was analyzed to quantify the degree of extrusion obtained during the clinical procedure. The ANOVA test was used for statistical analysis.

Results:

Significant differences were found between the groups 1-2, 1-3, 1-4 and 1-5. Average remanence was above 66.4%. Groups 2 (41.6%) and 5 (34.8%) displayed higher removal efficacy. ANOVA (α = 0.05) did not determine any significant differences between the 5 groups.

Conclusions:

Ultrasonic activation obtained greater calcium hydroxide removal from the dentinal walls than manual techniques. However, it proved to be a more invasive therapy due to the greater detritus extrusion.

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