title: Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy of conventional syringe, ultrasonic, EndoVac (Discus Dental, Culver City, CA), and Self-Adjusting File (SAF) (Re-Dent-Nova, Ra'nana, Israel) irrigation systems in removing calcium hydroxide (Ca[OH]2) from simulated root canal irregularities.
  
  
  METHODS
  The root canals of 88 extracted single-rooted teeth were prepared using ProTaper rotary instruments (Dentsply Maillefer, Ballagiues, Switzerland) up to size F4. The roots were split longitudinally, and a standardized groove was prepared in the apical part of 1 segment. The root halves were reassembled, and Ca(OH)2 medicament was placed into the root canals using a Lentulo spiral. The roots were randomly divided into 4 experimental groups and 2 control groups according to the different irrigation systems used: conventional syringe irrigation, continuous passive ultrasonic irrigation (PUI), EndoVac irrigation, and SAF irrigation. Each group was then divided into 2 subgroups (n = 10) according to the irrigation protocol: subgroup 1: 10 mL 2.5% NaOCl and subgroup 2: 10 mL 17% EDTA + 10 mL 2.5% NaOCl. The amount of remaining medicament was evaluated under a stereomicroscope at 30× magnification using a 4-grade scoring system. The influences of the different Ca(OH)2 medicament removal methods and irrigation protocols were statistically evaluated using 2-way analysis of variance and Tukey post hoc tests.
  
  
  RESULTS
  In the NaOCl-irrigated groups, PUI removed significantly more Ca(OH)2 medicament than the other techniques (P < .05). There was no significant difference among the other groups (P > .05). In the EDTA/NaOCl-irrigated groups, the SAF and PUI removed significantly more Ca(OH)2 than the other techniques (P < .05).
  
  
  CONCLUSIONS
  The use of the SAF system with the combination of EDTA and NaOCl enhanced Ca(OH)2 removal when compared with the use of only NaOCl irrigation with the SAF. Continuous PUI and SAF were more effective than EndoVac, and conventional syringe irrigation in the removal of the Ca(OH)2 medicament from an artificial standardized groove in the apical part of the root canal.
authors.affiliation: Department of Endodontics, İzmir Katip Çelebi University, İzmir, Turkey. Electronic address: capardt@hotmail.com.
authors.forename: Ismail Davut
authors.initials: ID
authors.lastname: Capar
authors.affiliation: Department of Endodontics, Selçuk University, Konya, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Ozcan
authors.affiliation: Department of Endodontics, İzmir Katip Çelebi University, İzmir, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Arslan
authors.affiliation: Department of Endodontics, İzmir Katip Çelebi University, İzmir, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ertas
authors.affiliation: Department of Endodontics, Selçuk University, Konya, Turkey.
authors.forename: Hale Ari
authors.initials: HA
authors.lastname: Aydinbelge
mesh_terms: D002126:Calcium Hydroxide / Q000737:chemistry*; D003786:Dental Pulp Cavity / Q000648:ultrastructure*; D004492:Edetic Acid / Q000737:chemistry; D006801:Humans; D011897:Random Allocation; D012388:Root Canal Irrigants / Q000737:chemistry*; D018915:Root Canal Preparation / Q000295:instrumentation; D012973:Sodium Hypochlorite / Q000737:chemistry; D013499:Surface Properties; D013594:Syringes; D007507:Therapeutic Irrigation / Q000295:instrumentation* / Q000379:methods; D019227:Tooth Apex / Q000648:ultrastructure*; D014465:Ultrasonics; D014618:Vacuum
chemical_list: D012388:Root Canal Irrigants; D004492:Edetic Acid; D012973:Sodium Hypochlorite; D002126:Calcium Hydroxide
keywords: Calcium hydroxide; EndoVac; Self-Adjusting File; ultrasonic irrigation