Comparison of calcium hydroxide removal efficiency of ethylenediaminetetraacetic acid, phytic acid and N-acetylcysteine using sonic activation: a micro-CT study.
Ahmet Tekdemir, Mügem Aslı Ekici, Berkan Çelikten, Bağdagül Helvacıoğlu Kıvanç
Abstract
Open AccessBACKGROUND: The aim of this study was to compare the efficacy of ethylenediaminetetraacetic acid (EDTA), phytic acid (IP6), and N-acetylcysteine (NAC) with sonic activation on the removal efficiency of calcium hydroxide (Ca(OH)2) from root canals with micro-computed tomography (micro-CT) analysis. METHODS: Thirty-two extracted human mandibular first premolars were used in this study. The teeth were randomly divided into 4 groups based on the chelating agents to be used to remove Ca(OH)2 from the root canals (n=8). The root canals were prepared with the ProTaper rotary system up to X5. The specimens were scanned using micro-CT after preparation. Calcium hydroxide paste was delivered into root canals using a syringe system (SURE-Paste) combined with a lentulo spiral. All teeth were scanned using micro-CT to determine the filling volume. After 7 days, Ca(OH)2 was removed from the root canals. EDTA was used with syringe irrigation for the first group while, EDTA, IP6, and NAC were used with sonic activation at other groups, respectively, to remove Ca(OH)2. Teeth were scanned using micro-CT to calculate the volume and the percentage of Ca(OH)2 remnants. Data were analyzed statistically by one-way ANOVA and Duncan's tests (α=0.05). RESULTS: None of the chelating agents and irrigation techniques completely removed Ca(OH)2. The percentage of the remnant volume of the Ca(OH)2 was significantly different between the groups (p < 0.05). The EDTA with syringe irrigation group had higher Ca(OH)2 remnant volume values compared to other groups (p < 0.05). The use of the EDTA, IP6, and NAC with sonic activation did not significantly affect the percentage of remaining Ca(OH)2 (p > 0.05). CONCLUSIONS: The calcium hydroxide removal efficiencies of all three chelating agents were similar. IP6 and NAC can be used as alternatives to EDTA for Ca(OH)2 removal from the root canals with sonic activation.