The aims of the present study were to evaluate the effect of various irrigating solutions on the removal of calcium hydroxide mixed with 2% chlorhexidine gel from an artificial groove created in a root canal and the generation of orange-brown precipitate in the remaining calcium hydroxide mixed with 2% chlorhexidine gel after irrigation with the various irrigating solutions.
The root canals of 48 mandibular premolars were prepared using ProTaper Universal Rotary instruments (Dentsply Maillefer, Ballaigues, 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 calcium hydroxide mixed with 2% chlorhexidine gel medicament was placed into the grooves. The roots were randomly divided into 4 experimental groups specified by the irrigation solution used: 1% NaOCl, 17% EDTA, 7% maleic acid, and 10% citric acid (n = 12). The amount of remaining medicament was evaluated under a stereomicroscope using a 4-grade scoring system. After irrigation, the specimens were also evaluated for the presence/absence of orange-brown precipitate. The effects of the different irrigation solutions on medicament removal were statistically evaluated using the Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction at a 95% confidence level (P = .0083).
Solutions of 7% maleic acid and 10% citric acid were superior to solutions of 1% NaOCl and 17% EDTA in removing calcium hydroxide mixed with 2% chlorhexidine gel (P < .0083). There were no significant differences among the other groups (P > .0083). Orange-brown precipitate was observed in all specimens of the NaOCl group but in no specimens in the other groups.
Irrigation solutions of 7% maleic acid and 10% citric acid were more effective in the removal of calcium hydroxide mixed with 2% chlorhexidine gel than those of 1% NaOCl and 17% EDTA. Orange-brown precipitate was found in all specimens of the NaOCl-irrigated groups. However, the precipitate was not observed in specimens in the groups irrigated with 17% EDTA, 7% maleic acid, and 10% citric acid.
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- Revascularization of an immature permanent tooth with apical periodontitis and sinus tract.Dent Traumatol. 2001; 17: 185-187
- One-visit versus two-visit root canal treatment: effectiveness in the removal of endotoxins and cultivable bacteria.J Endod. 2013; 39: 959-964
- Properties and applications of calcium hydroxide in endodontics and dental traumatology.Int Endod J. 2011; 44: 697-730
- Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis.Int Endod J. 2007; 40: 2-10
- The properties and applications of chlorhexidine in endodontics.Int Endod J. 2009; 42: 288-302
- In vitro assessment of the effectiveness of chlorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: e27-e31
- Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro.Int Endod J. 2003; 36: 267-275
- Microleakage of newly developed glass carbomer cement in primary teeth.Eur J Dent. 2013; 7: 15-21
- Antimicrobial effectiveness of intracanal medicaments on Enterococcus faecalis: chlorhexidine versus octenidine.Int Endod J. 2013; 46: 53-61
- Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial.J Endod. 2007; 33: 114-118
- Interaction between sodium hypochlorite and chlorhexidine gluconate.J Endod. 2007; 33: 966-969
- Using diazotization to characterize the effect of heat or sodium hypochlorite on 2.0% chlorhexidine.J Endod. 2009; 35: 1296-1299
- Determination of 4-chloroaniline and its derivatives formed in the interaction of sodium hypochlorite and chlorhexidine by using gas chromatography.J Endod. 2010; 36: 312-314
- Antagonistic interactions between sodium hypochlorite, chlorhexidine, EDTA, and citric acid.J Endod. 2012; 38: 426-431
- The effect of p-chloroaniline on leucocytes of sheep peripheral blood under the migration-inhibition test conditions.Immunopharmacol Immunotoxicol. 1995; 17: 577-584
- International Agency for Research on Cancer: Monographs on the Evaluation of Carcinogenic Risks to Humans—Occupational Exposures of Hairdressers and Barbers and Personal Use of Hair Colourants; Some Hair Dyes, Cosmetic Colourants, Industrial Dyestuffs and Aromatic Amines.International Agency for Research on Cancer, Lyon, France1993: 1-436
- Evaluation of efficiency of laser systems on removal of debris and smear layer in maxillary canine root canals.J Laser Appl. 2014; 26, 032005https://doi.org/10.2351/1.4870878
- Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion.Aust Endod J. 2013; 39: 66-72
- A comparative scanning electron microscopy evaluation of smear layer removal from teeth with different irrigation solutions and lasers.Microsc Microanal. 2013; 19: 1465-1469
- Comparative evaluation of different chelators in removal of calcium hydroxide preparations from root canals.Aust Dent J. 2012; 57: 344-348
- Evaluation of the effect of maleic acid and ethylenediaminetetraacetic acid on the microhardness and surface roughness of human root canal dentin.J Endod. 2010; 36: 1385-1388
- A comparative in vitro evaluation of cytotoxic effects of EDTA and maleic acid: root canal irrigants.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: 633-638
- Influence of calcium hydroxide intracanal medication on apical seal.Int Endod J. 2002; 35: 623-628
- 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: 52-57
- Pulp revascularization after root canal decontamination with calcium hydroxide and 2% chlorhexidine gel.J Endod. 2013; 39: 417-420
- Removal efficiency of calcium hydroxide intracanal medicament with two calcium chelators: volumetric analysis using spiral CT, an in vitro study.J Endod. 2006; 32: 1097-1101
- Efficacy of different irrigants in the removal of calcium hydroxide from root canals.Int Endod J. 2010; 43: 519-527
- Removal efficacy of various calcium hydroxide/chlorhexidine medicaments from the root canal.Int Endod J. 2006; 39: 55-61
- Calcium hydroxide intracanal dressing removal with different rotary instruments and irrigating solutions: a scanning electron microscopy study.Braz Dent J. 2010; 21: 310-314
- Comparison of the efficacy of ethylene diamine tetraacetic acid and maleic acid in the removal of three calcium hydroxide intra-canal dressings: A spiral computerized tomography volumetric analysis.J Conserv Dent. 2013; 16: 56-60
- Interactions between irrigants commonly used in endodontic practice: a chemical analysis.J Endod. 2013; 39: 505-510
- Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine.J Endod. 2010; 36: 1154-1157
Published online: September 05, 2014
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