Comparison of the efficacy of K-File, canal brush technique, and sonic irrigation technique in the retrievability of calcium hydroxide and metapex intracanal medicaments from root canals: An In vitro cone-beam computed tomography analysis

Background and Objectives: At present, none of the routinely used irrigating agents and activation techniques were able to completely remove the Ca(OH)2 intracanal medicament placed inside the root canal system during endodontic therapy. With this as the background, the aim of this study was to achieve complete removal of Ca(OH)2 when mixed with two different vehicles, using various irrigant activation techniques such as K-file, canal brush technique, and sonic irrigation technique, from the root canals of extracted human teeth. Materials and Methods: Seventy-two mandibular premolar teeth with straight single root canal were selected and filled either with oil-based Metapex or calcium hydroxide powder mixed with distilled water and were activated using different activation techniques such as K-file, canal brush, and sonic MM1500 and NaOCl alone. Volumetric analysis was performed utilizing cone-beam computed tomography. Results: None of the irrigants used were able to completely remove Ca(OH)2 from root canal. Sonic MM1500 showed significant removal efficacy than K-file, canal brush technique, and NaOCl for both aqueous-based and oil-based calcium hydroxide. Conclusion: Sonic MM1500 performed better than K-file, canal brush technique, and NaOCl in removing both Metapex and Ca(OH)2 powder. Regardless of the vehicles and agitation technique used, the remnants of Ca(OH)2 were present on all thirds of the canal walls.