A comparative evaluation of intracanal calcium hydroxide removal with hand file, rotary file, and passive ultrasonic irrigation: An in vitro study

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Abstract
Aim: The aim of this study was to compare the effectiveness of hand file (K-file), rotary file (HERO shaper), and passive ultrasonic irrigation (PUI; U-file) in removing Ca(OH)2 from the root canal. Materials and Methods: Thirty single-rooted teeth were collected and decoronated to standardize the length to 14mm. Cleaning and shaping were conducted using HERO shaper rotary files (up to no. 25, 4% taper). Ca(OH)2 powder was mixed with normal saline and filled into the canals using lentulo spiral and the orifice was sealed with zinc oxide eugenol. After 7 days of incubation, samples were divided into three groups of 10 samples each: Group I (hand files)—no. 20 K-file; Group II (rotary files)—no. 25, 4% HERO shaper; Group III (PUI)—no. 20 U-file. Ca(OH)2 paste was removed using 2mL of 3% sodium hypochlorite solution followed by 1-minute activation of the respective file system. All the samples were finally irrigated with 17% ethylenediaminetetraacetic acid and flushed with distilled water. Results: Ultrasonic group was more effective in removing Ca(OH)2 followed by HERO shaper and hand file. Conclusion: It was concluded that PUI had the highest ability to remove Ca(OH)2 from the root canal walls.

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