Comparative efficacy of irrigant activation techniques for removal of calcium hydroxide-based intracanal medicament from standardized artificial grooves: An in vitro study

Abstract Objectives: This in vitro study evaluated and compared the efficacy of various irrigant activation techniques for removing calcium hydroxide (CH) and N-methyl-2-pyrrolidone (NMP)-based CH (Cleanical) from artificially created grooves. Materials and Methods: Fifty-six extracted human permanent mandibular premolars were selected according to specific inclusion and exclusion criteria. Following decoronation, canals were prepared using rotary files. Samples were longitudinally split, and standardized coronal and apical artificial grooves were created in the canal walls using Cavitron tips. Root halves were reattached and fixed in Eppendorf tubes. Samples were randomly assigned to groups and subgroups ( n = 7) based on the irrigant activation technique and intracanal medicament (ICM) type. Artificial grooves were filled with either CH powder mixed with distilled water or Cleanical. Root halves were reattached and subjected to irrigant activation using needle irrigation (NI), EndoActivator, passive ultrasonic irrigation (PUI), or XP-Endo Finisher (XPF). The efficacy of ICM removal was evaluated under a stereomicroscope using van der Sluis et al. scoring criteria. Data were analyzed statistically using the Mann–Whitney U test, Kruskal–Wallis test, and Bonferroni correction, with significance set at a 95% confidence interval. Results: Cleanical was removed more efficiently than CH from both coronal and apical artificially created grooves. Statistically significant differences were observed between PUI and NI, as well as between XPF and NI. However, none of the techniques achieved complete removal of ICM. Conclusions: NMP-based CH demonstrated increased solubility with irrigants and enhanced penetration into dentinal tubules. PUI and XPF were more effective than other techniques in removing ICM from artificially created grooves.