Retrievability of calcium hydroxide intracanal medicament with three calcium chelators, ethylenediaminetetraacetic acid, citric acid, and chitosan from root canals: An in vitro cone beam computed tomography volumetric analysis

J Conserv Dent. 2017 Jan-Feb;20(1):25-29. doi: 10.4103/0972-0707.209068.

Abstract

Aim: This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the canal, after removal with two different chelators 17% EDTA, 20% Citric acid and 0.2% Chitosan in combination with ultrasonic agitation.

Methods and material: Cleaning and shaping of root canals of 28 mandibular premolar was done and canals were filled either with Metapex or Ca(OH)2 mixed with distilled water. Volumetric analysis was performed utilizing cone beam-computed tomography (CBCT) after seven days of incubation. Ca(OH)2 was removed using either 17% EDTA, 20% Citric acid or 0.2% Chitosan in combination with ultrasonic agitation.

Statistical analysis used: Volumetric analysis was repeated and percentage difference was calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney U test.

Results: All the three chelators failed to remove aqueous-based as well as oil-based Ca(OH)2 completely from the root canal. Aqueous-based Ca(OH)2 was easier to be removed than oil-based Ca(OH)2. 0.2% Chitosan in combination with ultrasonics performed better than 17% EDTA and 20% citric acid in removal of Ca(OH)2.

Conclusion: Combination of 0.2% Chitosan and ultrasonic agitation results in lower amount of Ca(OH)2 remnants than 17% EDTA, 20% Citric acid irrespective of type of vehicle present in the mix.

Keywords: Calcium hydroxide; chitosan; cone beam computed tomography; ethylenediaminetetraacetic acid; intracanal medicament; retrieval; ultrasonics.