The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris

Objective: To evaluate the effect of XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI), and conventional irrigation using a side-vented needle (SVN) on apically extruded debris and canal cleanliness after removing double antibiotic paste (DAP) from simulated immature root canals. Materials and Methods: Forty-eight extracted mandibular premolars were prepared with peeso drills to simulate open apices, filled with DAP, and assigned to XPF, PUI, or SVN groups (n=16). Apically extruded debris was quantified using an analytical balance. Roots were then split and stereomicroscopically imaged; residual DAP was quantified via ImageJ and scored. Data were analyzed using Kruskal–Wallis and Dunn’s tests; Spearman’s correlation assessed the relationship between extrusion and residue scores. Results: No significant differences in apical debris extrusion among groups (P=0.237). XPF and PUI left significantly less DAP than SVN (P<0.001), with no difference between XPF and PUI. A positive but non-significant correlation existed between apically extruded debris and residual DAP scores (r=0.318, P=0.087). Conclusion: XPF and PUI provided better canal cleanliness than SVN during DAP removal, while all three techniques produced similar amounts of apically extruded debris.

Shaimaa Nasr El-Din, Reham Hassan