Effects of different instrumentation techniques on calcium hydroxide removal from simulated immature teeth

The aim of this study was to evaluate the effectiveness of endodontic instrument systems in the removal of calcium hydroxide [Ca(OH)(2)] from simulated immature teeth. The root canals of 106 human single-rooted teeth were shaped with ProTaper rotary files up to an F5 file size. Simulation of roots with immature apices was carried out using size 4 green 1.5-mm diameter Unicore drills. A non-setting Ca(OH)(2) was injected into each root canal and inserted into the working length using lentulo spiral, after which cotton pellets were placed over canal orifices. The apical and coronal side of the roots were then sealed with glass ionomer cement and light cured. Specimens were stored in distilled water for 3 months at 37 °C. After 3 months, the temporary coronal seal was removed and the samples were randomly divided into five experimental groups according to the method used for Ca(OH)(2) removal (ProTaper, Reciproc, OneShape, WaveOne, and Manual) (n = 20), one positive control group (n = 3) and one negative control group (n = 3). The amount of remaining Ca(OH)(2) in the canal walls was measured under a stereomicroscope at 30× magnification. The data were analyzed using Kruskal-Wallis test and Mann-Whitney U test at a significance level of 0.05. Positive and negative control groups were found to be statistically different from all other groups (p < 0.05). There were no significant differences among the ProTaper, Reciproc, OneShape, WaveOne, and Manual groups (p > 0.05). As a conclusion, none of the techniques completely removed Ca(OH)(2) from simulated immature teeth.