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Evaluating Calcium Hydroxide Removal Techniques in Endodontics: A Comparative Analysis.

Vahid Fallahi Sarvenoei1, Mohsen Aminsobhani2, Babak Farzaneh2

  • 1Dept. of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Dentistry (Shiraz, Iran)
|November 21, 2025
PubMed
Summary

The Gentle Brush method effectively removes calcium hydroxide from root canals, outperforming other files. Combining it with ethylene-diamine-tetra-acetic acid (EDTA) offers superior cleaning for better endodontic treatment outcomes.

Keywords:
Calcium HydroxideEndodonticsEthylene-Diamine-Tetra-Acetic AcidRoot Canal PreparationSodium Hypochlorite

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Area of Science:

  • Endodontics
  • Dental Materials Science

Background:

  • Effective removal of intracanal medications is vital for successful endodontic therapy.
  • Residual calcium hydroxide can negatively impact sealer adhesion and treatment success.

Purpose of the Study:

  • To compare the efficacy of different methods for removing calcium hydroxide from root canal walls.
  • To evaluate cleaning effectiveness in coronal, middle, and apical regions.

Main Methods:

  • An in vitro randomized trial involving 108 extracted teeth.
  • Calcium hydroxide placement followed by various cleaning protocols using Gentle Brush, Gentlefile, or master apical files with EDTA or sodium hypochlorite.
  • Stereomicroscopic analysis and Digimizer software for quantifying residual calcium.

Main Results:

  • The Gentle Brush method demonstrated significantly higher efficacy in calcium hydroxide removal (p<0.01).
  • Ethylene-diamine-tetra-acetic acid (EDTA) was significantly more effective than sodium hypochlorite (p<0.05).

Conclusions:

  • A combination of the Gentle Brush and EDTA is the most effective protocol for calcium hydroxide removal.
  • Optimizing canal cleaning techniques is crucial for enhancing endodontic treatment quality.