Efficacy of XP-Endo finisher file compared to passive ultrasonic irrigation and conventional syringe irrigation on removal of triple antibiotic paste and calcium hydroxide

Aim: To compare the efficacy of XP-Endo finisher file (XP) (FKG Dentaire, La Chaux-de-Fonds, Switzerland) with that of passive ultrasonic irrigation (PUI) and conventional syringe irrigation (CSI) on the removal of triple antibiotic paste (TAP) and calcium hydroxide (Ca(OH)2) paste from root canal walls. Materials and methods: The root canals of 60 mandibular premolars with single straight oval canals were prepared using ProTaper Universal rotary instruments up to size F4 (Dentsply Maillefer, Ballaigues, Switzerland). TAP and Ca(OH)2 intracanal medications were placed inside the root canals (30 canals for each intracanal medication) and sealed with temporary filling for 3 weeks. The roots within each group were then randomly subdivided into three subgroups (n = 10) according to the irrigant activation method used to remove the intracanal medication - XP, PUI and CSI. The amount of remaining medicament was evaluated under 25× magnification using a stereomicroscope and scored in mm2 and recorded as a percentage of the overall canal surface area by using image analysis software. Statistical analysis was performed with and independent sample t-test and one-way ANOVA. The significance level was set at P ≤ 0.05. Results: None of the tested methods could completely remove either of the intracanal medications from the walls of root canals. XP and PUI removed significantly more TAP and Ca(OH)2 than CSI (P 0.001), with no significant differences between them. Conclusions: XP and PUI were more effective in removing intracanal medications from the root canal walls than CSI. Keywords: calcium hydroxide, passive ultrasonic irrigation, regenerative endodontics, syringe irrigation, triple antibiotic paste, XP-Endo finisher files