Comparative Evaluation of Metapex Removal Using Chelating Agents with and Without Ultrasonic Activation -An in-vitro CBCT volumetric analysis.

Abstract

BACKGROUND:

Effective removal of intracanal medicaments is essential before obturation to ensure optimal sealer adhesion and treatment success.

AIM:

Comparatively evaluate the effectiveness of 17% EDTA and 0.2% chitosan in removing Metapex intracanal medicament with and without ultrasonic activation.

MATERIAL & METHODS:

Forty single-rooted extracted human teeth were decoronated and instrumented using standard rotary techniques. In this in vitro study, root canals were filled with Metapex intracanal medicament, sealed with Cavit, and stored at 37 °C with 100% humidity for 7 days. CBCT imaging was performed after embedding samples in wax rims to simulate soft tissue, and volumetric analysis of medicament was carried out using software. Samples were then allocated into four subgroups for medicament removal: (A1) 0.2% chitosan with ultrasonic activation, (A2) 17% EDTA with ultrasonic activation, (A3) 0.2% chitosan without activation, and (A4) 17% EDTA without activation. A second CBCT will be done and the volume of remaining material in each tooth was estimated as before.

RESULTS

Post-hoc analysis showed that both 0.2% Chitosan and 17% EDTA demonstrated significantly greater Metapex removal when used with ultrasonic activation compared to when used alone (p < 0.001). No significant difference was observed between the two irrigants when ultrasonically activated (p = 1.000), indicating that ultrasonic activation, rather than the type of chelating agent, was the key factor in enhancing medicament removal.

CONCLUSION

Ultrasonic activation significantly enhances the removal of Metapex compared to conventional irrigation alone. The choice of chelating agent becomes less critical when activation is used, highlighting ultrasonic activation as the key determinant in effective intracanal medicament removal.