Retrievability of metapex dressing from root canal in case of stimulated internal root resorption using different irrigants with laser activation by cone-beam computed tomography volumetric analysis: An in vitro study

Aim: This study aimed to evaluate and compare the effectiveness of different irrigating solutions combined with laser activation for the retrieval of Metapex from simulated IRR defects using CBCT volumetric analysis. Methods: Seventy-two extracted single-rooted teeth were decoronated, instrumented with ProTaper Gold files, and split bucco-lingually. IRR defects were simulated using a round bur. After placing Metapex, samples were reassembled, and initial CBCT scans were taken. Teeth were divided into four groups based on the irrigants: saline (control), 0.2% chitosan nanoparticles, Morinda citrifolia , and Triphala . After 1 week, laser-activated irrigation using different irrigants was performed, followed by postirrigation CBCT to quantify residual Metapex. Mann–Whitney U -test and Kruskal–Wallis with post Hoc analysis test were used for statistical analysis. Results: Group B (laser-activated 0.2% CSN) showed the maximum Metapex removal with a mean value of 6.20, followed by Group C ( M. citrifolia) with 8.94, Group D (Triphala) with 11.11, and Group A (Control) with 26.2. Intercomparison between the chitosan, M. citrofolia, and Triphala groups has higher efficacy as compared to the control group. On the other hand, chitosan showed a significant difference as compared to M. citrofolia group and followed by Triphala. No significant difference was observed between M. citrofolia and Triphala in removal of Metapex. Conclusion: Laser-activated chitosan nanoparticles demonstrated superior cleaning efficacy in simulated IRR, highlighting their potential as an effective adjunct in endodontic irrigation protocols.