Retrievability of triple antibiotic paste from simulated grooves in molars: Impact of access design and agitation technique

ABSTRACT Aim: To assess the efficacy of sonic and ultrasonic activation in removing triple antibiotic paste (TAP) and calcium hydroxide (Ca(OH) 2 ) from simulated grooves in molars prepared with varying access cavity designs. The null hypothesis tested was (i) access cavity design does not influence the removal of TAP and Ca(OH) 2 from simulated grooves and (ii) sonic and ultrasonic agitation have the same effectiveness in removing TAP and Ca(OH) 2 from simulated grooves in molars. Methods: Eighty molars were divided into four groups ( n = 20) based on access design: Traditional endodontic cavity (TEC), Contracted endodontic cavity (CEC), Truss access cavity (TAC), and Caries-driven access cavity (CDAC). Distal/palatal roots were split, and longitudinal grooves were created. Grooves in each group were either filled with Ca(OH) 2 or TAP ( n = 10) and reassembled for cone-beam computed tomography (CBCT) imaging and volume measurement with ITK-SNAP 4.2.0 software. Medicament retrieval was performed using sonic or ultrasonic activation. Postretrieval CBCT scans assessed remaining volumes. Statistical Analysis Used: Independent t -test and one-way ANOVA test were applied, and P < 0.05 was taken as significant. Results: Retrieval of TAP and Ca(OH) 2 was maximum in the TAC group (50.36%) and minimum in the CAC group (40.31%). The amount of TAP removed was greater than Ca(OH) 2 ( P = 0.0009). The volume of TAP and Ca(OH) 2 removed by ultrasonic irrigation (49.74%) was more ( P = 0.0210) than sonic agitation (40.20%). Conclusions: Truss and caries-driven designs removed more TAP and Ca(OH) 2 than contracted access. However, the difference was not significant. TAP was significantly easier to remove than Ca(OH) 2 , and ultrasonic activation removed ~25% more medicament than sonic agitation, regardless of access design.