Removal of calcium hydroxide medicament from root canal walls - a review of the different techniques

Introduction: Calcium hydroxide is used widely as an intracanal medication dressing due to its antibacterial activity. It is left into the root canal for a different period of time. Intracanal calcium hydroxide is usually removed by the use of instrumentation and irrigation. The residual material may interact with the root canal sealer and interfere with its sealing ability. Aim : The aim of this article is to review the literature in order to compare the main techniques that can be used to remove calcium hydroxide from the root canal system. Results: Intracanal calcium hydroxide is usually removed by the use of continuous irrigation, in conjunction with rotary or hand instruments, sonic or ultrasonic activation of the irrigants. Conclusion: None of the described techniques is able to provide a complete removal of the intracanal calcium hydroxide from the root canal walls in all clinical cases, because of the complexity of the root canal system of every tooth. There is no standard protocol and different techniques should be applied and combined in order to achieve clean root canal walls before the definitive obturation of the root canal system.