Comparative scanning electron microscopy evaluation of Canal Brushing technique, sonic activation, and master apical file for the removal of triple antibiotic paste from root canal (in vitro study)

AIMS: To compare and evaluate the effectiveness of Canal Brushing technique, sonic activation, and master apical file (MAF) for the removal of triple antibiotic paste (TAP) from root canal using scanning electron microscopy (SEM). MATERIALS AND METHODS: Twenty-two single rooted teeth were instrumented with ProTaper up to the size number F2 and dressed with TAP. TAP was removed with Canal Brush technique (Group I, n: 6), sonic (EndoActivator) (Group II, n: 6), and MAF (Group III, n: 6). Four teeth served as positive (n: 2) and negative (n: 2) controls. The roots were split in the buccolingual direction and prepared for SEM examination (×1000) at coronal, middle, and apical third. Three examiners evaluated the wall cleanliness. STATISTICAL ANALYSIS: Statistical analysis was performed by Kruskal–Wallis test and Wilcoxon rank sum test. RESULTS: Difference in cleanliness between three groups is statistically significant in cervical region only. Pairwise comparison in cervical region Canal Brush and sonic activation showed more removal of TAP than MAF. CONCLUSIONS: Canal Brush and sonic activation system showed better result than MAF in the cervical and middle third of canal. In the apical third, none of the techniques showed a better result. None of the techniques showed complete removal of TAP from the canal.