EDTA VS. TWIN KLEEN: A SITE-SPECIFIC STEREOMICROSCOPIC COMPARISON OF THEIR EFFICACY IN ERADICATING INTRACANAL CALCIUM HYDROXIDE USING PASSIVE ULTRASONIC AND SONIC ACTIVATION

*Dr. Varun Sariya, Dr. Kailash Attur, Dr. Nikunj Patel, Dr. Palak Chhaya, Dr. Manali Solanki, Dr. Dhruvi Pandya

ABSTRACT

Context: Calcium hydroxide is extensively utilized as an intracanal medicament due to its high pH and wideranging
antimicrobial properties. However, its remnants on the canal walls can negatively impact dentin bond
strength and obstruct sealer penetration into dentinal tubules. Hence, it is imperative to investigate techniques
ensuring the complete elimination of this medicament from the canal walls. Aim: To assess the effectiveness of
Twin Kleen solution and EDTA with two different irrigation activation techniques in removing calcium hydroxide
from the root canal system. Material and Method: Sixty single-rooted anterior teeth were instrumented with
Protaper rotary instruments and filled with oil-based calcium hydroxide with iodoform. There were four groups
based on the irrigant used Group A: 17% liquid EDTA with sonic irrigation, Group B: Twin kleen solution solution
with sonic irrigation, Group C: 17% EDTA with Passive Ultrasonic Irrigation (PUI) Group D: Twin kleen with
PUI. Evaluation was done under stereomicroscope at three levels. Statistical Analysis: Mann Whitney U test,
Wilcoxon signed rank test, Kruskal wallis test. Result: Liquid EDTA showed slightly better efficacy than Twin
Kleen in removing calcium hydroxide from the root canal wall, but the differences were not statistically significant
(p > 0.05). Sonic activation showed marginally better results than PUI in only apical third. Conclusion: Present
study found no statistically significant differences in efficacy between sonic and ultrasonic irrigation methods using
liquid EDTA or Twin kleen solutions at coronal, middle, or apical canal sites. (p>0.5)

Keywords: Calcium hydroxide, Passive ultrasonic irrigation, sonic irrigation, Twin Kleen.