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"Latar Belakang: Preparasi saluran akar berpotensi menyebabkan ekstrusi debri nekrotik dan bakteri intrakanal yang dapat memicu respon inflamasi di periapeks. Teknik instrumentasi, desain file, dan teknik irigasi diketahui memengaruhi potensi terjadinya ekstrusi debri dan bakteri. Tujuan: Menganalisis dan membandingkan efek penggunaan single file rotasi kontinyu dan resiprokal terhadap terjadinya ekstrusi debri dan E.faecalis. Metode: Tiga puluh dua gigi premolar rahang bawah, akar tunggal dipilih secara acak dikontaminasi bakteri E.faecalis isolat klinis ke dalam saluran akar, lalu dibagi menjadi dua kelompok. Saluran akar dipreparasi menggunakan single file gerakan rotasi kontinyu (One Curve), dan single file gerakan resiprokal (Reciproc Blue). Model Myers dan Montogomery digunakan untuk mengumpulkan ekstrusi debri dan bakteri. Jumlah ekstrusi debri diketahui dari selisih berat tabung debri sebelum dan setelah instrumentasi. Sementara ekstrusi E.faecalis diketahui dengan identifikasi koloni hijau-biru pada media chromagar selektif. Analisis statistik menggunakan uji Mann Whitney dan komparatif kategorik. Hasil: Tidak terdapat perbedaan bermakna antara jumlah ekstrusi debri (p=0,513) dan persentase terjadinya ekstrusi E.faecalis (p=0,479) pada kelompok uji menggunakan single file rotasi kontinyu dengan resiprokal. Simpulan: Instrumen single file rotasi kontinyu dan resiprokal, berpotensi menyebabkan ekstrusi debri dan E.faecalis, namun tidak ditemui perbedaan bermakna pada jumlah ekstrusi debri dan E.faecalis di antara kedua gerakan tersebut.

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Background: Root canal preparation potentially cause extrusion of necrotic debris and intracanal bacteria which lead to inflammation in periapical tissue. The preparation technique, file design, and irrigation techniques influences the risk of debris and bacterial extrusion. Objective: The purpose of this study was to evaluate and compare the effects of rotating and reciprocating single file on debris and E.faecalis extrusion.Method: Thirty-two mandibular premolars, single roots randomly contaminated with E.faecalis bacterial isolates into the root canal, then divided into two groups. The root canals were prepared using rotating single file (One Curve) and reciprocating single file (Reciproc Blue). Myers and Montogomery models are used to collect debri and bacterial extrusions. The amount of debris extrusion is known from the difference of the debris tubes weight before and after instrumentation. While E.faecalis extrusion is known by identification of blue-green colonies on selective chromagar media. Non parametric test like Mann Whitney test and categorical comparative test were applied to determine the significant difference among the group. Results: There was no significant difference between debris extrusion (p = 0.513) and the percentage of E.faecalis extrusion (p = 0.479) among the group using rotating and reciprocating single file. Conclusions: In this study, both rotating and reciprocating single file system used resulted in some debris and E.faecalis extrusion, but there were no significant differences in the number of debris and E.faecalis extrusion between the instrumentation."

"Latar Belakang: Preparasi saluran akar dengan instrumen putar NiTi dapat menyebabkan crack pada dinding saluran akar.Tujuan: Menganalisa dan membandingkan efek penggunaan instrumen putar NiTi single-file gerakan resiprokal dan kontinyu terhadap terbentuknya crack pada dinding saluran akar. Metode: Tigapuluh dua sampel saluran akar tunggal dipilih secara acak dan dibagi menjadi dua grup (n=16) sesuai dengan instrumen yang digunakan untuk preparasi saluran akar, yaitu instrumen putar NiTi gerakan resiprokal dan gerakan kontinyu. Micro-CT digunakan untuk mengevaluasi crack  sebelum dan setelah preparasi saluran akar. Analisis statistik menggunakan Continuity correction. Hasil: Tidak terdapat perbedaan bermakna antara preparasi saluran akar menggunakan instrumen putar NiTi gerakan resiprokal dan gerakan kontinyu (p>0,05). Crack yang terbentuk ditemukan pada bagian sepertiga apikal saluran akar dengan tipe incomplete crack. Simpulan: Preparasi saluran akar menggunakan instrumen putar NiTi single-file dengan gerakan resiprokal dan kontinyu dapat menyebabkan terbentuknya crack pada dinding saluran akar.

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Background: Root canal preparation with NiTi rotary instrument has the potential to induce cracks in the root canal wall. Objective: To analyze and compare the effects of single-file NiTi rotary continuous and reciprocating instruments in the propagation of cracks in the root canal wall. Methods: Thirty two single root canal samples were randomly assigned into two groups (n=16 per group) according to the system used for root canal preparation : reciprocating instruments and rotary continuous instruments. The samples were scanned through high-resolution micro-computed tomographic imaging to evaluate cracks before and after root canal preparation. The comparison between two groups was analysed statistically using Continuity correction. Results: There was no significant difference in the number of cracks between reciprocating group and rotary continuous group (p> 0.05). Cracks that occured was found in the apical third of the root canal, with incomplete cracks. Conclusion: Root canal preparation with single-file NiTi rotary continuous and reciprocating instruments can induce dentinal cracks in the root canal wall."

"Preparasi saluran akar menghasilkan ekstrusi debri, memicu respons inflamasi di periapeks. Tujuan: Mengamati perbedaan jumlah ekstrusi debri ke periapeks pada saluran akar yang dipreparasi menggunakan gerakan rotasi kontinyu dan resiprokal. Metode: Tigapuluh dua gigi premolar secara acak dibagi dalam dua kelompok. Kelompok 1 dipreparasi menggunakan gerakan rotasi kontiyu. Kelompok 2 menggunakan gerakan resiprokal. Penimbangan tabung penampung debri dilakukan dua kali, yaitu sebelum dan setelah preparasi. Perbedaan berat tabung tersebut dianggap sebagai berat debri terekstrusi. Hasil: Tidak terdapat perbedaan bermakna antara kelompok 1 dan 2 (p=0,844) Kesimpulan: Perbedaan gerakan preparasi saluran akar menggunakan rotasi kontinyu maupun resiprokal tidak memengaruhi jumlah ekstrusi debri ke periapeks.

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Root canal preparation produces debris extrusion, lead to inflammation in periapical tissue.

Objective: Assess the differences of periapically extruded debris amount after preparation using continous rotation and reciprocating motion.

Method: Thirty two premolars in a receptor tube were randomly divided into 2 groups. Group 1 was prepared using continuous rotation, Group 2 using reciprocating motion. Amount of the extruded debris was obtained by the receptor tube weight differences before and after preparation.

Results: The difference between groups were not statistically significant (p = 0,844).

Conclusion: Continuous rotation and reciprocating motion have no influence in the amount of periapically extruded debris."

"Latar Belakang: E.faecalis isolat klinis merupakan bakteri yang menyebabkan lesi periapeks persisten. Bioceramic dan Mineral Trioxide Aggregate merupakan siler yang mempunyai sifat anti bakteri. Tujuan: Untuk menganalisis efek anti bakteri siler Bioceramic dan MTA terhadap E.faecalis isolat klinis pada waktu 2 menit segera , 4 jam initial setting , 1 dan 7 hari setelah pengadukan siler. Metode: Efek anti bakteri siler Bioceramic dan MTA diperiksa dengan direct contact test. Masing-masing siler dikontakkan langsung dengan E.faecalis isolat klinis 2 menit, 4 jam, 1 dan 7 hari setelah pengadukan siler. Suspensi ini dioleskan pada medium agar dan diinkubasi 24 jam untuk melihat koloni bakteri yang tumbuh CFU/ml. Hasil: Terdapat perbedaan bermakna antara siler Bioceramic dan MTA pada waktu 7 hari, antara siler Bioceramic pada waktu 2 dan 4 jam serta waktu 4 jam dan 7 hari setelah pengadukan siler. Kesimpulan: siler Bioceramic dan MTA mempunyai efek anti bakteri yang baik terhadap E.faecalis pada saat segera, initial setting, dan 1 hari setelah pengadukan siler, pada waktu 7 hari setelah pengadukan, siler MTA yang paling baik. Siler MTA mempunyai efek anti bakteri yang konstan sampai 7 hari Keywords : Entereococcus faecalis isolat klinis, Siler Bioceramic dan Mineral Trioxide Aggregate MTA

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Background: E.faecalis isolate clinic is a kind of bacteria that cause persistent periapical lesion. Bioceramic and Mineral Trioxide Aggregate are sealers that having antibacterial properties.

Aim: To analyze antibacterial effect of Bioceramic and MTA sealers against E.faecalis isolate clinic at 2 minutes fresh , 4 hours initial setting , 1 day and 7 day after mixed the sealers.

Methods: Antibacterial effect of Bioceramic and MTA sealers was assessed by direct test contact. Each sealer was contacted with E.faecalis isolate clinic at 2 minutes, 4 hours, 1 day and 7 days after mixed the sealers. This suspension was swab in agar medium and incubated for 24 hours. The colony in agar plates is counted with colony forming unit CFU .

Result: The significant differences was shown by Bioceramic and MTA at 7 days, between Bioceramic at 2 minutes fresh and 4 hours initial setting also at 4 hours initial setting and 7 days after mixed the sealer.

Conclusion: Both of Bioceramic and MTA sealers have a good antibacterial effect at fresh, initial setting and 1 hour after mixed the sealer but at 7 days, MTA was the greater. MTA sealer has a constant antibacterial effect until 7 days. "

"Enterococcus faecalis adalah bakteri yang paling dominan pada kasus infeksi pasca perawatan endodontik. Telah diteliti aktivitas fenotipnya (kemampuan membentuk biofilm dan Gel E serta viabilitasnya terhadap NaOCL dan khlorheksidin) dan profil genotipnya. Ternyata tidak ada perbedaan aktivitas Gel E E. faecalis saluran akar dan saliva pasien pra dan pasca perawatan. Dalam membentuk biofilm, kemampuan E. faecalis saluran akar pra-perawatan lebih kuat daripada pasca-perawatan, sedangkan kemampuan E. faecalis saliva tidak berbeda. Viabilitas E. faecalis menurun jika kadar NaOCl dan khlorheksidin meningkat; 30 menit adalah waktu inkubasi efektif. Terdapat keragaman profil genotip antara E. faecalis saliva dan saluran akar, pra dan pasca perawatan.

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Enterococcus faecalis is strong dominance bacteria in post treatment endodontic disease. Its phenotype activity (its ability to produce biofilms and Gel E also its viability to NaOCL and chlorexidine) and its genotype profile has been observed. It turns out that there?s no difference in E. faecalis Gel E activity of root canal and saliva from pre- nor post-endodontic treated patients. In producing biofilms, the ability of E. faecalis pre-endodontic treated root canal was stronger than the postendodontic treated root canal, while the ability of E. faecalis from saliva have no difference. The viability of E. faecalis decline if the concentration of NaOCl and chlorexidine were increasing; the effective incubation time was 30 minutes. There?s various genotype profile between E. faecalis of saliva and root canal either pre- or post-endodontic treatment."

"Latar Belakang: Preparasi saluran akar gigi dengan file endodontik Ni-Ti umum digunakan saat ini dalam praktik klinis maupun institusi pendidikan karena karakteristik bahan yang baik. File perlu melalui sterilisasi autoklaf sebelum digunakan kembali. Namun, setelah siklus preparasi dan sterilisasi terlihat perubahan morfologi dan belum ada kesepakatan batas penggunaan untuk menghindari hal tersebut. Tujuan: Menganalisis efek frekuensi preparasi dan sterilisasi terhadap perubahan morfologi file endodontik Ni-Ti hand-use. Metode: File ProTaper® Universal hand-use (Dentsply Maillefer) digunakan untuk preparasi 135 gigi premolar akar tunggal, sebanyak 5 kali (kelompok 1) dan 10 kali (kelompok 2), antar tiap preparasi file dibersihkan dengan larutan enzimatik, scouring sponge, ultrasonic cleaner dan sterilisasi autoklaf. Kemudian sampel diamati dengan stereomicroscope (Nikon® SMZ800, Japan). Data dianalisis dengan uji Kruskal-wallis dan Mann-Whitney (p<0,05). Hasil Penelitian: Terdapat perbedaan bermakna antara perubahan morfologi file setelah 5 dan 10 kali preparasi dan sterilisasi (p<0,05). Tidak terdapat perbedaan bermakna antara perubahan morfologi file F1 setelah 5 dan 10 siklus (p>0,05). Terdapat perbedaan bermakna antara perubahan morfologi file F2 setelah 5 dan 10 siklus (p<0,05) dan antara perubahan morfologi file F1 dan F2 setelah 5 siklus (p<0,05). Tidak terdapat perbedaan bermakna antara perubahan morfologi file F1 dan F2 melalui 10 siklus (p>0,05). Kesimpulan: Frekuensi preparasi dan sterilisasi file endodontik Ni-Ti hand use memiliki efek terhadap perubahan morfologi pada file.

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Background: Root canal preparation using Ni-Ti endodontic file was generally used today, due to its more elastic characteristic. In clinical setting, file requires autoclave sterilization before next usage. However, morphological changes could be seen after cycles of preparation and sterilization and there is still no agreement on safe usage limits for the re-use of these files.

Objective: To analyze the effect of preparation and sterilization frequency on Ni-Ti endodontic hand-use files by their morphological changes.

Method: ProTaper® Universal Hand-use files (PTU) (Dentsply Maillefer, Switzerland) were used on 135 single-rooted canal premolars for 5 times (1st group), 10 times (2nd group), then after every use, files are cleaned with enzymatic solution, scouring sponge, ultrasonic cleaner and sterilized by autoclave. Afterward, F1 and F2 files observed with stereomicroscope. Data was analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05).

Result: There were statistically significant differences of file morphological changes after 5 and 10 cycles (p<0.05). There were no statistically significant differences of F1 files morphological changes after 5 and 10 cycles (p>0.05). There were statistically significant differences of F2 files morphological changes after 5 and 10 cycles (p<0.05). There were statistically significant differences of F1 and F2 files morphological changes after 5 cycles (p<0.05). There were no statistically significant differences of F1 and F2 files morphological changes after 10 cycle (p>0.05).

Conclusion: The frequency of preparation and sterilization on Ni-Ti endodontic hand-use files had effect on its morphological changes."

"Latar Belakang: Preparasi saluran akar gigi menghasilkan smear layer saat bersentuhan dengan dinding saluran akar yang berpotensi menyebabkan kegagalan perawatan. Bentuk penampang file mempengaruhi pembentukan smear layer. Penelitian ini membandingkan kuantitas smear layer pada dinding saluran akar sepertiga apikal yang dipreparasi menggunakan file berpenampang melintang segitiga dan segi empat. Metode: 32 sampel gigi premolar rahang bawah dibagi ke dalam dua kelompok perlakuan yang dipreparasi dengan file berpenampang segitiga (One Curve®, n = 16) dan segi empat (Hyflex EDM®, n = 16). Setelah preparasi, saluran akar diirigasi menggunakan kombinasi larutan NaOCl 2,5% dan EDTA 17%. Smear layer pada dinding saluran akar sepertiga apikal diamati menggunakan scanning electron microscope (SEM) dan dikuantifikasi menurut sistem skoring Foschi. Hasil: Uji Mann- Whitney menunjukkan perbedaan bermakna secara statistik antara preparasi saluran akar menggunakan kedua instrumen dengan skor smear layer. Kelompok yang dipreparasi dengan file berpenampang segitiga menghasilkan skor smear layer lebih rendah dibanding kelompok yang dipreparasi dengan file berpenampang segi empat. Kesimpulan: Preparasi saluran akar menggunakan file berpenampang segitiga dan segi empat dengan irigasi kombinasi NaOCl 2,5% dan EDTA 17% tetap menghasilkan smear layer pada daerah sepertiga apikal, namun preparasi dengan file berpenampang segitiga menunjukkan kuantitas smear layer yang lebih sedikit dibandingkan file berpenampang segi empat.

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Background: Root canal preparation produces smear layer when in contact with its wall, which potentially causing treatment failures. Cross-section shape of file influences smear layer production. This experiment compares smear layer quantity at apical third of root canal walls prepared using files with triangular and rectangular cross-section.

Methods: Thirty-two premolar samples taken from mandibles were divided into two groups whose root canals were prepared using file with triangular (One Curve®, n = 16) and rectangular (Hyflex EDM®, n = 16) cross-section. After preparation, root canals were irrigated with combination of NaOCl 2,5% and EDTA 17% solutions. Smear layer in apical third of root canal walls were then observed using scanning electron microscope (SEM) dan quantified according to Foschi scoring system.

Results: Mann- Whitney test shows significant difference between root canal preparation using both instruments and produced smear layer score. Group prepared with triangular file produced lower smear layer score compared to those which prepared with rectangular file.

Conclusions: Root canal preparation using files with triangular and rectangular cross-section, followed by combined NaOCl 2,5% and EDTA 17% irrigation still produces smear layer in apical third area. However, preparation with triangular file shows less smear layer quantity compared to rectangular file."

"Latar Belakang : Enterococcus faecalis merupakan bakteri yang mampu membentuk biofilm dan banyak ditemukan pada kasus kegagalan perawatan saluran akar. Tujuan : Melihat daya antibakteri kitosan dan klorheksidin terhadap E. faecalis dalam biofilm. Metode : Deteksi dan kuantifikasi E. faecalis dalam biofilm yang hidup pasca pemaparan bahan uji, dengan real time PCR. Hasil : Terdapat perbedaan jumlah bakteri yang signifikan antara kedua kelompok bahan uji terhadap kontrol (p ≤ 0,05), tetapi tidak terdapat perbedaan bermakna antara kelompok kitosan dan klorheksidin. Kesimpulan : Daya antibakteri kitosan 2% terhadap biofilm E. faecalis sebanding dengan klorheksidin 2%.

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Background : Enterococcus faecalis has an ability to form biofilms and become a predominant bacteria that plays a major role in the etiology of persistent lesions after root canal treatment.

Aim : To analyze the efficacy of chitosan and chlorhexidine against E. faecalis in biofilms.

Methods : Detection and quantification of E. faecalis DNA that survive and live after immersing the biofilm in antibacterial solution, with real time PCR.

Result : Statistically there is significant difference of living E. faecalis between chitosan and control and between 2% chlorhexidine and control (p ≤0,05). But there is no significant different between chitosan and chlorhexidine (p>0,05).

Conclusion : Antibacterial effectivity of chitosan is equal to chlorhexidine against E. faecalis in biofilm."

"Latar Belakang: Penggunaan instrumen endodontik steril diperlukan untuk keberhasilan perawatan saluran akar. Desain dan bentuk instrumen endodontik menjadi tantangan dalam proses sterilisasi. Instrumen yang kini sering digunakan adalah instrumen putar NiTi, dengan salah satu desain terbaru adalah instrumen putar NiTi off-centered, yang bisa berupa variable taper maupun regressive taper. Bakteri resisten yang perlu diwaspadai dalam perawatan saluran akar adalah Enterococcus faecalis. Beberapa tahapan sterilisasi sudah pernah diajukan, namuan tidak spesifik pada instrumen putar NiTi off-centered yang terkontaminasi bakteri Enterococcus faecalis. Perlu siasat dan langkah-langkah khusus untuk mendapatkan instrumen putar NiTi off-centered yang steril dari bakteri Entercoccus faecalis. Tujuan: Membandingkan jumlah bakteri Enterococcus faecalis pada instrumen putar NiTi off-centered variable taper dan regressive taper setelah melalui dua metode sterilisasi yang berbeda. Metode: Delapan kelompok uji yang terdiri dari empat kelompok instrumen putar NiTi off-centered variable taper dan empat kelompok instrumen putar NiTi off-centered regressive taper. Masing-masing dari keempat kelompok tersebut dibagi menjadi kelompok kontrol negatif, kelompok kontrol positif, kelompok sterilisasi Parashos dan kelompok sterilisasi Linsuwanont. Selain kelompok negatif, instrumen-instrumen dari kelompok lainnya digunakan untuk mempreparasi saluran akar gigi premolar yang sudah dikontaminasi bakteri Enterococcus faecalis. Kedelapan kelompok kemudian diuji kultur menggunakan agar kromogenik untuk melihat keberadaan bakteri Enterococcus faecalis dan menghitung koloni yang terbentuk. Hasil: Pada kelompok kontrol negatif, tidak ditemukan adanya bakteri Enterococcus faecalis. Kelompok positif menunjukkan keberadaan bakteri Enterococcus faecalis dengan jumlah besar. Kelompok Parashos dan Linsuwanont menunjukkan jumlah bakteri Enterococcus faecalis yang beragam, dengan kelompok Parashos memberikan hasil jumlah bakteri yang lebih besar daripada kelompok Linsuwanont. beragam.terbanyak dan tersedikit Kesimpulan: Metode sterilisasi Linsuwanont adalah metode paling efektif untuk mensterilisasi bakteri Enterococcus faecalis pada instrumen putar NiTi off-centered regressive taper. Metode sterilisasi Parashos tidak efektif untuk mensterilisasi bakteri Enterococcus faecalis pada instrumen putar NiTi off-centered variable taper maupun regressive taper. Kata kunci: sterilisasi, intrumen putar NiTi, off-centered, Enterococcus faecalis, CFU

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Backrgound: The use of sterile endodontic instruments is necessary to achieve successful root canal treatment. The design and shape of endodontic instruments poses challenges in their sterilization process. The current most widely used endodontic instrument are NiTi rotary files, and one of the newest design results in off-centered NiTi rotary files, which can either have a variable taper or a regressive taper. Resistant bacteria that must be noticed in root canal treatment is Enterococcus faecalis. Several sterilization processes have been put forward for endodontic instruments; however, none were specific for off-centered NiTi rotary files that were contaminated by Enterococcus faecalis. Specific strategies and steps are necessary to achieve sterile off-centered NiTi rotary files that are free from Entercoccus faecalis. Aim: Compare the amount of Enterococcus faecalis on off-centered NiTi rotary files with variable taper and regressive taper after being processed using two different sterilization methods. Method: Eight test groups were established consisting of four off-centered NiTi rotary files with variable taper and four off-centered NiTi rotary files with regressive taper. Each of these four groups were divided into the following groups: negative control group, positive control group, Parashos sterilization group and lastly Linsuwanont sterilization group. Besides the negative control group, instruments from the other groups were used to perform root canal preparation of premolars that were contaminated by Enterococcus faecalis. The eight test groups were then tested for bacterial culture using chromogenic agar media to observe the presence and count the colony forming units of Enterococcus faecalis. Results: In the negative control group, no Enterococcus faecalis bacteria were found. The positive control group showed a large amount of Enterococcus faecalis present. The Parashos and Linsuwanont groups showed a variety in the amount of Enterococcus faecalis present, with the Parashos group showing a higher number of Enterococcus faecalis bacteria than the Linsuwanont group. Conclusion: The Linsuwanont sterilization method is the most effective method to sterilize Enterococcus faecalis bacteria from off-centered NiTi rotary files with regressive taper. The Parashos sterilization method was ineffective in sterilizing Enterococcus faecalis bacteria from both off-centered NiTi rotary files with variable taper and regressive taper."

"Residu Ca(OH)2 dapat mengganggu hermetisitas obturasi saluran akar. Tujuan penelitian ini adalah untuk menganalisis tiga metode pembersihan residu Ca(OH)2. Metode. Tigapuluh premolar bawah dipeparasi dengan ProTaper sampai F3, kemudian diberi medikamen Ca(OH)2 dan disimpan selama 7 hari. Setelah itu, sampel dibagi tiga sama banyak. Residu Ca(OH)2 di Kelompok I dibersihkan dengan irigan gabungan NaOCl-EDTA, kelompok II dengan CanalBrush, dan Kelompok III dengan file NiTi. Sampel kemudian dibelah arah buko-lingual dan residu diperiksa dengan mikroskopstereo dan program Axiocam. Hasil. Pembersihan paling baik adalah pada kelompok II, disusul oleh kelompok III, dan kelompok I, walaupun secara statistik tidak berbeda signifikan (p <0,05). Kesimpulan. Ketiga metode menghasilkan efek pembersihan residu Ca(OH)2 yang tidak berbeda.

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The residu of Ca(OH)2 will hamper the hermeticity of root canal obturation. The aim of this study was to analyze the effectiveness of the methods of its removal. Methods. Root canal preparation was performed on 30 lower premolar using Proaper system. The Ca(OH)2 paste was put on the root canal for 7 days. The samples were then divided equally into three groups. The residu of Ca(OH)2 in group I, II, and III were removed by combined irrigant of NaOCl-EDTA, Canal Brush, and NiTi file respectively. After bisected bucco-lingually, the residu was assessed under stereomicroscope (12x magnification) and AxioCam. Results. Substantially, the most effective method was group II, followed by group III and I, but statistically no significance difference (p < 0.05). Conclusion. The canal brush is the best methods in removing Ca(OH)2 residu, although the difference is statistically not significant."