Research Article

Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study

Volume: 60 Number: 1 September 9, 2026

Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study

Abstract

Purpose

This study aimed to evaluate the effects of passive ultrasonic irrigation (PUI) and sonic activation (SA) on apical extrusion and the removal efficacy of bioceramic (BC), and calcium hydroxide (CH) based intracanal materials in simulated open-apex teeth.

Materials and Methods

Thirty-two extracted mandibular canines were prepared according to ISO #140, and an open-apex condition was created by apical resection. Specimens were randomly assigned to bioceramic (Bio-C Temp) and CH (DiaPaste) intracanal medication groups and subdivided among PUI or SA methods (n = 8). Extruded intracanal medicament was collected in pre-weighed tubes, and residual medicament was scored under a microscope. Residual intracanal medicament was evaluated using a four-grade scoring system. Normality was assessed using the Shapiro–Wilk test; group comparisons were performed with the Kruskal–Wallis test and Dunn’s posthoc test, with significance set at p<0.05.

Results

Apical Extrusion values were as follows: Group BC-PUI = 0.048 mg, Group BC-SA = 0.036 mg, Group CH-PUI = 0.052 mg, and Group CH-SA = 0.049 mg. No significant difference was observed in apical extrusion among the groups (p = 0.265). Median residual scores were Group BC-PUI = 0.5, Group BC-SA = 3, Group CH-PUI = 0.5 and Group CH-SA = 1. PUI resulted in significantly lower residual medicament scores than SA (p = 0.002).

Conclusion

Bio-C Temp demonstrated superior removal and apical extrusion characteristics were comparable to CH. These findings support its potential as a reliable alternative to CH.

Keywords

Ethical Statement

Ethics committee approval required for the study was obtained from the Kocaeli University Non-Interventional Ethics Committee (KU GOKAEK- 2024/15.23 project no.: 2024/404). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki. Both written and oral informed consents were obtained from the patients whose teeth were used for this study after extraction.

References

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Details

Primary Language

English

Subjects

Endodontics

Journal Section

Research Article

Publication Date

September 9, 2026

Submission Date

November 27, 2025

Acceptance Date

May 5, 2026

Published in Issue

Year 2026 Volume: 60 Number: 1

APA
Kaşıkçı, S., & Şirinoğlu, E. (2026). Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study. European Oral Research, 60(1), 275-282. https://doi.org/10.26650/eor.20261831306
AMA
1.Kaşıkçı S, Şirinoğlu E. Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study. EOR. 2026;60(1):275-282. doi:10.26650/eor.20261831306
Chicago
Kaşıkçı, Sena, and Ebru Şirinoğlu. 2026. “Influence of Activation Systems on the Removal and Apical Extrusion of a Bioceramic Intracanal Medicament in Immature Teeth: An in Vitro Study”. European Oral Research 60 (1): 275-82. https://doi.org/10.26650/eor.20261831306.
EndNote
Kaşıkçı S, Şirinoğlu E (September 1, 2026) Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study. European Oral Research 60 1 275–282.
IEEE
[1]S. Kaşıkçı and E. Şirinoğlu, “Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study”, EOR, vol. 60, no. 1, pp. 275–282, Sept. 2026, doi: 10.26650/eor.20261831306.
ISNAD
Kaşıkçı, Sena - Şirinoğlu, Ebru. “Influence of Activation Systems on the Removal and Apical Extrusion of a Bioceramic Intracanal Medicament in Immature Teeth: An in Vitro Study”. European Oral Research 60/1 (September 1, 2026): 275-282. https://doi.org/10.26650/eor.20261831306.
JAMA
1.Kaşıkçı S, Şirinoğlu E. Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study. EOR. 2026;60:275–282.
MLA
Kaşıkçı, Sena, and Ebru Şirinoğlu. “Influence of Activation Systems on the Removal and Apical Extrusion of a Bioceramic Intracanal Medicament in Immature Teeth: An in Vitro Study”. European Oral Research, vol. 60, no. 1, Sept. 2026, pp. 275-82, doi:10.26650/eor.20261831306.
Vancouver
1.Sena Kaşıkçı, Ebru Şirinoğlu. Influence of activation systems on the removal and apical extrusion of a bioceramic intracanal medicament in immature teeth: an in vitro study. EOR. 2026 Sep. 1;60(1):275-82. doi:10.26650/eor.20261831306