The purpose of this study was to evaluate the efficacy of different techniques in removing calcium silicate intracanal medicament (Bio-C Temp). Forty human single-canaled premolars were randomly distributed into five groups (n = 8). All root canals were instrumented, then filled with Bio-C Temp. Following 1-week incubation, the intra-canal medicament was removed using one of five techniques according to tooth group: conventional syringe irrigation, Endo Activator, passive ultrasonic irrigation (PUI), ProTaper Universal F3 and XP-endo Finisher (XPF). Micro-CT scanning was performed before and after removal of Bio-C Temp. All techniques significantly reduced the volume of Bio-C Temp (p < 0.001) without reaching complete elimination. The percentage of Bio-C Temp removed was significantly higher in the XPF group (98.2%) compared to conventional syringe irrigation (70.6%), the Endo Activator (75.7%), and the ProTaper Universal (76.6%). There was no significant difference between the XPF and PUI (95.1%) groups. None of the removal techniques were able to completely remove Bio-C Temp from the root canal. However, XPF was the most effective method, but was not statistically significant when compared to PUI. Clinical Relevance: This study demonstrated that both XPF and PUI outperform conventional irrigation in removing Bio-C Temp intracanal medicament.

Background/Objectives: The miswak, crafted from the Salvadora persica tree, is a traditional teeth-cleaning twig that has served as a natural substitute for toothbrushes and toothpaste across diverse regions for centuries. This study aimed to evaluate and compare the effectiveness of miswak and a conventional toothbrush in reducing dental plaque and gingivitis over a two-week period. Methods: This two-week randomized, single-blind (clinical investigator), two-parallel-arm clinical trial was conducted at Princess Nourah University College of Dentistry (PNUCD). Stratified random sampling identified sixty participants who were then randomly assigned to two study groups: the miswak group and the toothbrushing group. To facilitate data collection, a self-designed form was employed to document participants’ initials, assigned group, the Silness and Loe plaque index, and the Loe and Silness gingival index. The clinical examination, conducted by two blinded and trained examiners using a mouth mirror and explorer under natural light, aimed to assess the specified indices. The collected data were analyzed using IBM SPSS Statistics, Version 22. Results: Following the intervention, the miswak group exhibited no significant change in the plaque scores (p = 0.58) compared to the toothbrush group (p = 0.007). A notable rise in gingival score was observed within the miswak group (p < 0.001), whereas no significant change was noted within the toothbrush group (p = 0.52). Conclusions: Over a two-week period, miswak was successful in controlling dental plaque; however, gingival scores were higher, which could be attributed to the aggressive use of miswak. With proper training, the use of miswak has the potential to contribute positively to gingival health, particularly in regions where it is readily accessible and affordable.