CC BY-NC-ND 4.0 · Eur J Dent 2014; 08(01): 053-057
DOI: 10.4103/1305-7456.126241
Original Article
Dental Investigation Society

Effectiveness of different irrigation systems on smear layer removal: A scanning electron microscopic study

Fuat Ahmetoglu
1   Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
,
Ali Keles
1   Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
,
Muhammet Yalcin
2   Department of Restorative Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkiye
,
Neslihan Simsek
1   Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
› Author Affiliations
Further Information

Publication History

Publication Date:
24 September 2019 (online)

ABSTRACT

Objectives: To evaluate effectiveness of the apical negative pressure irrigation (EndoVac), passive ultrasonic irrigation (PUI), and conventional needle irrigation (CI) systems on smear layer (SR) removal. Materials and Methods: Sixty single-rooted canines were prepared using NiTi rotary files and subjected to different irrigation regimens: EndoVac with NaOCl (Group 1) or NaOCl/EDTA (Group 2); PUI with NaOCl (Group 3) or NaOCl/EDTA (Group 4); CI with NaOCl (Group 5) or NaOCl/EDTA (Group 6). The roots were split longitudinally. SEM images were taken to evaluate the amount of residual SR. Results: In Groups 1, 3, and 5, there was no removal of SR (P > 0.05). The coronal thirds within Groups 2, 4, and 6 were cleaned completely, but the middle and the apical thirds was achieved partially or completely (P > 0.05). Conclusion: Regardless of which irrigation system was used, the use of NaOCl alone failed to remove the SR. In NaOCl/EDTA combination groups, the SR was removed partially or completely and no statistical significance. This study demonstrated that in order to remove the SR should be used EDTA solution for final irrigation in the root canal, regardless of the technique in each of the three.

 
  • REFERENCES

  • 1 Violich DR, Chandler NP. The smear layer in endodontics – A review. Int Endod J 2010; 43: 2-15
  • 2 Eick JD, Wilko RA, Anderson CH, Sorensen SE. Scanning electron microscopy of cut tooth surfaces and identification of debris by use of the electron microprobe. J Dent Res 1970; 49 Suppl 1359-68
  • 3 McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975; 1: 238-42
  • 4 Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007; 33: 472-5
  • 5 Nielsen BA, Craig Baumgartner J. Comparison of the EndoVac system to needle irrigation of root canals. J Endod 2007; 33: 611-5
  • 6 Shin SJ, Kim HK, Jung IY, Lee CY, Lee SJ, Kim E. Comparison of the cleaning efficacy of a new apical negative pressure irrigating system with conventional irrigation needles in the root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 479-84
  • 7 van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: A review of the literature. Int Endod J 2007; 40: 415-26
  • 8 Krell KV, Johnson RJ, Madison S. Irrigation patterns during ultrasonic canal instrumentation. Part I. K-type files. J Endod 1988; 14: 65-8
  • 9 Saber Sel-D, Hashem AA. Efficacy of different final irrigation activation techniques on smear layer removal. J Endod 2011; 37: 1272-5
  • 10 Schoeffel GJ. The EndoVac method of endodontic irrigation, part 2 – Efficacy. Dent Today 2008; 27: 82 84, 86-7
  • 11 Schoeffel GJ. The EndoVac method of endodontic irrigation: Part 4, clinical use. Dent Today 2009; 28: 64 66-7
  • 12 Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K. et al. A new solution for the removal of the smear layer. J Endod 2003; 29: 170-5
  • 13 Brunson M, Heilborn C, Johnson DJ, Cohenca N. Effect of apical preparation size and preparation taper on irrigant volume delivered by using negative pressure irrigation system. J Endod 2010; 36: 721-4
  • 14 Uroz-Torres D, González-Rodríguez MP, Ferrer-Luque CM. Effectiveness of the EndoActivator System in removing the smear layer after root canal instrumentation. J Endod 2010; 36: 308-11
  • 15 Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smear layer removal: An SEM analysis. Int Endod J 2005; 38: 285-90
  • 16 Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod 2011; 37: 1437-41
  • 17 Abarajithan M, Dham S, Velmurugan N, Valerian-Albuquerque D, Ballal S, Senthilkumar H. Comparison of EndoVac irrigation system with conventional irrigation for removal of intracanal smear layer: An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: 407-11
  • 18 Walmsley AD, Williams AR. Effects of constraint on the oscillatory pattern of endosonic files. J Endod 1989; 15: 189-94
  • 19 Blank-Gonçalves LM, Nabeshima CK, Martins GH, Machado ME. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: Conventional irrigation versus activation systems. J Endod 2011; 37: 1268-71
  • 20 Jiang LM, Verhaagen B, Versluis M, Langedijk J, Wesselink P, van der Sluis LW. The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. J Endod 2011; 37: 688-92
  • 21 Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod 2009; 35: 545-9
  • 22 Ribeiro EM, Silva-Sousa YT, Souza-Gabriel AE, Sousa-Neto MD, Lorencetti KT, Silva SR. Debris and smear removal in flattened root canals after use of different irrigant agitation protocols. Microsc Res Tech 2012; 75: 781-90
  • 23 Baker NA, Eleazer PD, Averbach RE, Seltzer S. Scanning electron microscopic study of the efficacy of various irrigating solutions. J Endod 1975; 1: 127-35
  • 24 Sedgley CM, Nagel AC, Hall D, Applegate B. Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro . Int Endod J 2005; 38: 97-104