Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study.

Abstract

INTRODUCTION:

The purpose of this study was to evaluate the effectiveness of different irrigating methods in removing the smear layer at 1, 3, 5, and 8 mm from the apex of endodontic canals.

METHODS:

Sixty-five extracted single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer, Ballaigues, Switzerland) and irrigated with 5.25% NaOCl at 37°C. Teeth were divided into 5 groups (2 control groups [n = 10] and 3 test groups [n = 15]) according to the final irrigant activation/delivering technique (ie, sonic irrigation, passive ultrasonic irrigation [PUI], or apical negative pressure). Root canals were then split longitudinally and observed by field emission scanning electron microscopy. The presence of debris and a smear layer at 1, 3, 5, and 8 mm from the apex was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests.

RESULTS:

The EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK) was significantly more efficient than PUI and the control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System (Discus Dental, Culver City, CA) removed statistically significantly more smear layer than all groups at 1, 3, 5, and 8 mm from the apex. At 5 and 8 mm from the apex, PUI and the EndoVac did not differ statistically significantly, but both performed statistically better than the control groups.

CONCLUSIONS:

In our study, none of the activation/delivery systems completely removed the smear layer from the endodontic dentine walls; nevertheless, the EndoActivator and EndoVac showed the best results at 3, 5, and 8 mm (EndoActivator) and 1, 3, 5, and 8 mm (EndoVac) from the apex.

• Authors: Manuele Mancini, Loredana Cerroni, Lorenzo Iorio, Emiliano Armellin, Gabriele Conte, Luigi Cianconi
• Journal: Journal of endodontics (J Endod) Vol. 39 Issue 11 Pg. 1456-60 (Nov 2013) ISSN: 1878-3554 [Electronic] United States
• PMID: 24139274 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Root Canal Irrigants
• Edetic Acid
• Sodium Hypochlorite

Topics

• Adolescent
• Adult
• Dental Pulp Cavity (ultrastructure)
• Dentin (ultrastructure)
• Edetic Acid (administration & dosage)
• Humans
• Materials Testing
• Microscopy, Electron, Scanning
• Root Canal Irrigants (administration & dosage)
• Root Canal Preparation (instrumentation)
• Smear Layer (pathology, therapy)
• Sodium Hypochlorite (administration & dosage)
• Sonication (instrumentation)
• Temperature
• Therapeutic Irrigation (instrumentation)
• Tooth Apex (ultrastructure)
• Ultrasonics (instrumentation)
• Vacuum
• Young Adult