The impact of different irrigants on the quality of root canal walls

Introduction: Root canal irrigation plays an important part in the endodontic therapy. Inadequate irrigation or instrumentation without irrigation increase the accumulation of debris on the cutting surfaces of instruments as well as debris and smear layer on root canal walls. Aim: The aim of this study was to evaluate smear layer removal after irrigation with saline, 5% NaOCl, 15% EDTA and the combination of 15% EDTA and 5% NaOCl. Materials and Methods: The study was conducted at the Clinic for Dentistry and Institute for biomedical research of the School of Medicine in Nis. Twenty five premolars, extracted from orthodontic reasons, were allocated to 5 groups (A-E) of 5 teeth. Root canals of all teeth were instrumented using hand K files. Samples from Group A were instrumented without irrigation (control group). In Group B, the irrigation was done using saline, in Group C 5% NaOCl, in Group D 15% EDTA and in Group E the combination of 15% EDTA and 5% NaOCl. After the treatment, all samples were prepared for scanning electron microscopy (SEM). Central parts of root canals were examined and photomicrographs were taken at different magnification. The amount of debris and smear layer was quantified and the data were statistically analyzed. Results: All four treatment modalities (B, C, D, E) induced changes in the appearance of dentinal walls and the amount of debris and the smear layer compared to the control group (A). The difference between the control group and Group B was statistically significant (p<0.01) and highly significant between the control group and Groups C, D and E (p<0.0001). The combined use of 15% EDTA and 5% NaOCl for irrigation and 1 min final rinse resulted in a complete elimination of the smear layer; the use of saline, 5% NaOCl or 15% EDTA alone failed to remove the debris and smear layer completely. Conclusion: The use of singular solutions for root canal irrigation significantly reduces the amount of debris and the smear layer whereas the combined use of NaOCl and EDTA results in the complete elimination of the smear layer from root canal walls.

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Effect of Smear Layer on the Apical Seal of Endodontically Treated Teeth: An ex vivo Study

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1090 ◽

2012 ◽

Vol 13 (1) ◽

pp. 23-26 ◽

Cited By ~ 1

Author(s):

KG Nischith ◽

GPV Srikumar ◽

Shuaib Razvi ◽

R Vinay Chandra

Keyword(s):

Root Canal ◽

Ex Vivo ◽

Smear Layer ◽

Control Group ◽

Endodontically Treated Teeth ◽

Root Canals ◽

Group A ◽

Group B ◽

Root Canal Irrigant ◽

Ex Vivo Study

ABSTRACT Aim The purpose of this study was to evaluate the effect of smear layer on apical seal of endodontically treated teeth. Materials and methods Sixty freshly extracted human maxillary central incisor teeth were selected and were randomly divided into two experimental groups. Group A of 25 teeth and group B of 25 teeth and a control group of 10 teeth. Cleaning and shaping of the root canals were performed using endodontic K-files up to no. 50 size file in step-back technique. During the process, in root canals of group A, 17% EDTA (ethylenediaminetetraacetic acid) followed by 3% NaOCl (sodium hypochlorite) was used as root canal irrigant. In group B, MTAD (mixture tetracycline citric acid and detergent) was used as a root canal irrigant. In control group, saline was used as root canal irrigant. The root surfaces were then coated with nail polish of both experimental groups and control group. The samples were then immersed in India ink dye for 1 week at 37°C. Results The statistical analysis of the results showed that the apical leakage was significantly more in teeth, where smear layer was not removed. Conclusion The removal of smear layer improves the longterm apical seal and success of endodontically treated teeth. Clinical significance The development and maintenance of apical seal is desirable and considered to be a major prerequisite to improve the outcome of root canal treatment. How to cite this article Nischith KG, Srikumar GPV, Razvi S, Chandra RV. Effect of Smear Layer on the Apical Seal of Endodontically Treated Teeth: An ex vivo Study. J Contemp Dent Pract 2012;13(1):23-26.

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A scanning electron microscopic evaluation of different root canal irrigation regimens

Brazilian Oral Research ◽

10.1590/s1806-83242006000300010 ◽

2006 ◽

Vol 20 (3) ◽

pp. 235-240 ◽

Cited By ~ 12

Author(s):

Chaves Medici Mônika ◽

Izabel Cristina Fröner

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Ricinus Communis ◽

Smear Layer ◽

Electron Microscopic ◽

Canal Irrigation ◽

Root Canals ◽

Root Canal Irrigation ◽

Microscopic Evaluation ◽

Scanning Electron

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl); 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

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Potential of mangrove (Acanthus Ilicifolius) leave extract as an alternative root canal irrigation in removing smear layer (in-vitro study)

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1566 ◽

2019 ◽

Vol 10 (4) ◽

pp. 2869-2874

Author(s):

Dennis D ◽

Winda Fatika Sari ◽

Trimurni Abidin ◽

Widi Prasetia

Keyword(s):

Root Canal ◽

Negative Control ◽

Smear Layer ◽

Control Group ◽

Kappa Statistics ◽

Control Group Design ◽

Canal Irrigation ◽

Root Canal Irrigation ◽

Acanthus Ilicifolius ◽

Control Samples

Factor that should be considered in the use of irrigation is the loss of the smear layer on root canal walls. Therefore the prepared root canal can be irrigated using materials, such as EDTA 17% and 2,5% NaOCl and of extract Acanthus ilicifolius 7,5% and 10%. To determine the potential of extract Acanthus ilicifolius leaves as an alternative of root canal irrigation in removing smear layer at a concentratiom of 7,5% and 10%. The type of this study is a laboratory experimental with post-test only control group design. The total sample is 24 teeth samples that have been prepared and irrigated consisting of four groups. 6 samples for irrigation 7,5% extract Acanthus ilicifolius, 6 samples for irrigation 10% extract Acanthus ilicifolius, 6 positive control samples for combination 2,5% NaOCl and EDTA 17%, and 6 negative control samples. Shooting tool used to observe the cleanliness level in the walls of the root canal is a Scanning Electron Microscope (SEM). Data were analyzed using Kappa statistics, followed by Kruskal wallis analysis test and continued with Mann-Whitney analysis. Acanthus ilicifolius 7.5% and 10% extracts can remove the smear layer when compared with the negative control group. The combination of 2.5% NaOCl and 17% EDTA is better in smear layer removal compared to 7.5% and 10% Acanthus ilicifolius extracts. Acanthus ilicifolius was able to clean the smear layer on the root canal and can be used as an alternative root canal irrigation.

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The differences in root canal smear layer removal between 6,25% pineapple (Ananas comocus L. Merr.) peel extract and 17% Ethylene diamine tetra-acetic acid

Dental Journal (Majalah Kedokteran Gigi) ◽

10.20473/j.djmkg.v52.i3.p122-125 ◽

2019 ◽

Vol 52 (3) ◽

pp. 122

Author(s):

Nirawati Pribadi ◽

Karlina Samadi ◽

Meliavita N. K. Astuti ◽

Hendy J. Kurniawan ◽

Adelina K. Tandadjaja ◽

...

Keyword(s):

Acetic Acid ◽

Root Canal ◽

Smear Layer ◽

Control Group ◽

Canal Irrigation ◽

Layer Removal ◽

Root Canal Irrigation ◽

Group I ◽

Pineapple Peel ◽

Peel Extract

Background: The smear layer is attached to dentine and occludes the orifice and, consequently, must be removed in order to improve the success of inroot canal treatment. The ideal irrigation material removes both the organic and inorganic smear layers. Ethylene diamine tetra-acetic acid (EDTA) is one of the most commonly used root canal irrigation materials, but removes only inorganic smear layer. To overcome this problem, Pineapple (Ananas comosus L. Merr.) peel extract, which contains saponins, bromelain, polyphenol and flavonoid, is used during root canal irrigation. Purpose: The study aimed to analyze the difference in smear layer removal between the use of 6.25% pineapple peel extract and 17% EDTA. Methods: 27 samples of mandibular premolar teeth with straight root canals were divided randomly into three groups (n = 9) and subsequently prepared using protaper. Irrigation was performed on the control group (aquadest), group I (17% EDTA) and group II (6.25% pineapple peel extract). The samples were dried, temporarily compressed and cut horizontally from the apical to the coronal. Samples were fixed with holder before the smear layer was observed through a scanning electron microscope (SEM). The resulting data was analyzed by means of an ANOVA test. Results: The highest score of root canal hygiene was recorded by group II, followed by group I and, finally, the control group. There were significant differences between the groups (p< 0.000). Conclusion: 6.25% pineapple peel extract produces a higher smear layer removal effect than 17%EDTA on the apical 1/3 of the root canal.

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Influence of Taper of Root Canal Shape on the Intracanal Bacterial Reduction

The Open Dentistry Journal ◽

10.2174/1874210601610010568 ◽

2016 ◽

Vol 10 (1) ◽

pp. 568-574 ◽

Cited By ~ 5

Author(s):

Mary Th. Paraskevopoulou ◽

Marouan G. Khabbaz

Keyword(s):

Root Canal ◽

Bacterial Count ◽

Positive Control ◽

Multiple Hypothesis Testing ◽

Control Group ◽

Bacterial Reduction ◽

Root Canals ◽

Significant Difference ◽

Group A ◽

Group B

Objectives: Taper is a factor that determines final root canal dimensions and consequently, the space available for the cleaning action of irrigants. Therefore, the aim of this study was to investigate the influence of taper on intracanal bacterial reduction. Methods: Sterilized root canals of 25 mandibular incisors were inoculated with E. faecalis and then divided into two experimental groups and one control group (A= saline, B= NaOCl + EDTA and C= control, not prepared). Groups A and B were prepared to an apical size of #30/0.04, a culture was obtained and then prepared to #30/0.08 and cultured again. Final irrigation sequence was 30 ml of saline for group A and 10 ml of 17% EDTA followed by 10 ml of 2.5% NaOCl and 10 ml of saline for group B. The CFU ml-1 of the pre- and two post-operative samplings were recorded. Values were compared by performing ANOVA and FDR for multiple hypothesis testing. Results: No statistically significant difference between initial CFU ml-1 readings was recorded, whereas significant differences between group A and B at both 4% and 8% tapers were noted. Furthermore, a linear-dependent reduction of CFU ml-1 was recorded in each group from non-instrumented root canals to #30/0.04 and subsequently to #30/0.08. The positive control group shows the expected reduction of bacterial count. Conclusion: Chemomechanical instrumentation was more efficient at reducing E. faecalis when the taper of root canals increased from 4% to 8% and NaOCl plus EDTA led to a greater intracanal bacterial reduction than saline, regardless of the taper achieved.

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Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers

BMC Oral Health ◽

10.1186/s12903-021-01671-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cheng Wen ◽

Yuanyuan Kong ◽

Jian Zhao ◽

Yang Li ◽

Ya Shen ◽

...

Keyword(s):

Fluorescence Intensity ◽

Root Canal ◽

Distilled Water ◽

Canal Irrigation ◽

Root Canals ◽

Atp Assay ◽

Root Canal Irrigation ◽

Average Fluorescence Intensity ◽

Different Diameters ◽

Average Fluorescence

Abstract Background This study aimed to compare the use of photon-initiated photoacoustic streaming (PIPS) and conventional needle irrigation (CNI) in conjunction with different concentrations of sodium hypochlorite (NaOCl) to remove Enterococcus faecalis (E. faecalis) suspended bacteria and biofilms from root canal systems with different diameters or tapers. Methods Artificial root canal samples (n = 480) were randomly divided into three groups (n = 160/group). The canals were prepared to fit file sizes #10/.02, #25/.02, or #25/.06. The size #10/.02 group was incubated for seven days. The size #25/.02 or #25/.06 group was incubated for 2 days. A stable biological model of E. faecalis infection was established. The root canals were washed with distilled water or with 1%, 2%, or 5.25% NaOCl combined with CNI or PIPS. Bacterial suspensions and biofilms were assessed using an ATP assay kit and fluorescence microscopy. Image-Pro Plus was used to analyse the average fluorescence intensity to determine the most suitable root canal irrigation solution. Results In the CNI and PIPS groups, the ATP value of the 5.25% NaOCl subgroup was the lowest, followed by that of the 2% and 1% NaOCl subgroups. The ATP value of the distilled water subgroup was the highest (P < 0.05). When the root canal taper was 0.02, the ATP value of the #10/.02 + PIPS group was significantly lower than that of the #25/.02 + CNI group (P < 0.05). The average fluorescence intensity of the #10/.02 + PIPS group was lower than that of the #25/.02 + CNI group (P < 0.05). When the apical diameter was #25, the ATP value of the 0.02 taper in the PIPS group was lower than that of the 0.06 taper in the CNI group (P < 0.05), and the average fluorescence intensity of the 0.02 taper + PIPS group was lower than that of the 0.06 taper + CNI group (P < 0.05). PIPS combined with 2% and 5.25% NaOCl effectively improved the long-term antibacterial effect after irrigation and re-culture for 6 h. Conclusions Compared with CNI, PIPS has greater ability to remove bacteria in root canals with a small preparation diameter and a small taper. PIPS with 2% and 5.25% NaOCl exhibited superior antibacterial and bacteriostatic effects.

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In vivo analysis of post space sealing with different adhesive materials

Journal of Applied Oral Science ◽

10.1590/s1678-77572003000300003 ◽

2003 ◽

Vol 11 (3) ◽

pp. 168-174 ◽

Cited By ~ 2

Author(s):

Carlos Alexandre Souza Bier ◽

José Antônio Poli de Figueiredo ◽

Álvaro Della Bona ◽

Patrícia Maria Poli Kopper ◽

José Roberto Vanni ◽

...

Keyword(s):

Root Canal ◽

Adhesive System ◽

Control Group ◽

Filling Material ◽

Root Canals ◽

India Ink ◽

Group A ◽

Provisional Restoration ◽

Post Space

This in vivo study analyzed the sealing ability of two adhesives in post spaces, cyanoacrylate (Super Bonder® - Henkel Loctite Adesivos Ltda., Itapevi, SP, Brazil) and ScotchbondTM Multi-Purpose (3M Dental Products, St. Paul, MN, USA), testing the hypothesis that their use would result in a decreased leakage through the remaining filling material. Forty extracted premolars (80 root canals) of dogs were used. The root canals were cleaned, shaped and filled by the lateral condensation technique using Sealer 26TM. The post space was created removing two thirds of the filling material within the root canal. The canals were randomly divided in three groups, which were treated as follows: Group A received the ScotchbondTM Multi-Purpose adhesive system; for Group B the cyanoacrylate adhesive, Super BonderTM, was employed; and no adhesive was applied into the post space for Group C (control group). A glass ionomer provisional restoration was placed allowing the sealer to set for 72 hours. Then the restoration was removed and the root canal was exposed to the oral environment for 45 days. The dogs were then killed and their jaws were removed. The post spaces were filled with India ink and the teeth were restored for 96 hours. Afterwards, the teeth were extracted and the roots were sectioned at the furcation for allocation to their specific groups. The teeth were turned transparent and the quantitative analysis of leakage was performed using light microscopy. The results showed no significant differences between groups, rejecting the initial hypothesis. Leakage occurred in a great extent in all specimens. Therefore, sealing post spaces with the adhesives used in this study was not an effective method to prevent microleakage.

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Endodontic Irrigants and Their Activation Efficacy on Cleansing Post-Space Root Canal Walls

Prosthesis ◽

10.3390/prosthesis3040036 ◽

2021 ◽

Vol 3 (4) ◽

pp. 406-414

Author(s):

Manuela Marchese ◽

Pontoriero I. K. Denise ◽

Edoardo Ferrari Cagidiaco ◽

Alfredo Iandolo ◽

Simone Grandini ◽

...

Keyword(s):

Root Canal ◽

Continuous Wave ◽

Smear Layer ◽

The Other ◽

X Rays ◽

Ultrasonic Activation ◽

Gutta Percha ◽

Bonding System ◽

Group A ◽

Group B

The aim of this study was to evaluate the efficacy of activated irrigants (EDTA e NaOCL) during the cleansing of root walls, of the smear layer, of the debris, and gutta-percha after the preparation of the restorative space. Twenty single and multi-rooted (n = 20) have been collected. All samples were prepared by the same operator, using Nickel-titanium rotating instruments (Mtwo) through the Simultaneous Shaping Technique. The continuous-wave of condensation technique of obturation was used. To all specimens, the restorative space has been made, leaving 5 mm of apical gutta-percha, and postoperative periapical X-rays were performed. The samples were randomly divided into two groups: Group (A): cleansing of the root walls with ultrasonic activation of the irrigants (NEWTRON P5 XS; Satelec Acteon); Group (B): radicular walls wash without ultrasonic activation of endodontic irrigants (NaOCl 5.25% and EDTA 17%). Both dental sample groups were cut longitudinally with a low-speed saw (Isomet); the samples were observed by using a scanning electron microscope (Jeol, Jsm-6060LV) in order to evaluate: (1) the amount of debris/smear layer; (2) the mount of obstruction of dentinal tubules found in the two groups; and (3) evaluation of the presence of gutta-percha. Then, the other five samples each group (with and without ultrasonic activation) were prepared following the same protocol. Then, a universal bonding system (G-Praemio Bond, GC) and a layer of a flowable resin composite (Gaenial Flow, GC) were light-cured and used on top of the prepared root canal walls. The samples were cut in two pieces along the long axis of the root. Then, half sample teeth were kept in an acidic solution (37% HCl) for 48 h in order to completely dissolve dental structures and to have a direct view of resin tags formation under SEM. The other half was prepared to observe the adhesive interface under SEM. The amount of debris was not satisfactory in 9 out of 10 cases in Group B, while in Group A, which has been treated with ultrasounds, the result was either good or great in most of the samples. For the sample group treated with ultrasound, the tubules were evaluated as perfectly clean in 9 out of 10 cases, instead, the results are unsatisfactory for 9 out of 10 cases of group B not treated with ultrasound. Differences between Group A and B were statistically significant. With respect to the presence of debris and tubules obstruction treatment with ultrasonic activation, it offers with no doubt better results. When ultrasonic activation is used in combination with endodontic irrigants, a clean dentin substrate is be obtained for the adhesion of restorative materials, but in order to confirm the findings of this study, further in vivo trials are needed.

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The Effectiveness of 2.5% NaOCl Irrigation and 17% EDTA against the Sealing Ability of Resin Paste

Conservative Dentistry Journal ◽

10.20473/cdj.v9i2.2019.105-108 ◽

2020 ◽

Vol 9 (2) ◽

pp. 105

Author(s):

Tamara Nitya A ◽

Nanik Zubaidah ◽

Moch Mudjiono

Keyword(s):

Root Canal ◽

Conventional Technique ◽

Control Group ◽

Canal Wall ◽

Canal Irrigation ◽

Gutta Percha ◽

Root Canal Irrigation ◽

Sealing Ability ◽

The Mean ◽

Apical Leakage

Background: Root canal irrigation seeks the elimination of bacteria and its products from the root canal. If debris is left in the root canal, it can prohibit adaptation between obturationmaterial and root canal wall. Therefore, it can decrease the sealing ability of obturation material. Purpose: To assess the effectiveness of 2.5% NaOCl and 17% EDTA on the apical sealing ability of resin obturation paste. Method: The roots of 18 human mandibular premolar teeth were selected and the root canal was prepared using a conventional technique. Samples were irrigated with 2.5% NaOCl, and17% EDTA, and sterile aquadest (Aqua Deastilata) as a control group. Samples were filled with gutta-percha and top seal. Samples were soaked in 2% methylene blue for 48 hours to measure the depth of microleakage. Result: The mean apical leakage after irrigation with 2.5% NaOCl; 17% EDTA; and sterile aquadest in the sequence were 0.92 mm; 3.6 mm; and 8.08 mm. Conclusion: 2.5% NaOClhas less depth of microleakage than 17% EDTA. However, the depth of microleakage cannot demonstrate the exact sealing ability of the resin paste due to some factors.

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