The effect of pH of the sodium hypochlorite on smear layer removal

Introduction. Canal irrigation is an important segment of endodontic treatment. The aim of this study was to assess the efficacy of 0.5% NaOCl solutions of different pH values on smear layer removal. Material and Methods. Thirty-two freshly extracted single rooted teeth with gangrenous pulp were used in the study. The samples were divided into four groups of eight teeth in each. Four solutions of 0.5% NaOCl having pH values 5, 7, 9 and 12 respectively, were used during chemomechanical instrumentation with hand instruments and using step back technique. SEM analysis was done to assess the quality of smear layer removal in apical, middle and coronal part of root canal. Presence and quantity of smear layer and detritus was quantified using the scale from 1 to 5. Results. SEM analysis results showed similar results for 0.5% NaOCl solutions of different pH values in root canal cleaning with no statistically significant differences. Conclusion. The most effective cleaning root canal was achieved with 0.5% NaOCl solution of pH 5.

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An In Vitro Evaluation Study of the Geometric Changes of Root Canal Preparation and the Quality of Endodontic Treatment

International Journal of Dentistry ◽

10.1155/2020/8883704 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Svetlana Razumova ◽

Anzhela Brago ◽

Ammar Howijieh ◽

Haydar Barakat ◽

Ashot Manvelyan ◽

...

Keyword(s):

Root Canal ◽

Endodontic Treatment ◽

Smear Layer ◽

Apical Region ◽

Root Canal Preparation ◽

Layer Removal ◽

Mechanical Preparation ◽

Geometric Changes

Introduction. The geometry of root canals differs in different parts, especially in the apical region, and it is affected by different preparation techniques. The aim of this study was to evaluate the geometric changes of root canal preparation by general dentists regardless of the endodontic instrumentation systems and to study the quality of endodontic treatment by evaluating the untouched areas after mechanical preparation and the smear layer removal. Materials and Methods. 100 extracted maxillary canines were collected for the in vitro study from 10 dentists, and the dentists were asked to treat the teeth endodontically. The teeth then were separated and examined under an optical microscope to evaluate the root canal final diameter and the untouched areas. Then, the teeth were examined under a scanned electronic microscope to evaluate the smear layer in coronal, middle, and third parts of the canal. Statistical significance was set as P<0.05. Results. The mean diameter of the root canal after instrumentation in the coronal and middle thirds was 2.50 ± 1.12 and 1.75 ± 1.24 mm, respectively, and the untouched area percentage observed in the apical thirds was 71%. For smear layer removal, it was better in the coronal and middle thirds than in the apical (P<0.05). Conclusion. The changes in the diameter of the root canal, the percentage of untouched areas after mechanical preparation, and the percentage of smear layer were observed in a higher percent in the apical third than in the coronal and middle thirds, and this raises the question of changing the technique of processing the root canal, especially in the apical third.

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Time-dependent effects of chitosan on dentin structures

Brazilian Dental Journal ◽

10.1590/s0103-64402012000400008 ◽

2012 ◽

Vol 23 (4) ◽

pp. 357-361 ◽

Cited By ~ 20

Author(s):

Polliana Vilaça Silva ◽

Débora Fernandes Costa Guedes ◽

Jesus Djalma Pécora ◽

Antonio Miranda da Cruz-Filho

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Sem Analysis ◽

Smear Layer ◽

Time Dependent ◽

Successful Outcome ◽

Maxillary Canine ◽

Layer Removal ◽

Severe Erosion ◽

Erosive Effect

Complete debridement with smear layer removal are essential measures for achieving a successful outcome of root canal treatment. The aim of this study was to evaluate the effects of chitosan at different concentrations on the removal of the smear layer and on dentin structure after 3 and 5 min of application. Twelve recently extracted maxillary canine teeth were instrumented using the crown-down technique and irrigated with 1% sodium hypochlorite. The specimens were distributed according to the time and concentration of the final irrigating solution: G1: 0.1% chitosan for 3 min; G2: 0.2% chitosan for 3 min; G3: 0.37% chitosan for 3 min; G4: 0.1% chitosan for 5 min; G5: 0.2% chitosan for 5 min; G6: 0.37% chitosan for 5 min. All samples were prepared for SEM analysis. G1 exhibited removal of the smear layer, but not the smear plugs. G2 showed visible and open tubules with slight erosion of the peritubular dentin. Cleaning in G3 was similar to that in G2, however, the erosive effect was greater. There was expansion of the diameter of the tubules in G4; and in G5 and G6, there was severe erosion with deterioration of dentin surface. In conclusion, 0.2% chitosan for 3 min appeared to be efficient for removing the smear layer, causing little erosion of dentin.

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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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Smear layer removal capacity of disinfectant solutions used with and without EDTA for the irrigation of canals: a SEM study

Pesquisa Odontológica Brasileira ◽

10.1590/s1517-74912003000400010 ◽

2003 ◽

Vol 17 (4) ◽

pp. 349-355 ◽

Cited By ~ 13

Author(s):

Ana Carolina Silveira Cardoso de Menezes ◽

Caio Gorgulho Zanet ◽

Márcia Carneiro Valera

Keyword(s):

Root Canal ◽

Saline Solution ◽

Sem Analysis ◽

Smear Layer ◽

Electron Microscopic ◽

Significance Level ◽

Layer Removal ◽

Root Canals ◽

Removal Capacity ◽

Group 5

The purpose of this study was to carry out a scanning electron microscopic (SEM) analysis of the cleaning qualities and smear layer removal from root canal walls, instrumented and irrigated with 2.5% NaOCl, 2.0% chlorhexidine and saline solutions. Fifty extracted teeth were used in this study. All teeth were radiographed to determine the existence of a single canal. The crowns were cut at the cervical limit and the root canals were instrumented with K-type files up to size 45. During root canal preparation, irrigations were made with the different solutions being evaluated: Group 1: 2.5% NaOCl (10 roots); Group 2: 2.5% NaOCl and 17% EDTA for 2 minute (10 roots); Group 3: 2.0% chlorhexidine (10 roots); Group 4: 2.0% chlorhexidine and 17% EDTA for 2 minutes (10 roots); Group 5: saline solution (5 roots); Group 6: saline solution and 17% EDTA for 2 minutes (5 roots). After instrumentation, the canals were irrigated with each one of the solutions and the roots were cut in the buccolingual direction for SEM analysis, at the cervical, middle and apical thirds, to ascertain the presence or absence of smear layer and debris. SEM analysis was performed by three calibrated examiners and scores were submitted to Kruskal-Wallis test at the significance level of p = 5%. Results showed that the use of 17% EDTA decreased the smear layer significantly (p < 0.05) for all evaluated solutions in all thirds. When EDTA was not used, a significantly higher quantity of smear layer on the apical third was observed only in the NaOCl groups. The use of 17% EDTA was significant for debris removal except for the chlorhexidine groups. The following conclusion could be drawn: the use of 17% EDTA was necessary to enhance cleanness of the root canals.

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Comparison Between Different Endodontic Irrigating Protocols In Smear Layer Removal From Radicular Dentin

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n15p38 ◽

2016 ◽

Vol 12 (15) ◽

pp. 38

Author(s):

Ramona Vlad ◽

Monika Kovacs ◽

Dragos Sita ◽

Mihai Pop

Keyword(s):

Root Canal ◽

Endodontic Treatment ◽

Smear Layer ◽

Friedman Test ◽

Cleaning Efficiency ◽

Layer Removal ◽

Significant Difference ◽

System Data ◽

Root Canal Dentin ◽

Level Of Significance

The aim of our study was to measure the cleaning efficiency of irrigating solutions used during endodontic treatment regarding smear layer removal from the root canal dentin walls. Ethylenediaminotetraacetic acid (EDTA) 17%, citric acid (CA) 10% and sodium hypochlorite (NaOCl) 2,5 % solutions were tested as final irrigating solutions. The study was conducted on extracted teeth, divided in four groups according to the irrigation protocol used. The specimens were analyzed by scanning electron microscopy and the amount of smear layer present at apical, middle and coronal level was recorded, based on a scoring system. Data were statistically analyzed using Kruskal-Wallis and Friedman test and the level of significance was set at p<0.05. In the coronal and middle segments of dental roots we noticed no statistically significant difference between EDTA and CA in smear layer removing capacity. Final irrigation with 17% EDTA proved to be more efficient than 10% CA and 2,5% NaOCl in smear layer removal at apical level of the root canal, with p<0.05 (p=0.042), which is an important area for disinfection in endodontic treatment.

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Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry

Journal of Veterinary Dentistry ◽

10.1177/0898756420918700 ◽

2020 ◽

Vol 37 (1) ◽

pp. 35-40

Author(s):

Laura Sasser

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Ethylenediaminetetraacetic Acid ◽

Endodontic Treatment ◽

Smear Layer ◽

Canal System ◽

Root Canal Therapy ◽

Complex Anatomy ◽

Root Canal System ◽

Necrotic Debris

Pulp debridement and disinfection in the pulp cavity is a critical step in achieving a successful root canal therapy. Microorganisms remaining in the root canal system after endodontic treatment are a main cause of root canal failure. The challenges faced in endodontic disinfection include the complex anatomy of the root canal system, the existence of a biofilm within the root canal, and the creation of a problematic smear layer during instrumentation of the canal. Historically, sodium hypochlorite and ethylenediaminetetraacetic acid have been utilized as irrigants and still remain as the most effective disinfectants due to their synergistic abilities to eradicate microorganisms, dissolve necrotic debris, and remove the smear layer and biofilm. This article addresses challenges in endodontic disinfection, objectives of endodontic irrigants, properties of an ideal irrigant, currently used irrigants, and irrigant delivery systems utilized in veterinary dentistry.

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The Effect of Chitosan Nanoparticle as A Final Irrigation Solution on The Smear Layer Removal, Micro-hardness and Surface Roughness of Root Canal Dentin

The Open Dentistry Journal ◽

10.2174/1874210602014010019 ◽

2020 ◽

Vol 14 (1) ◽

pp. 19-26

Author(s):

Diatri Nari Ratih ◽

Raras Ajeng Enggardipta ◽

Aqilla Tiara Kartikaningtyas

Keyword(s):

Surface Roughness ◽

Root Canal ◽

Chitosan Nanoparticles ◽

Lower Surface ◽

Smear Layer ◽

Micro Hardness ◽

Canal Irrigation ◽

Layer Removal ◽

Root Canal Irrigation ◽

Root Canal Dentin

Background: Root canal irrigation is one of the most important stages during root canal treatment. One of the requirements of root canal irrigation material is that it can eradicate the smear layer but does not alter the physical properties of the root canal dentin. Objective: To investigate the effect of chitosan nanoparticle as a final irrigation solution on the smear layer removal, micro-hardness and surface roughness of root canal dentin. Methods: Seventy-two premolars used in this study and divided by three evaluations, namely smear layer removal, micro-hardness and surface roughness. Each study used 24 teeth and was assigned randomly into three groups of eight teeth. Group-1, final irrigation with 17% EDTA; group-2, with 0.2% chitosan nanoparticles; group-3, with 2.5% NaOCl. Specimens were evaluated for smear layer removal, micro-hardness and surface roughness using a Scanning Electron Microscope, Vickers hardness tester and surface roughness measuring instrument, respectively. Data obtained from smear layer removal evaluation were statically analyzed using Kruskal-Wallis and Mann-Whitney U and data from micro-hardness and surface roughness were analyzed using one-way ANOVA and Tukey’s test. Results: Final irrigation using 0.2% chitosan nanoparticles produced similar smear layer removal than 17% EDTA (P>0.05), but it was greater than 2.5% NaOCl (P<0.05). Chitosan had higher micro-hardness and lower surface roughness than EDTA (P<0.05), but it was the same as 2.5% NaOCl (P>0.05). Conclusion: Final irrigation using 0.2% chitosan nanoparticles had the same effect on smear layer removal compared to 17% EDTA; however, 0.2% chitosan produced higher micro-hardness and lower surface roughness of root canal dentin than 17% EDTA.

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In Vitro Evaluation of Different Irrigation Protocols on Intracanal Smear Layer Removal in Teeth with or without Pre-Endodontic Proximal Wall Restoration

Journal of Clinical Medicine ◽

10.3390/jcm9103325 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3325

Author(s):

Naji Kharouf ◽

Eugenio Pedullà ◽

Giusy Rita Maria La Rosa ◽

Frédéric Bukiet ◽

Salvatore Sauro ◽

...

Keyword(s):

Root Canal ◽

Resin Composite ◽

Smear Layer ◽

Canal Irrigation ◽

Layer Removal ◽

Apical Level ◽

Root Canal Irrigation ◽

Significant Difference ◽

Sonic Activation

To investigate the influence of pre-endodontic coronal wall restoration on smear layer removal during different root canal irrigation strategies, single-root premolars were prepared with a mesio-occlusal cavity. Half were left untreated (G1), while the mesial walls of the remaining half were reconstructed using a resin composite (G2). The specimens were divided into control (ctrl) groups, which used the conventional needle irrigation method, and four experimental subgroups according to irrigation strategy: Sonic activation using the Endoactivator, sonic activation using the EQ-S, mechanical activation using the XP-Endo finisher, and ultrasonic activation using the EndoUltra. Smear layer removal was assessed through SEM and the results were statistically analyzed. At the coronal and middle thirds, no significant difference (p > 0.05) was detected for G1 and G2, except for the control subgroups (G1ctrl vs G2 ctrl) at the middle third. At the apical third, the smear layer removal was significantly greater for G2 than G1. In G1, both at the middle and apical level, EQ-S and EndoUltra showed greater smear layer removal (p < 0.05) compared to the others G1 subgroups. In G2, at the apical level, the EQ-S and EndoUltra were the most effective in smear layer removal. Pre-endodontic coronal wall restoration may improve the smear layer removal during 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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Efficiency of XP Endo Shaper (XPS) and Irrigation Protocol on the Quality of Cleaning the Apical Third of Root Canal: SEM Study

Balkan Journal of Dental Medicine ◽

10.2478/bjdm-2019-0006 ◽

2019 ◽

Vol 23 (1) ◽

pp. 31-35

Author(s):

Slavoljub Živković ◽

Milica Jovanović-Medojević ◽

Jelena Nešković ◽

Marijana Popović Bajić ◽

Marija Živković Sandić

Keyword(s):

Cross Section ◽

Root Canal ◽

Sem Analysis ◽

Smear Layer ◽

Apical Segment ◽

Continuous Irrigation ◽

Sem Study ◽

Intermittent Irrigation ◽

Apical Area

SummaryBackground/Aim: The aim of this study was to evaluate the efficacy of new rotary NiTi instrument XP- endo SHAPER (XPS) used with two irrigation protocols on the root canal cleaning in the apical area.Material and Methods: The research was conducted on 30 single-rooted teeth extracted for orthodontic reasons which were divided into the two groups. Instrumentation of the canals was conducted with XPS instrument and 2% solution of NaOCl was used as irrigant. Instrumentation in the first group was performed using a conventional continuous irrigation, in the second group, protocol of final irrigation was performed intermittently in 3 cycles. The SEM analysis of the apical third of the canal was performed on longitudinal root cross-section standardized photomicrography with a magnification of 2000X.Results: Results showed that a thicker smear layer was observed in the first group and with continuous irrigation protocol (2,10) in relation to the intermittent irrigation protocol in 3 cycles (1,96), but without significant differences.The walls of the root canal in the apical third of the samples of the second group were slightly cleaner (73.3%) in comparison with the teeth of the first group (64, 7%), but also without significant differences.Conclusions: The use of XPS and 2% solution of NaOCl in the root canal enables efficient cleaning of the apical third of tooth. The final irrigation protocol in three cycles improves the efficiency of the smear layer removal in the apical segment of the canal.

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