A comparative scanning electron microscopy evaluation of smear layer removal with apple vinegar and sodium hypochlorite associated with EDTA

George Táccio De Miranda Candeiro,Cristiane Sá Roriz Fonteles,Mônica Sampaio Do Vale,Clarice Fernandes Eloy Da Costa,Isabela Barbosa De Matos

doi:10.1590/s1678-77572011000600016

George Táccio De Miranda Candeiro, Cristiane Sá Roriz Fonteles + Show 3 more

Open Access

https://doi.org/10.1590/s1678-77572011000600016

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Abstract

ObjectiveThe purpose of this study was to evaluate by scanning electron microscopy (SEM) the removal of smear layer from the middle and apical root thirds after use of different irrigating solutions. Material and MethodsForty roots of permanent human teeth had their canals instrumented and were randomly assigned to 4 groups (n=10), according to the irrigating solution: apple vinegar (group A), apple vinegar finished with 17% ethylenediaminetetraacetic acid (EDTA) (group B), 1% sodium hypochlorite (NaOCl) finished with 17% EDTA (group C) and saline (group D - control). After chemomechanical preparation, the roots were cleaved longitudinally and their middle and apical thirds were examined by SEM at ×1,000 magnification. Two calibrated examiners (kappa=0.92) analyzed the SEM micrographs qualitatively attributing scores that indicated the efficacy of the solutions in removing the smear layer from the surface of the dentin tubules (1 - poor, 2 - good and 3 - excellent). Data from the control and experimental groups were analyzed by the Kruskal-Wallis and Dunn's test, while the Wilcoxon test was used to compare the middle and apical thirds of the canals within the same group (α=0.05). ResultsThe middle third presented less amount of smear layer than the apical third, regardless of the irrigant. There was statistically significant difference (p=0.0402) among the groups in the middle third. In the apical third, the apple vinegar/EDTA group showed the greatest removal of smear layer (p=0.0373). ConclusionApple vinegar associated or not with EDTA was effective in removing smear layer when used as an endodontic irrigant.

Highlights

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Summary

INTRODUCTION

Sodium hypochlorite (NaOCl) is one of the PRVW ZLGHO\ XVHG HQGRGRQWLF LUULJDQWV IRU WKH chemomechanical preparation of root canals because of its excellent antimicrobial action and capacity of dissolving organic materials[15], ZKLFK LQFUHDVH GLUHFWO\ ZLWK WKH LQFUHDVH RI WKH concentration21 +RZHYHU WKH RSWLPDO RUJDQLF tissue-dissolving property of NaOCl is non-selective, ZKLFK PHDQV WKDW HVSHFLDOO\ DW KLJK FRQFHQWUDWLRQV this chemical agent may dissolve both vital and necrotic pulp remnants indistinguishably and have high toxicity to the periapical tissues in case of inadvertent extrusion through the apical foramen to the periradicular space[13] Another disadvantage of NaOCl is that it decreases the mechanical resistance of dentin[15,22] by causing deterioration of. The high biocompatibility of apple vinegar is mainly attributed to the high concentration of malic acid in its composition[2]

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