Comparative evaluation of ethylenediaminetetraacetic acid, maleic acid, and peracetic acid in smear layer removal from instrumented root canal system: A scanning electron microscopic analysis study

Abstract

Introduction: The aim of this study was to assess the ability of 7% maleic acid, 0.5% peracetic acid (PAA), and 17% ethylenediaminetetraacetic acid (EDTA) in removing smear layer from root canal system of human teeth using scanning electron microscopic analysis (SEM). Materials and Methods: Thirty-five non-carious human anterior teeth with single roots were selected for the study. Chemo-mechanical preparation was done using crown down technique with irrigation of 2.5% NaOCl after every instrument use. Depending on the final irrigation solution, the samples were divided randomly into three experimental groups and one control group: (1) The maleic acid group: 07% (n = 10), (2) the PAA group: 0.5% (n = 10), (3) the EDTA group: 17% (n = 10), and (4) the control group: 0.9% saline (n = 5). These teeth were then evaluated using SEM analysis for the absence or presence of smear layer, thereby analyzing their cleaning effectiveness in the coronal, middle, and apical thirds of the root canal system. The inter examiner's reliability was verified with the use of Kappa test. The data of the score for intragroup comparison and intergroup comparison for evaluation of the presence or absence of smear layer were statistically analyzed by Pearson Chi-square test. The level of statistical significance was set at P Results: In the coronal thirds of the root canal, there was no statistically significant difference between the EDTA and the maleic acid groups when evaluated for their efficacy at smear layer removal. Whereas, maleic acid performed significantly better than PAA and EDTA in removing smear layer from middle and apical thirds of the root canal system. Conclusion: A final irrigation with 7% maleic acid is more efficacious than 17% EDTA and 0.5% PAA when used as a smear layer removal agent in the apical third of the root canal system.