Abstract
This study evaluated the effectiveness of a highly flexible endodontic brush made of polypropylene canal brush (CanalBrush; Coltène) on smear layer removal from the canal walls when used according to the manufacturer's recommendations. Forty-four single-rooted mandibular incisors were prepared to apical size 30/0.06 and randomly divided into three groups A, B and C, where the final irrigation regimen was 10 mL 17% EDTA and 10 mL 2.5% NaOCl for group A, 10 mL EDTA, 5 mL NaOCl, CanalBrush for 20 s at 450 rpm and 5 mL NaOCl for group B, 10 mL NaOCl, CanalBrush and 10 mL NaOCl for group C. One medium-sized CanalBrush was used for each root canal and all brushes were examined under the optical microscope after application to evaluate bristle deformation. Afterwards, roots were split longitudinally and the presence of smear layer was evaluated under a scanning electron microscope. Used brushes invariably exhibited bristle deformation. Group C exhibited the highest means of smear layer in all thirds. Comparing the apical thirds in all groups, there was no statistical difference between groups A and B (3.64 ± 0.48 and 3.68 ± 0.62 respectively), while group C exhibited significantly higher scores (3.9 ± 0.28) than the other two groups. In conclusion, the CanalBrush proved unable to remove smear layer from the instrumented root canals, when used according to the manufacturers' instructions.
Highlights
Endodontic treatment aims at eliminating or critically reducing the microbial load of root canal system and at removing inorganic remnants and organic tissues, which constitute a potential nutrient for microorganisms
Bristle deformation All used CanalBrushes invariably exhibited bristle deformation (Fig 2); during the SEM examination no residues of those bristles were detected on the canals walls and no crushing was noticed
The results of the present study did not show any improvement in smear layer removal when the CanalBrush was used according to the manufacturer’s
Summary
Endodontic treatment aims at eliminating or critically reducing the microbial load of root canal system and at removing inorganic remnants and organic tissues, which constitute a potential nutrient for microorganisms. This goal is reached by chemomechanical preparation, i.e instrumentation and irrigation. Instrumentation, though, produces a 1-5 μm thick smear layer on the dentinal surface, consisting of dentin, predentin, pulpal remnants, odontoblast processes, irrigant remnants and bacteria, in infected teeth [1,2,3,4,5]. Several materials and methods have claimed to be successful in smear layer removal, such as chelating agents (EDTA, citric acid, etc), lasers, sonic and ultrasonic devices, all of them with conflicting results [6,12,13,14,15,16,17]
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