Effects of rotary instruments and ultrasonic irrigation on debris and smear layer scores: a scanning electron microscopic study.

Abstract

This study evaluated debris and smear layer scores after two types of instruments manufactured from different alloys were used to ultrasonically activate irrigants during canal preparation. The influence of two rotary preparation techniques on cleanliness of the shaped canals was also studied. Apical stops were prepared to size 45 in 42 single-canalled extracted premolars and canines, which were divided into six equal groups. Groups 1, 2 and 3 were prepared by ProFile.04 (PF) while groups 4, 5 and 6 were prepared by Lightspeed (LS). All groups were irrigated using 5.25% NaOCl and 17% EDTA. Irrigants in groups 2 and 5 were ultrasonically activated using a size 15 steel K-file and by a blunt flexible nickel-titanium wire in groups 3 and 6. Groups 1 and 4 served as negative controls. Roots were split and canal walls examined at 15x, 200x and 400x magnification in an SEM. Smear layer and debris scores were recorded at 3, 6 and 9 mm levels using a 5-step scoring scale and a 200- micro m grid. Means were tested for significance using nonparametric Mann-Whitney U and Kruskal-Wallis tests. Debris and smear layer scores for the six groups varied from 1.98 +/- 1.04 to 3.47 +/- 0.97 and from 1.37 +/- 0.4 to 2.36 +/- 0.99, respectively. Although all groups had significantly higher smear layer and debris scores at the 3 mm levels compared to the 9 mm levels (P < 0.05), no significant differences were recorded due to the ultrasonic energy transmitted by the two alloys. Ultrasonically activated irrigants did not reduce debris or smear layer scores. This finding was not influenced by the material nor by the design of the instrument used to transmit ultrasonic activation.