Smear Layer removal efficacy of different types of Irrigation Solutions with single file system: An in vitro SEM Study

Abstract

Aim: To compare the effectiveness of three different irrigating solutions (NaOCl+ EDTA, REMIX 2 IN 1, TWIN KLEEN) on the removal of smear layer with the single file system (XP-Endo Shaper) in mandibular premolars using a scanning electron microscope. Materials and Methods: Thirty-three human single-rooted mandibular premolar teeth were selected and decoronated to a standardized length. Biomechanical preparation was done with a single file system (XP-Endo Shaper) using 3% NaOCl as an irrigant during instrumentation. Three experimental groups were formed by randomly dividing teeth, with eleven teeth in each Group (n=11), and final irrigation was carried out using the following solutions; Group I - (control group) 5.25% Sodium Hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic (EDTA), Group II - REMIX 2 IN 1 solution (Neelkanth healthcare, India), Group III - freshly prepared TWIN KLEEN (Maarc dental, India) solution. The teeth were separated into two halves and observed under a scanning electron microscope at 3mm, 6mm, and 9mm from the apex to analyze the amount smear layer in 1000X and were evaluated using a 5-grade scoring system. Kruskal–Wallis test and Mann–Whitney U test were used to analyze the data. Results: On comparing the three different irrigating solutions, no statistically significant difference was found in the ability to remove the smear layer from the coronal and middle third's (P>0.05). Group I (1.14±0.68) and Group II (1.18±0.40) showed significantly higher removal of smear layer when compared to Group III (1.81±0.60) in the apical third. Conclusion: Sequential use of 5.25% NaOCl + 17% EDTA and REMIX 2 IN 1 solution were found to be the most efficient than TWIN KLEEN solution in removing the smear layer in the apical third of root canals instrumented with the single file system (XP-Endo Shaper).