Smear Layer Removal Research Articles

Cerium- and samarium-nitrate interaction and accumulation on human dentin

ObjectiveTo investigate the accumulation of cerium-nitrate and samarium-nitrate on dentin without or with smear-layer and to test their antibacterial activity. Design24 dentin-enamel slices were cut from 24 extracted molars. 12 slices underwent smear-layer creation (320 grit, 200 g, 5 s), the other 12 smear-layer removal (20 % EDTA, 300 s). Slices were halved to 48 semilunar-shaped specimens. One specimen per tooth was treated with either Ce(NO3)3 (50 wt% aqueous solution; pH = 1.29; n = 6) or Sm(NO3)3 (50 wt% aqueous solution; pH = 1.88; n = 6). The other specimen served as control (A. demin). After water rinsing, elemental composition (Ce, Sm, Ca, P, O, N, Na, Mg, C) was measured (EDX; EDAX Octane-Elect, APEX v2.5, low-vacuum) in dentin. Atomic percent (At%), Ca/P- and Ca/N-ratios were calculated and analyzed non-parametrically (α = 0.05, error rates method). Additionally, antibacterial activity (2 min exposure) of Ce(NO3)3 and Sm(NO3)3 against Streptococcus mutans, Actinomyces naeslundii, Schaalia odontolytica, and Enterococcus faecalis was determined (colony forming units) after anaerobic incubation at 37 °C for 24 h (control: 0.2 % CHX). ResultsAt% (median) of Ce and Sm were as follows: Ce(NO3)3 3.4 and 0.9 At%Ce with and without smear-layer, respectively; Sm(NO3)3 2.4 and 1.3 At%Sm with and without smear-layer, respectively. Ce(NO3)3 and Sm(NO3)3-application significantly decreased Ca/P-ratios (1.22 – 1.45; p ≤ 0.02) compared to controls (1.47 – 1.63). With smear-layer, significantly higher Ca/N-ratios (5.1 – 29.3) could be detected across all groups (p ≤ 0.004) compared to specimens without smear-layer (0.37 – 0.48). Ce(NO3)3 and Sm(NO3)3 showed reduction rates of up to ≥ 5 log10 steps for S. mutans, A. naeslundii, and S. odontolytica. ConclusionsCerium and samarium nitrate showed accumulation on dentin and certain antibacterial activity and could therefore be identified as potential compounds to treat and prevent dentin and root caries and dentin hypersensitivity.

Evaluation of smear layer and Ca/P ratio in intra-radicular dentine irrigated with different irrigants adjunct with diode laser

BackgroundThis study aims to determine the smear layer removal from the root canals using different irrigant solutions with diode laser.MethodsA set of sixty human upper incisor teeth were chosen. Access cavity preparation was done followed by canal instrumentation. Samples were divided into six groups (Group A: sodium hypochlorite NaOCl, Group B: NaOCl + diode laser, group C: NaOCl + EDTA ethylene diamine tetra-acetic acid solution, Group D: NaOCl + EDTA + diode laser, Group E: NaOCl + garlic extract, Group F: NaOCl + garlic extract + diode laser. Examining the smear layer removal at the coronal, middle and apical thirds of the root canals was done by using electron microscope analysis. Using an energy-dispersive X-ray, the calcium/phosphorus Ca/P ratio was measured.ResultsAmong the examined groups, there were not any significant differences regarding the smear layer removal. The elimination of smear layers at the middle and coronal thirds was greater in all examined groups than in the apical third. EDX analysis revealed no statistically significant variation between the tested groups.ConclusionsUsing diode laser with sodium hypochlorite and ethylene diamine tetra-acetic acid irrigant solution was more effective for the elimination of smear layers. Garlic extract could be used as an alternative irrigant solution in debris removal.

Assessment of Smear Layer Removal and Push-Out Bond Strength Efficacy of Traditional and Herbal Root Canal Irrigants Across Different Root Levels: An In Vitro Study.

Endodontic therapy requires meticulous root canal debridement, pathogen elimination, and effective obturation to prevent microbial intrusion. The presence of the smear layer hinders sealer penetration, compromising sealing effectiveness. Sodium hypochlorite and chlorhexidine are esteemed endodontic irrigants. Herbal extracts like neem and tulsi, with antimicrobial and anti-inflammatory properties, show promise for root canal irrigation. The study aimed to evaluate the efficacy of various irrigants in removing the smear layer and enhancing push-out bond strength at different root canal levels. One hundred mandibular premolars with single canals were collected, and 50 samples each were used for the smear layer and push-out bond strength analysis. Neem and tulsi extracts were prepared for irrigation. Teeth were decoronated, and up to 30 (6%) canals were prepared and were randomly divided into five groups based on irrigants used. A smear layer examination was conducted after longitudinally sectioning the tooth and sections were observed in a scanning electron microscope (SEM). Obturation was done in the remaining samples, and the push-out bond strength was assessed using a universal test machine. Sodium hypochlorite showed the highest smear layer removal efficacy followed by chlorhexidine, neem, tulsi leaves with rose water extract, and normal saline. Chlorhexidine exhibited the highest push-out bond strength, with the coronal third presenting the strongest values, followed by neem, tulsi with rose water, normal saline, and sodium hypochlorite. The study underscores the potential of herbal irrigants in endodontic therapy, indicating promising results while emphasizing the necessity for further clinical trials to validate their efficacy and other properties.

Evaluation and comparison of the efficiency of ultrasonically activated intracanal irrigants grapeseed and pineapple extract in removing smear layer from the apical third of the root canal: An in vitro SEM analysis

ABSTRACT Aim: This study aims to evaluate and compare the efficiency of grapeseed and pineapple extract in removing smear layer from the apical third of root canal, with and without ultrasonic activation. Methods: Eighty single-rooted permanent teeth were divided into two main groups: Group I: conventional syringe irrigation and Group II: ultrasonic activation. Each group was subdivided into two experimental groups, i.e. grapeseed and pineapple extract and one control group, i.e., 17% ethylenediaminetetraacetic acid (EDTA). For each subgroup, instrumentation was done using ProTaper Gold up to size F3 and irrigated with 5 mL of the respective irrigant, followed by a final rinse of 2.5 mL of 5.25% NaOCl. For Group II, the respective irrigant was ultrasonically activated for 1 min, followed by a final rinse of 2.5 mL of 5.25% NaOCl. Smear layer evaluation was done with scanning electron microscope, and data were statistically analyzed. Results: In Group I, both pineapple and grapeseed extracts were more effective than 17% EDTA in removing smear layer from the apical root canal. However, in Group II, 17% EDTA showed highest efficacy in smear layer removal, followed by pineapple and grapeseed extracts (P < 0.05). Conclusion: Natural extracts such as pineapple and grapeseed seeds extracts exhibit potential for smear layer removal in the apical third, without the disadvantage of dentinal erosion from synthetic smear layer removing agents.

Effectiveness of EndoActivator, PATS Vario system, and XP-endo Finisher files on smear layer removal under scanning electron microscope: A comparative study.

The smear layer may harbor many bacteria; hence, alternative methods are used to disrupt and remove biofilm. The aim of the study was to compare the effectiveness of EndoActivator, PATS Vario System, and XP-endo Finisher files on smear layer removal using a scanning electron microscope. Sixty single-rooted extracted premolars with Vertucci Type 1 configuration were decoronated and divided into four groups. The groups were instrumented with the rotary ProTaper file system. All specimens were flushed with 1 ml of 3% sodium hypochlorite. Group 1 was irrigated with a conventional needle and syringe. In Group 2, the irrigant was activated with an EndoActivator. In Group 3, the irrigant was activated with PATS Vario system, and in Group 4, XP-endo Finisher files were used after biomechanical preparation to remove debris and smear layer. All specimens were finally rinsed with 3 ml of 3% sodium hypochlorite. The teeth underwent longitudinal splitting and grooving in the coronal, middle, and apical thirds, and then, the samples were taken for scanning electron microscopy to evaluate the amount of smear layer removal in each third. The middle and coronal thirds Showed that almost similar efficacy to remove smear layer in both Group II and Group III. At the apical third, Group III showed comparatively better results than Group I, II, and IV, respectively. Equal amount of smear layer was seen with EndoActivator and PATS Vario system when used as sonic irrigation devices.

The Efficacy of Nano Magnesium Oxide and Nano Silver Fluoride on Canal Cleanliness and Smear Layer Removal (An In Vitro Study).

The Efficacy of Nano Magnesium Oxide and Nano Silver Fluoride on Canal Cleanliness and Smear Layer Removal (An In Vitro Study).

Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study.

The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of p < 0.05. At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels (p < 0.001). In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group. With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, et al. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.

Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study.

The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth. For the study, 90 extracted primary maxillary incisors without internal or external resorption and with at least two-thirds of complete roots were chosen. Then, based on the kind of instruments used to clean and shape the canals, they were randomly assigned to three experimental groups, each consisting of 30 teeth. Group-I: The canal was instrumented manually with K-files, Group-II: The canal was instrumented with Kedo-S files, Group-III: The canal was instrumented with Kedo-SG Blue files. After the canals were finally instrumented, 2 mL of QMixTM solution was used to irrigate 15 samples from each group. The samples were subsequently allowed to remain in the canals for 90 seconds in order to eliminate the smear layer. After that a stereomicroscope was used to assess the cleaning effectiveness. With irrigant solution, the highest mean value was found in manual K-files (2.86 ± 0.34), followed by Kedo-S files group (1.34 ± 0.26) and Kedo-SG Blue files (1.28 ± 0.18). Without irrigant solution, the highest mean value was found in manual K-files (2.92 ± 0.22) followed by Kedo-S files group (1.44 ± 0.18) and Kedo-SG Blue files (1.36 ± 0.14). There was a statistically significant difference found at all the three levels. On conclusion, the current study's findings demonstrated that irrigation solution was significantly more effective in cleaning and removing smear layers from pediatric rotary files than manual K-files. The effectiveness of endodontic therapy depends on a successful chemomechanical preparation. The canals are instrumented using either hand files or rotary instruments; there are several irrigation and instrumentation techniques. In order to completely sterilize the canals, chemical agents are utilized for irrigation during instrumentation. Due to their numerous biological, antibacterial, anti-inflammatory, and antioxidant qualities, many natural compounds are also utilized as irrigants. How to cite this article: Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):354-357.

Qualitative and Quantitative Evaluation of the Effects of Different Chelating Agents on the Calcium Content of Root Canal Dentin Using Atomic Absorption Spectrophotometer: An In Vitro Study.

Evaluation of the effects of different chelating agents on the calcium loss of root canal dentin. Around 65 single-rooted teeth were collected and decoronated. The working length was determined, and biomechanical preparation was done in a crown-down fashion using the HyFlex Control Memory rotary nickel-titanium (Ni-Ti) system until apical preparation of 30.04. Canals were irrigated with chelating agents and sodium hypochlorite between each file insertion. Based on the type of chelating agents used, the samples were randomly divided into five groups (n = 13)-group I, liquid ethylenediaminetetraacetic acid (EDTA); group II, EDTA and chlorhexidine (CHX); group III, etidronic acid; group IV, SmearClear; and group V (control), distilled water. The total volume of the solution used was collected, and calcium ion release was quantified using an atomic absorption spectrophotometer. The qualitative analysis was done by observing the acetylene (C2H2)/air flame. Images were obtained for each sample, compared, and analyzed. With respect to the control group, groups IV and I show a statistically significant difference compared to groups II and III (p < 0.05). Qualitatively, the highest intensity was observed in group IV and the least intensity in group III. SmearClear showed significantly higher decalcifying capability compared to EDTA, EDTA and CHX, and etidronic acid. Hence, its combined use with an organic solvent can be recommended for efficient smear layer removal. Minimally invasive endodontic treatment is aimed at preserving the strength of the treated tooth without compromising cleaning effectiveness. Therefore, comparing the efficacy of different chelating agents will be promising with respect to maximum calcium loss both qualitatively and quantitatively. Singhal P, Raisingani D, Prasad AB, et al. Qualitative and Quantitative Evaluation of the Effects of Different Chelating Agents on the Calcium Content of Root Canal Dentin Using Atomic Absorption Spectrophotometer: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(6):647-652.

Water-soluble vitamin-E for enhancing fluorescence diagnosis in infected human dentine treated with NaOCl

IntroductionBacterial fluorescence methods are of interest in endodontics for informing endpoints for debridement. This study explored potential fluorescence quenching reversal effects of a water-soluble vitamin E conjugate (d-α-Tocopherol polyethylene glycol 1000 succinate, TPGS) when applied to polymicrobial biofilms grown on dentine that had been exposed to sodium hypochlorite (NaOCl) to cause quenching. MethodExtracted human teeth were debrided, embedded in transparent acrylic resin and sectioned. After smear layer removal, tooth dentine sections were inoculated with a polymicrobial inoculum, and cultured for 7 days to create biofilms. Samples (n = 8 per group) were exposed to 1 % or 4 % NaOCl for 2 or 4 min, and then treated with TPGS. Bacterial fluorescence readings under laser excitation at 655 nm were assessed over 10 min using a calibrated DIAGNOdent device. All data were assessed for normality (Kolmogorov-Smirnov test) and analysed with ANOVA followed by Bonferroni post-hoc tests. ResultsNaOCl at both concentrations quenched fluorescence readings of biofilms grown on dentine samples, with a maximal reduction of 40.4 % at 5 min after 4 % NaOCl. Treatment with TPGS gave faster recovery of fluorescence readings compared to the control at 5 and 10 min. ConclusionThe water-soluble antioxidant TPGS partially reversed fluorescence quenching caused by NaOCl. This agent may have value clinically for reducing the time needed for fluorescence readings to recover when NaOCl is used as an irrigant. This will facilitate more accurate assessment of endpoints for canal debridement.

Comparative Evaluation of Ultrasonic and Sonic Irrigant Activation Systems: Assessing Extrusion Risk, Debridement, and Biofilm Removal in Distinct Apical Preparation Sizes

This study aims to compare the effectiveness of ultrasonically and sonically activated irrigation in terms of extrusion risk, root canal debridement, and biofilm removal, considering distinct apical preparation sizes, through an ex vivo study in human teeth. Instrumented teeth, to an apical size of 35/.06 or 50/.06, were assigned to three different irrigation procedures: ultrasonically activated irrigation, sonically activated irrigation, and conventional manual irrigation. Apical extrusion risk was evaluated by quantifying irrigant and debris extrusion (n = 10/group). Debris evaluation and smear layer removal from the root canal wall were conducted by scanning electron microscopy (SEM) (n = 5/group), and the elimination of a mature biofilm of Enterococcus faecalis was assessed through resazurin assay and SEM (n = 10/group). For statistical analyses, Student’s paired t-test and the ANOVA with post-hoc Tukey were used. Activated irrigations exhibited a higher risk of extrusion for the larger apical size, while the risk for manual irrigation remained independent of the apical size. Substantially fewer residual debris and smear layers were observed after the activation of the irrigant, and there was a notable enhancement in biofilm elimination compared to manual irrigation (p &lt; 0.05). Notably, the effectiveness of both activated irrigations was more pronounced in root canals prepared to a size 50/.06, with ultrasonic activation showing enhanced improvements. The findings of this study underscore the substantial impact of both ultrasonically and sonically activated irrigation on the effectiveness of root canal disinfection and debridement. This impact is especially prominent with larger apical size, albeit accompanied by an increased risk of extrusion.

Effect of Using 5% Apple Vinegar Irrigation Solution Adjunct to Diode Laser on Smear Layer Removal and Calcium/Phosphorus Ion Ratio during Root Canal Treatment

Effect of Using 5% Apple Vinegar Irrigation Solution Adjunct to Diode Laser on Smear Layer Removal and Calcium/Phosphorus Ion Ratio during Root Canal Treatment

Canal disinfection using Nd: YAG Laser, synchronized microbubble-photodynamic activation, and carbon quantum dots on microhardness, smear layer removal, and extrusion bond strength of zirconia post to canal dentin. An invitro scanning electron microscopic analysis.

Evaluation of the impact of the latest root canal disinfectant, that is carbon quantum dots (CQDs), synchronized microbubble-photodynamic activation (SYMPA), and Nd: YAG laser along with ethylenediaminetetraacetic acid (EDTA) as a final irrigant on the Marten hardness (MH), smear layer (SL) removal, and extrusion bond strength (EBS) of zirconia post to the canal dentin. Eighty intact single-rooted premolars were obtained and disinfected using 0.5% chloramine-T solution. Root canal preparation was performed using ProTaper files followed by obturation. The post space was prepared for prefabricated zirconia post and all the teeth were randomly divided into four groups based on the disinfection used (n = 20 each) Group 1: 5.25% NaOCl + 17% EDTA (Control), Group 2: Nd: YAG laser + 17% EDTA, Group 3: SYMPA + 17% EDTA, and Group 4: CQDs + 17% EDTA. MH, SL removal, and EBS of zirconia post-bonded to root dentin were performed using a microhardness tester, scanning electron microscope (SEM), and universal testing machine, respectively. Both intragroup and intergroup comparisons were performed using one-way analysis of variance (ANOVA) and posthoc-Tukey test for significant difference (p < .05). Group 2 samples (Nd: YAG laser + 17% EDTA) (0.24 ± 0.06 GPa) exhibited highest values of MH. Samples in group 3 (SYMPA + 17% EDTA) treated teeth unveiled the lowest MH scores (0.13 ± 0.02 GPa). Moreover, the coronal third of Group 3 specimens (SYMPA and 17% EDTA) (1.54 ± 0.31) eliminated SL from the canal with the greatest efficacy as well as presented the highest EBS (10.13 ± 0.69 MPa). However, the apical third of Group 1 samples (5.25% NaOCl + 17% EDTA) (2.95 ± 0.33) exhibited the least efficient elimination of SL from the radicular dentin as well as the lowest bond strength (5.11 ± 0.19 MPa) of zirconia post to the dentin. The SYMPA technique with 17% EDTA proved highly effective in removing the SL from canal dentin and enhancing the EBS of zirconia posts. The least preferable method for SL removal and MH improvement was found to be 5.25% NaOCl + 17% EDTA. CQDs and Nd: YAG laser demonstrated satisfactory smear layer removal properties from the canal, along with achieving appropriate bond strength of zirconia posts. RESEARCH HIGHLIGHTS: Nd: YAG laser and 17% EDTA as canal disinfectant exhibited the highest values of MH. Specimens irrigated with SYMPA and 17% EDTA eliminated SL from the canal with the greatest efficacy. The coronal third of Group 3 (SYMPA + 17% EDTA) samples unveiled the highest zirconia post-bond integrity score to the canal dentin. Cohesive failure was a dominant failure type among different experimental groups.

High-Intensity Focused Ultrasound in Dentistry: A Literature Review

Although high-intensity focused ultrasound (HIFU) has been applied widely in medicine, utilising its non-invasive dual ablation and thermal coagulation properties, its application in dentistry has primarily remained in the research phase, predominantly in in vitro studies. Nonetheless, there has been a consistent increase in the number of publications on this subject in recent decades, focusing on areas such as remineralisation of dentine surfaces, removal of smear layers, drug delivery, and microbial elimination. The number of advantages HIFU can offer, such as its non-surgical nature, absence of ionising radiation, lack of residue, and absence of aerosols, is driving this upward trend, indicating the potential for HIFU in clinical dentistry and ongoing efforts towards developing HIFU-based devices for routine dental use. This succinct review aims to outline the historical context, operational mechanisms of HIFU, summarise recent dental research, and provide a forward-looking perspective on the role of HIFU in modern clinical dentistry.

Efficiency of Canal Brush and Ultrasonic Activated Irrigation in Smear Layer Removal Using Two Different Chelating Agents (In Vitro Study)

Objective: This study aims to evaluate the efficiency of two different activation methods after using two different chelating agents inthe removal of the smear layer.&#x0D; Methods: In this study, seventy single-rooted mandibular premolar teeth were included, and divided into six study groups and onecontrol group according to the chelating agents and activation methods used. In groups 1,3, and 5, EDTA was used as the chelatingagent, where it was activated by Canal Brush in G3 and by Ultra Smart in G5. In groups 2,4, and 6, 7% Maleic acid was used insteadand activated by Canal Brush in G4 and Ultra Smart in G6. While in G1 and G2, no activation systems were used. The 7th group wasa negative control and purposed to verify the internal microstructure, so only distal water was irrigated (no activation and no chelatingagent was used). Samples were sectioned longitudinally and prepared for Scanning Electron Microscope (SEM) analysis in the coronal,middle, and apical parts. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests. The level of significancewas set to 0.05 (P &lt; 0.05).&#x0D; Results: Although the G5 (Ultra Smart +EDTA) median score showed the best smear layer removal score, it was not statisticallysignificant in comparison with the other 5 study groups. In all groups (whether Maleic acid or EDTA were used), smear layer removalwas effective in the coronal and middle thirds while less effective in the apical third, with no statistically significant difference betweenthe chelating agents.&#x0D; Conclusions: Under the limitations of this in vitro study, no activation system was able to remove the smear layer from the root canalwall completely. However, NaOCl and EDTA's irrigation sequence combined with Ultra Smart (ultrasonic activation) obtained betterresults than the other techniques.

Effectiveness of Chitosan Oligosaccharide as Chelating agent in Smear Layer Removal and The effect on Fracture Resistance of Endodontically Treated Teeth

One factor affecting root canal treatment's success is the cleanliness of root canal systems. Smear layer removal is needed to ensure the cleanliness of root canals. Fracture resistance is also essential things in endodontic-treated teeth. Chitosan is one of the irrigant alternatives in dentistry that is biocompatible. The study aimed to investigate the effect of chitosan oligosaccharide as a root canal chelating alternative in the cleaning smear layer and its impact on fracture resistance of endodontic treated teeth.Experimental research with 56 mandibular premolar teeth with a single canal was used. For the smear layer cleanliness test, 24 teeth were used and divided into four treatment groups. Statistical analysis used was the one‑way analysis of variance and LSD Post Hoc test. Thirty-two teeth were divided into two treatment groups for the fracture resistance test. The statistical analysis used was the Independent T-test. There was no significant difference between smear layer removal in chitosan oligosaccharide 2% and EDTA 17% groups. There was a considerable difference between fracture resistance of endodontic treated teeth in chitosan oligosaccharide 2% and EDTA 17% groups. Chitosan oligosaccharide 2% can be used as an alternative in the final irrigation of root canal treatment.

Combined use of XP-Endo Finisher and different chelating agents on the smear layer

ABSTRACT Aims: The aim of this study was to assess the effect of XP-Endo Finisher (XPF) in conjunction with three different chelating agents, namely, 0.2% chitosan nanoparticles (CNP), 17% ethylenediaminetetraacetic acid (EDTA), and 7% maleic acid (MA) on residual debris and smear layer on the root canal walls of the mandibular premolars. Materials and Methods: Eighty extracted human mandibular premolars were used in the study. Canals were prepared using an XP-Endo Shaper, and the final finishing was done with an XPF file. Teeth were randomly divided into four experimental groups based on chelating agents, Group I (XPF + 0.2% CNP), Group II (XPF + 17% EDTA), Group III (XPF + MA), and Group IV XPF + 2.5% sodium hypochlorite (NaOCl) (control group). Teeth were longitudinally split and prepared for scanning electron microscopy analysis. For comparing the smear layer and debris score between groups, the Kruskal–Wallis ANOVA was used, followed by the post hoc Bonferroni test. The level of significance was set at P &lt; 0.05. Results: Group I (XPF + 0.2% CNP) gave the best results (P = 0.001) in all the thirds of root canal, followed by Group II (XPF + 17% EDTA) with P = 0.001. Group III (XPF + MA) showed results similar to that of the control group (XPF + NaOCl) with P = 0.001. There was a significant difference in the scores between Group I (XPF + CNP) and the other three groups. Conclusion: In all three-thirds of a root canal, the use of XPF + 0.2% CNP performed best at removing the smear layer. This was followed by XPF + 17% EDTA and XPF + 7% MA. For all groups, smear layer removal was less efficient in the apical third.

Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study.

The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth. The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed. The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third. On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent. Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

Comparative evaluation of smear layer removal by using different irrigant activation techniques: An in vitro scanning electron microscopic study.

This in vitro study aims to assess and compare the effectiveness of different irrigation activation techniques in removing the smear layer from the root canal dentin using Scanning electron microscope (SEM) analysis. A total of 60 extracted single-rooted premolar with straight canal and mature apex were used for this study. After the selection of teeth, all the samples were decoronated followed by biomechanical preparation. The sample after preparation was irrigated with sodium hypochlorite and randomly divided into three groups with 20 sample in each group (n = 20), (Group 1) control, (Group 2) ultrasonic, and (Group 3) laser. The irrigant activation was done in all the groups and then sample was prepared for the scanning electron microscope analysis. The statistical analysis was performed using the Mann-Whitney-U-test. The findings suggested that the diode laser irrigant activation technique was superior to the ultrasonic and conventional techniques to eradicate smear layers. With the limitation of this study, diode laser activation showed better cleaning of root dentinal walls compared to ultrasonic activator and traditional method.

Debris and Smear Layer Removal in Curved Root Canals: A Comparative Study of Ultrasonic and Sonic Irrigant Activation Techniques.

The aim of this study was to compare the cleaning efficacy of three irrigant activation devices with a control of non-activated syringe and needle irrigation in curved root canals. Sixty human curved roots were endodontically prepared and divided into four groups (n = 15) with similar root curvature distributions. Final irrigation using 4% NaOCl was performed with a syringe and needle (30-G) alone, or with Eddy sonic powered irrigation system (polymeric tip #0.25/0.06), Endosonic ultrasonic activation (polymeric tip #0.25/0.03), or Irrisafe ultrasonic activation (stainless-steel tip, #0.25/0.00). SEM was used to evaluate cleaning efficacy, employing five-score systems for debris and smear layer. While no significant difference in debris removal was observed between Endosonic or Irrisafe activation and non-activated irrigation, Eddy sonic powered irrigation system significantly improved debris removal in the apical third of curved root canals. Smear layer removal was effective in coronal and mid-root sections for all groups but less so in the apical third. Thus, Eddy sonic powered irrigation system demonstrated higher efficacy in removing debris from the apical third of curved root canals compared with non-activated syringe and needle irrigation. However, all three irrigant activation systems exhibited no difference from the non-activated control in smear layer removal.