Smear Layer Removal Research Articles

The Effectiveness of Triton Used With XP-3D Adaptive Files and Active Irrigation on Smear Layer Removal During Root Canal Preparation: A Qualitative Scanning Electron Microscopy (SEM) Study.

Standard irrigating protocols during root canal treatment call for the use of sodium hypochlorite during chemo-mechanical preparation, followed by final irrigation with ethylenediaminetetraacetic acid (EDTA). This study determined the effectiveness of a new irrigant, Triton (Brasseler, USA), on smear layer removal during root canal treatment compared to that of 5.25% sodium hypochlorite and CanalPro EDTA 17% (Coltene). Twenty-one extracted anterior teeth were prepared for root canal treatment. The teeth were divided into three groups: five teeth were used as control with saline as the irrigant, eight teeth with sodium hypochlorite and 17% EDTA as irrigants, and eight teeth with Triton as the irrigant. Root canal preparation was done using the XP-3D shaper and finisher files (Brasseler, USA) for all teeth with respective irrigants. A single operator performed all root canal treatment procedures. The teeth were prepared for scanning electron microscopy (SEM), and analysis was performed by a second investigator. The smear layer removal was qualitatively assessed to determine the effectiveness of irrigants. Smear layer removal was most effective for teeth irrigated with 5.25% sodium hypochlorite, followed by 17% EDTA (Group B). Teeth irrigated with Triton (Group A) showed a similar appearance to the hypochlorite/EDTA group but with isolated instances of inter-tubular debris. Sodium hypochlorite use followed by a final rinse with EDTA remains the gold standard for the removal of the smear layer created during canal instrumentation.

Antibacterial effect and smear layer removal ability of herbal intra-canal irrigants in primary teeth

Natural irrigants, specifically when used with children are important as they have fewer adverse effects. Objectives: To evaluate the antibacterial effect and smear layer removal ability of sage versus turmeric irrigants. Methods: 60 roots of primary teeth were inoculated with E. faecalis and randomly allocated to the following subgroups (12 roots each): Subgroup (I): 0.2% sage solution, Subgroup (II): 12.5% turmeric solution, Subgroup (III): 2% chlorhexidine solution, Subgroup (IV): contaminated only, Subgroup (V): negative controls. Microbiological culturing was performed. Assessment of the smear layer removal ability, 40 roots (10 roots in each group) were randomly divided; Subgroup 1: 0.2% Sage solution. Subgroup 2: 12.5% turmeric solution. Subgroup 3: 2% chlorohexidine. Subgroup 4: saline. The evaluation of smear layer removal was performed by SEM. Results: Chlorohexidine showed the highest percentage reduction in bacterial count followed by turmeric, then the sage group. A comparison of the smear layer removal, scores showed significant differences in the middle section of the different groups, with the turmeric group having a significantly higher median score than the sage group. Conclusion: chlorohexidine showed the highest antibacterial properties and smear layer removal ability followed by turmeric then sage.

Post-Space Disinfectants With Sodium Hypochlorite and Methylene Blue Loaded in Silver and Quartz Nanoparticles Activated by Photodynamic Therapy. A SEM Analysis.

Post-space disinfectants methylene blue loaded with silver (Ag) and Quartz nanoparticles (NPs) and MB alone activated by photodynamic therapy (PDT) on the survival of Enterococcus faecalis, smear layer (SL) removal efficacy, and extrusion bond strength (EBS) of fiber posts to canal dentin. Hundred mandibular premolars underwent root canal treatment using the rotary ProTaper system. The canals were obturated and post-space was prepared up to a length of 8 mm, maintaining a 5 mm seal. To assess antibacterial efficacy E. faecalis were inoculated in the canal (n = 20). The samples were then randomly allocated into four groups according to the canal disinfectant used to sterilize the canals. Group 1: 2.5% NaOCl+17% EDTA, Group 2: MB-PDT, Group 3: MB@QP-PDT, and Group 4: MB@AgNP-PDT (n = 25). SEM analysis was conducted on five samples from each disinfectant group to assess the removal of the SL. Survival rates were calculated (n = 5 from each group). Glass fiber post (GFP) was cemented to the root dentin of the remaining samples followed by artificial aging. Sectioning of the specimens was performed in all three-thirds of the canals. PBS was assessed followed by failure evaluation. ANOVA and Tukey post hoc test were used to compare the E. faecalis survival rate and PBS of fiber post among different investigated groups. Group 4 (MB@AgNP-PDT) treated canals exhibited the minimum survival rate (0.30 ± 0.04 CFU/mL) of E. faecalis and maximum PBS. However, the highest survival rate and minimum bond strength of GFP were observed in Group 1 (NaOCl+17% EDTA) and Group 2 (MB-PDT) treated teeth respectively. The highest SL removal was recorded in the coronal section of the samples of Group-4 disinfected with MB@AgNP-PDT. The lowest removal of SL was recorded in Group 2 samples sterilized with MB-PDT at apical one-third. Silver nanoparticles when utilized as nano-carriers to enhance the efficiency of MB activated by PDT, have been shown to exhibit the highest antimicrobial potency, improved capacity for SL removal and improved PBS.

Impact of Tulsi extract on sealer penetration in dentinal tubules as compared to 17% EDTA as the final root canal irrigant (in vitro analysis)

Introduction: Penetration of endodontic sealers into dentinal tubules is essential for ensuring successful root canal treatment by creating a hermetic seal that prevents reinfection. Traditionally, 17% EDTA has been used as the final irrigant for smear layer removal. However, concerns regarding its limited antimicrobial properties and potential for dentin erosion have prompted the exploration of alternative solutions. This in vitro study compared the effectiveness of Tulsi extract with that of 17% EDTA in promoting sealer penetration within the dentinal tubules. Methodology: Thirty extracted single-rooted teeth were randomly divided into three groups: Group 1, 17% EDTA; Group 2, Tulsi extract; and Group 3, saline control. After preparation, the root canals were irrigated with their respective soluti ons, filled with gutta-percha, and sealed with a calcium hydroxide-based sealer. Sealer penetration was analyzed using scanning electron microscopy (SEM) at the 2 mm and 5 mm levels from the root apex. Results: The results showed no significant difference in sealer penetration at 2 mm among all the groups. However, at 5 mm, both EDTA and Tulsi groups exhibited significantly greater sealer penetration than the control group (p < 0.001). No significant difference was observed between the EDTA and Tulsi groups at 5 mm (p = 0.706). Conclusion: Tulsi extract demonstrated similar efficacy to 17% EDTA in facilitating sealer penetration, suggesting its potential as a biocompatible and antimicrobial alternative for root canal irrigation protocols. Further studies are warranted to explore its clinical applications and commercial viability.

The Efficacy of Brush File Used for Irrigation Activation Versus Passive Ultrasonic Irrigation in Terms of Smear Layer Removal and Canal Cleanliness in Single Rooted Teeth: A Comparative In-Vitro Study

The Efficacy of Brush File Used for Irrigation Activation Versus Passive Ultrasonic Irrigation in Terms of Smear Layer Removal and Canal Cleanliness in Single Rooted Teeth: A Comparative In-Vitro Study

Antimicrobial Activity of Metal Oxide Nanoparticles

A broad range of gram positive and gram negative bacteria have been demonstrated to be effectively suppressed in growth by Metal Oxide Nanoparticles (MONPs), suggesting that these particles may be useful in the fight against antibiotic resistance. The antibacterial characteristics of MONPs, including those of silver, zinc, titanium, zirconia, iron, copper, magnesium, and cobalt oxide are widely recognized. The use of these nanoparticles made of synthetic and natural materials in dentistry is developing quickly, has been included in a variety of dental materials and has assisted in the treatment of oral disorders as well as the removal of biofilms and smear layers. The reader will gain up-to-date knowledge on MONPs, their modes of action, and their significance in endodontics in this review.

Titanium oxide and chitosan nanoparticles loaded in methylene blue activated by photodynamic therapy on caries affected dentin disinfection, bond strength, and smear layer removal efficacy

AimEffect of nanoparticles (NPs) loaded methylene blue (MB) mediated photodynamic therapy (PDT) on caries-affected dentin (CAD) against S.mutans, smear layer (SL) elimination, and shear bond strength (SBS) of single bottle 7th generation adhesive. MethodologySixty human molars with carious lesions were selected. Samples were randomly allocated into four groups, based on the disinfection regime (n = 11) Group 1-(CHX), Group 2-(MB-PDT), Group 3-(MB-CNPs-PDT), and Group 4-(MB-TiO2NPs-PDT). Following disinfection S.mutans' survival rate was assessed using the pour plate method. Five specimens from each disinfection group were subjected to SL removal assessment using a scanning electron microscope (SEM). Bonding of 7th generation adhesive and composite restoration was performed on ten samples from each group. Artificial aging of the bonded samples was performed followed by SBS and failure mode analysis using a universal testing machine and stereomicroscope respectively. One-way analysis of variance (ANOVA) and Tukey post hoc test were used to analyze the data. ResultsGroup 3 (MB-CNPs-PDT) treated CAD surface unveiled the lowest survival rate (0.12 ± 0.02 CFU/mL) of tested bacteria, maximum SL removal (1.21 ± 0.35), and highest bond strength (13.42 ± 1.05). However, Group 1 (CHX) treated specimens displayed the highest survival rate (0.53 ± 0.11 CFU/mL) with the lowest SL removal (2.24 ± 0.30) and SBS (8.88 ± 0.73 MPa). ConclusionMB-CNPs-PDT appears to be a suitable alternative to CHX for CAD disinfection as it displayed better antibacterial efficacy, SL removal, and SBS with 7th generation single bottle adhesive.

Smear layer removal and antimicrobial efficacy of chitosan as a root canal irrigant: a systematic review of in-vitro studies

Smear layer removal and antimicrobial efficacy of chitosan as a root canal irrigant: a systematic review of in-vitro studies

Smear Layer Removing and Pulp Dissolving Ability of Sodium Hypochlorite Mixed with Two Etidronate-Containing Irrigants in Continuous Chelation Technique

The study aimed to assess the effect of two etidronate-containing irrigants and EDTA on the ability of sodium hypochlorite (NaOCl) to remove the smear layer and dissolve organic tissues. This study evaluated the following solutions: distilled water, 3% NaOCl, 3% NaOCl + EDTA, and 3% NaOCl mixed with etidronate powder from two manufacturers [Dual Rinse, (DR); IsraDent, (ID)] to obtain 9%, 15%, and 18% solutions. To assess the proteolytic activity, bovine muscle tissue samples (56.1 ± 5.4 mg; n = 10 per group) were immersed in the tested solutions for 15 min. Absolute weight changes and percentages of weight changes (wt%) were calculated. To assess smear layer removal, the root canals of human wisdom teeth were instrumented, irrigated with the tested solutions (n = 10 per group), and evaluated using SEM. Statistical analysis employed an ANOVA with a post-hoc Tukey test and paired t-test, the Kruskal–Wallis test with a pairwise Wilcoxon rank sum test, and the Friedman test with a pairwise Wilcoxon signed-rank test. The mean weight loss in the NaOCl group comprised 17.3 mg (32 wt%). Sequential use of NaOCl and EDTA resulted in a significant increase in proteolytic activity of the former (57 wt%), while mixing these solutions led to a reduction of proteolytic activity (17 wt%). All NaOCl/DR groups exhibited a significantly greater dissolution activity than that of NaOCl alone, with the mean weight loss ranging from 23.3 mg (40 wt%) to 24 mg (41 wt%). ID9% and ID15% significantly decreased the proteolytic activity of NaOCl. In most groups, the apical thirds of the root canals demonstrated a significantly heavier smear layer compared to the middle and coronal thirds. The most effective smear layer removal was observed after irrigation with NaOCl combined with EDTA or DR (all concentrations); however, in the NaOCl + EDTA and DR18% groups, it was accompanied by moderate to severe erosion. Irrigation with ID did not result in smear layer removal or dentin erosion. In conclusion, the smear layer removal and pulp dissolving effects of continuous chelation using etidronate were manufacturer/composition-dependent. DR9% combined with NaOCl demonstrated the most promising results.

Effectiveness of Smear Layer Removal Using Different Activated Irrigating Solutions and Techniques: An in-Vitro Study

effectiveness of Smear Layer Removal Using Different Activated Irrigating Solutions and Techniques: An in-Vitro Study

A qualitative and quantitative evaluation of smear layer removal efficacy of three different chelating agents using scanning electron microscopy and inductively coupled plasma mass spectrometry

ABSTRACT Aim: The main goal of the present experimental research was to analyze the smear layer removal efficacy of chelating agents and correlate with the amount of calcium released from the radicular dentin with the canal space. Materials and Methods: Forty single-rooted teeth were exposed to standardized root canal instrumentation technique with copious amount of irrigation with 2.5% sodium hypochlorite solution between each instrumentation, following which the specimens were randomly allocated into four groups: Group I: 17% ethylenediaminetetraacetic acid (EDTA), Group II 0.2% Chitosan, Group III Qmix™, and Group IV Control group with no final irrigation. After the irrigation protocol, the specimens were subjected to the scanning electron microscopy (SEM) evaluation to determine the smear layer removal efficacy and induced plasma mass spectrophotometric analysis was done to quantify the amount of calcium ions content in the irrigating solution. The data were statistically analyzed using Kruskal–Wallis and Dunnett’s tests for smear layer removal analysis. Quantitative data were interpreted by the analysis of variance and Tukey’s-Karmer test for the spectroscopic data analysis. Results: The result of the SEM analysis showed that there was no significant difference among the smear layer removal efficacy between the experimental groups with P > 0.05. The quantitative spectrophotometric data showed that the highest calcium ions release was from the 17% EDTA group followed by 0.2% chitosan and lesser from the Qmix™ group. Conclusion: Within the limitation of this in vitro experimental research, all the three experimental groups showed a better smear layer removal efficacy. EDTA showed the greater amount of mineral release compared to Qmix™ and chitosan group.

Chitosan nanoparticles, Rose Bengal-chitosan activated photodynamic therapy as final irrigant on pushout bond strength, smear layer removal efficacy and antibacterial effectiveness against E.faecalis

AimImpact of final root canal disinfectants diode laser (DL), Rose Bengal photosensitizer (RBP), Chitosan Nanoparticles (CNPs), and CNPs modified RBP on Enterococcus faecalis (E.faecalis) survival rate, smear layer (SL) removal efficacy and push out bond strength (PBS) of resin sealer to the radicular dentin. Material and methodSingle rooted seventy-five human mandibular premolar teeth were sectioned at a level of cementoenamel (CEJ) and root canal treatment was performed using a ProTaper rotary instrument. To assess the antibacterial efficiency E.faecalis inoculation was performed using a pour plate method. The samples were arbitrarily allocated into five groups based on the final disinfectant received (n = 15) Group-1 (NaOCl+17 % EDTA), Group-2 (NaOCl+DL), Group-3 (NaOCl+CNPs), Group-4 (NaOCl+RBP activated by DL) and Group-5 (NaOCl+CNPs-RBP activated by DL). SEM analysis for SL removal was performed on five specimens from each group. Root canal obturation and sectioning were performed at cervical, middle, and apical levels. PBS and failure mode were analyzed using a universal testing machine (UTM) and stereomicroscope respectively. The data was subjected to analysis using one-way analysis of variance (ANOVA) and Tukey's post hoc test. ResultGroup 1 (NaOCl+17 % EDTA) (0.36 ± 0.01 CFU/mL) unveiled the maximum survival rate of tested bacteria. However, Group 5 (NaOCl+CNPs-RBP activated by DL) (0.11 ± 0.01 CFU/mL) displayed minimum survival of E.faecalis. The highest SL removal (1.44 ± 0.11) and bond integrity scores (12.23 ± 0.24 MPa) were recorded in the coronal section of Group 5 (NaOCl+ CNPs-RBP activated by DL) treated roots. However, the lowest removal of SL (3.15 ± 1.09) and PBS (7.24 ± 0.09 MPa) were recorded in Group 4 (NaOCl+RBP activated by DL) treated canals. CONCLUSIONCNPs-RBP activated by DL as the final irrigant provided satisfactory antibacterial activity, SL removal, and bond strength outcomes compared to other tested groups.

Comparative Evaluation of Different Methods of Activation of Chelating Solution for Smear Layer Removal in the Apical Portion of the Root Canal Using a Scanning Electron Microscopy: An In Vitro Study.

Background The smear layer has an adverse effect on the sealing of root canals during obturation, and it is the main reason for the failure of root canal treatment.Root canal irrigation using a conventional irrigation system is ineffective for smear layer removal, especially from the apical third region, where mostlateral canals are present. For successful endodontic treatment, the smear layer should be removed from the apical third region using an effective irrigation activation system. Aim This study aimed to compare smear layer removal by conventional irrigation, XP Endo Finisher (XPF), endoactivator (EA), passive ultrasonic activation, and root canal brushusing 17% ethylenediaminetetraacetic acid (EDTA) as a chelating solution and 5.25% sodium hypochlorite after chemomechanical preparation, using scanning electron microscopy (SEM). Method A total of 50 extracted human mandibular single canal premolars with mature roots were selected for this study. Samples were decoronated to obtain a standard working length (WL) of 15 mm. Canal patency was achieved using a 10 k file. Samples were sealed with sticky wax to obtain the vapor lock effect. Biomechanical preparation is done till F3. The samples were divided into five groups according to the final irrigation activation protocol: Group 1, control group; group 2, XPF; group 3, EA; group 4, passive ultrasonic irrigation (PUI); and group 5,, root canal brush. Samples were divided into two equal halves longitudinally. Each sample was analyzed for a smear layer under SEM at 2000x magnification. Statistical analysis was done using the one-way Anova "F" test and Tukey's post-hoc test. Results Group 3 showed the least presence of a smear layer, followed by groups 4, 2, 5, and 1. All the groups exhibited highly significant differences between each other (p < 0.001). Group B shows no significant difference with groups C, D, and E. Group C shows no significant difference with groups D and E. Group D shows no significant difference with group E. Conclusion The EA removes the smear layer effectively as compared with other groups. All the irrigation activation system shows the presence of smear layer. No activation systems were able to remove the smear layer completely.

Comparison of hand, rotary, reciprocating and self-adjusting files in cleaning mesio-buccal canals of maxillary first molars.

The smear layer removal capability of different instrumentation techniques on the mesio-buccal root canals of maxillary first molars is of interest to dentists. Sixty extracted maxillary first molars with fully developed apices, curved root canals, and curvatures between 30 to 45 degrees were selected. The teeth were divided into four groups (n=15) based on the instrumentation technique used. The samples were analyzed using a thermal field emission scanning electron microscope to assess smear layer removal at the apical, middle, and coronal thirds of the canals. The Wave One file system showed superior performance in smear layer removal across all three regions of the canal compared to hand files, Hyflex CM rotary files and SAF.

Effectiveness of chitosan nanoparticles, and novel chemical irrigants with surfactant on smear layer removal and microhardness alteration

ObjectiveThis current study was designed to compare and correlate between smear layer eradication and reduction in microhardness by natural 0.2%chitosan nanoparticles and novel chemical irrigants with surfactant at the apical root third. Materials and methodOne hundred and twenty straight single-rooted extracted lower premolars were decoronated and working length obtained with #10 K-file. Pro-taper rotary files were used till apical size F3. The canals were simultaneously flushed with assigned irrigant containing surfactant [(ChX-Ultra, NaOCl-Extra, Pro-EDTA, 0.2%chitosan nanoparticles, Biopure MTAD]. The samples were randomly divided into two equal groups (n = 60). InGroup S (n = 60), the residual smear layer was examined by scanning electron microscope and in Group M(n = 60) microhardness was determined by Vickers Microhardness Tester. Further both groups were divided into six equal groups (n = 10 each) according to assigned irrigating solutions.For smear layer removal; Kruskal-Wallis tests followed by pair wise comparison using Mann Whitney U test was done. For change in microhardness ANOVA and post hoc Tukey tests was done. ResultsMaximum smear layer removal was recorded in Biopure MTAD (1.8 ± 0.63), followed by pro-EDTA (2.2 0 ± 0.63) then 0.2%chitosan (2.6 ± 0.51), then NaOCL Extra (3.5 ± 0.53)and least in CHX-Ultra (4.4 ± 0.52) and saline (5.0 ± 0.00). Pro-EDTA group (12.8 ± 2.47) revealed significant highest reduction in microhardness followed by Biopure MTAD (8.01 ± 3.06), 0.2%chitosan nanoparticles (5.48 ± 2.87), NaOCl-Extra (5.44 ± 1.62) and least recorded in CHX-Ultra (4.94 ± 1.43) and saline (3.04 ± 0.63). ConclusionThe elimination of the smear layer is always accompanied by a reduction in microhardness. Moreover, irrigant with surfactant and chelators enhanced smear layer removal, with best perceived in Biopure MTAD.

Effectiveness of Smear Layer Removal Using Different Activated Irrigating Solutions and Techniques: An in-Vitro Study

Effectiveness of Smear Layer Removal Using Different Activated Irrigating Solutions and Techniques: An in-Vitro Study

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 &lt; 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.