Smear layer removal capacity of disinfectant solutions used with and without EDTA for the irrigation of canals: a SEM study

Abstract

ABSTRACT:The purpose of this study was to carry out a scanning electron microscopic (SEM) analysis of the cleaning qualities and smear layer removal from root canal walls, instrumented and irrigated with 2.5% NaOCl, 2.0% chlorhexidine and saline solutions. Fifty extracted teeth were used in this study. All teeth were radiographed to determine the existence of a single canal. The crowns were cut at the cervical limit and the root canals were instrumented with K-type files up to size 45. During root canal preparation, irrigations were made with the different solutions being evaluated: Group 1: 2.5% NaOCl (10 roots); Group 2: 2.5% NaOCl and 17% EDTA for 2 minute (10 roots); Group 3: 2.0% chlorhexidine (10 roots); Group 4: 2.0% chlorhexidine and 17% EDTA for 2 minutes (10 roots); Group 5: saline solution (5 roots); Group 6: saline solution and 17% EDTA for 2 minutes (5 roots). After instrumentation, the canals were irrigated with each one of the solutions and the roots were cut in the buccolingual direction for SEM analysis, at the cervical, middle and apical thirds, to ascertain the presence or absence of smear layer and debris. SEM analysis was performed by three calibrated examiners and scores were submitted to Kruskal-Wallis test at the significance level of p = 5%. Results showed that the use of 17% EDTA decreased the smear layer significantly (p < 0.05) for all evaluated solutions in all thirds. When EDTA was not used, a significantly higher quantity of smear layer on the apical third was observed only in the NaOCl groups. The use of 17% EDTA was significant for debris removal except for the chlorhexidine groups. The following conclusion could be drawn: the use of 17% EDTA was necessary to enhance cleanness of the root canals. DESCRIPTORS: Smear layer; Sodium hypochlorite; Chlorhexidine; EDTA; Root canal irrigants. RESUMO:Este estudo propôs avaliar, através da microscopia eletrônica de varredura (MEV), a capacidade de limpeza e remoção de "smear layer" e debris das paredes de canais radiculares preparados e irrigados com soluções de hipoclorito de sódio (NaOCl) a 2,5%, gluconato de clorexidina (CLX) a 2,0% e soro fisiológico (controle). Utilizaram-se 50 dentes unirradiculares extraídos com um único canal. Cortaram-se as coroas no limite cervical e os canais foram preparados até o instrumento 45. Durante o preparo foram feitas irrigações com as soluções a serem avaliadas: Grupo 1: NaOCl a 2,5% (10 raízes); Grupo 2: NaOCl a 2,5% seguido de irrigação com EDTA a 17% por 2 minutos (10 raízes); Grupo 3: CLX a 2,0% (10 raízes); Grupo 4: CLX a 2,0% e EDTA a 17% por 2 minutos (10 raízes); Grupo 5: soro fisiológi-co (5 raízes); Grupo 6: soro fisiológico e EDTA a 17% por 2 minutos (5 raízes). Após o preparo, os canais foram irrigados com as soluções em teste, e as raízes cortadas no sentido V-L para avaliação por MEV, nos terços cervical, médio e apical, verificando-se a presença de "smear layer" e debris. Os dados relativos aos escores atribuídos foram avaliados pelo teste Kruskal-Wallis com p = 5%. Os resultados mostra...

The Effect of Polyhexamethylen Biguanide on Microorganisms in Root Canal

“…To se postiže mehanič-kom obradom, dakle uporabom strojnih ili ručnih instrumenata (1) i korištenjem irigacijskih otopina. Antimikrobne irigacijske otopine mogu doprijeti do područja nepristupač-nih mehaničkom čišćenju korijenskih kanala te u dentinske tubule (2).…”

“…PHMB je stabilan u širokom rasponu pH (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11), slabo se pjeni i ne sadržava formaldehid. Također je važno da je to tekućina bez mirisa i boje.…”

“…This is usually accomplished by mechanical preparation using either rotary or hand files (1) along with the use of irrigant solutions. Antimicrobial irrigant solutions may reach canal ramifications and inaccessible areas and permeate completely through the dentinal tubules (2). This is even more important if we consider the penetration depth of some very resistant and small bacteria such is E.faecalis which can penetrate dentinal tubules to the depth 1483.33 µm (nutrient rich aerobic condition) or 620µm (nutrition deprive anaerobic conditions).…”

The effective concentration of red betel leaf (Piper crocatum) infusion as root canal irrigant solution

“…21,31,32 Red betel leaf infusion actually contains active substance, saponin, a type of glycoside found in many plants with characteristics as "surfactants". 4,7,12 Saponins (phytonutrients) has properties resembling soap, so often called as "natural detergent", that is a foaming solution classified by the structure of the complex aglykon into triterpenoid and steroid saponins. 4,26,33 This compound has a long hydrocarbon chain with ion tip which consists of clusters of non polar (hydrophobic) and polar (hydrophilic) groups.…”

“…3,5 This root canal irrigation procees is aimed to remove necrotic tissue, to water root canals, and to dispose smear layer, so it can simplify the implementation of the preparation as well as can reduce the number of microorganisms in root canals. [7][8][9][10][11] Red betel leaf (Piper crocatum) is one of the natural materials that could potentially be used as an ingredient of root canal irrigation. 5,9,11 Red betel leaf contains saponin compound characterized as "surfactants" which can lower the surface tension so that it has an ability to dissolve organic materials, inorganic materials, and microorganisms in root canal.…”