A comparative evaluation of smear layer removal by using ethylenediamine tetraacetic acid, citric acid, and maleic acid as root canal irrigants: An in vitro scanning electron microscopic study

Abstract

Introduction: Irrigants remove or dissolve smear layer formed during instrumentation. Thus it is important to study the effect of different irrigant solutions on smear layer removal. Objectives: The aim of this study is to determine which irrigant effectively removes the smear layer from the coronal, middle, and apical third of the root canal. Materials and Methodology: One hundred and twenty single-rooted mandibular premolars were decoronated and biomechanical preparation was done through hand instrumentation up to size 40 k file with 2.5% NaOCl irrigation between each successive filing, followed by irrigation with 5 ml of saline. The teeth were divided into Groups I, II, III, and IV containing 30 samples each and irrigated with 5 ml of 17% ethylenediamine tetraacetic acid (EDTA), 10% Citric acid, 7% Maleic acid and normal saline respectively for 1 min and final irrigation was done with 5 ml of distilled water of each sample. The canals were dried with 2% absorbent paper points. The roots were then split with a chisel and mallet. One-half of each tooth was selected and then was analyzed using a scanning electron microscope. The dentinal surfaces were observed at the cervical, middle, and apical third with ×2000 for the smear layer. The scores were attributed, according to Torabinejad et al . rating system. Results: 7% maleic acid and 10% citric acid both are equally effective in smear layer removal from coronal and middle third, but in apical third 7% maleic acid is more effective than 10% citric acid. Between citric acid and EDTA, both are equally effective in smear layer removal from coronal and middle third, but in apical third, 10% citric acid is more efficacious than 17% EDTA. Conclusion: Within the limitations of the study, it can be concluded that all three tested irrigants removed the smear layer from coronal, middle, and apical third. However, in apical third 7% maleic acid is the most efficacious irrigant in smear layer removal.

Evaluation of the antimicrobial action and cleaning ability of different naturally based vinegar used as endodontic irrigants

“…Results of the current study demonstrated that the removal of the smear layer was statistically less effective in the apical third of the root canal compared to coronal and middle thirds, regardless of the irrigation solution used except for saline solution. This is in agreement with previous results and could be explained by less diameter of apical third, decreased permeability and presence of sclerosed dentin in the apical third which limits the chelating effect of any chelator (46) . The result of Pearson correlation test revealed that there was a positive correlation between the results of antibacterial action and smear layer removal ability of the tested irrigants and this correlation was statistically significant (P > 0.05(.…”

Dental Surface Conditioning Techniques to Increase the Micromechanical Retention to Fiberglass Posts: A Literature Review

“…The use of different solutions has been implemented to improve dentin conditioning and an effective remove of the SSL throughout the space created for the fiber post; these solutions include acid solutions, that is, ethylenediaminetetraacetic acid (EDTA) [10,25,34], OA [25,30,34], maleic acid [20], and citric acid at several concentrations such as 10%, 20%, and 50% [9,25]. Also, the use of several combined solutions allows a reduction of superficial tension, facilitating irrigants contact with dentinal walls, and enhancing SSL removal [35]; some examples are MTAD [34,36,37] and Q-mix [18,24]. There activity is summarized in Table 1.…”

“…Remove the SL and open the dentinal tubules [40] Citric acid Demineralizing solution [18] Maleic acid Demineralization of the intertubular dentin [18,41] Table 1. Cont.…”

“…To facilitate SSL removal, conditioning solutions are employed, resulting in improvements in the surface conditioning of the intra-radicular dentin to promote adhesion, forming a hybrid layer composed of collagen fiber and resin, through the penetration of cement into dentinal tubules establishing resin tags [9,11,[16][17][18][19][20][21][22]. Also, irrigant activation is used to enhance removal, promoting the opening of the dentin tubules by employing ultrasonic [16,[23][24][25][26], laser [17,24,[27][28][29], or sonic devices [30].…”

An in vitro study of comparative evaluation of efficacy of electrochemically activated water as a root canal irrigant in smear layer removal

“…Maleic acid is a mild organic acid that removes the smear layer effectively at concentrations of 5% and 7%. [ 6 ] MTAD is a new irrigating solution containing a mixture of a tetracycline isomer, an acid, and a detergent developed by Torabinejad et al .…”