Effectiveness of various irrigation activation protocols and the self-adjusting file system on smear layer and debris removal

Abstract

The purpose of the present study is to evaluate smear layer generation and residual debris after using self-adjusting file (SAF) or rotary instrumentation and to compare the debris and smear layer removal efficacy of the SAF cleaning/shaping irrigation system against final agitation techniques. One hundred and eight maxillary lateral incisor teeth were randomly divided into nine experimental groups (n = 12), and root canals were prepared using ProTaper Universal rotary files, with the exception of the SAF instrumentation group. During instrumentation, root canals were irrigated with a total of 16 mL of 5% NaOCl. For final irrigation, rotary-instrumented groups were irrigated with 10 mL of 17% EDTA and 10 mL of 5% NaOCl using different irrigation agitation regimens (syringe irrigation with needles, NaviTip FX, manual dynamic irrigation, CanalBrush, EndoActivator, EndoVac, passive ultrasonic irrigation (PUI), and SAF irrigation). In the SAF instrumentation group, root canals were instrumented for 4 min at a rate of 4 mL/min with 5% NaOCl and received a final flush with same as syringe irrigation with needles. The surface of the root dentin was observed using a scanning electron microscope. The SAF instrumentation group generated less smear layer and yielded cleaner canals compared to rotary instrumentation. The EndoActivator, EndoVac, PUI, and SAF irrigation groups increased the efficacy of irrigating solutions on the smear layer and debris removal. The SAF instrumentation yielded cleaner canal walls when compared to rotary instrumentation. None of the techniques completely removed the smear layer from the root canal walls.

Effect of time and ultrasonic activation on ethylenediaminetetraacetic acid on smear layer removal of the root canal

“…G2, G5, and G6 showed no significant difference among their scores. Similar to the others studies (Andrabi et al, ; Castagna et al, ) the agitation of the EDTA solution with ultrasound did not increase the efficiency of smear layer removal, but other authors found different results (Arslan et al, ; Capar & Aydinbelge, ; Kuah et al, ). The different results found may be related to the use of human teeth and the modeling of the canal of instruments with smaller diameter.…”

“…A lower volume of at prepared root canal hinders the diffusion of irrigating solution throughout its interior during conventional irrigation. The use of an ultrasonic tip improves the irrigating solutiońs contact with all walls of the root (Capar & Aydinbelge, ; Castagna et al, ; Kuah et al, ) and the higher scores in samples with the ultrasonic irrigation of the sodium hypochlorite solution (G4) suggest that the mechanical action of this agitation can cause the formation of a smear layer. The present study did not assess the action of irrigation solutions in areas of anatomical complexity such as the isthmus and grooves.…”

“…Markings inside the root canal and the use of a microscope at low vacuum allowed for the recording of images in the same region before and after irrigation protocols, favoring the establishment of scores in the same region. The use of scores as the method of analysis has been used in other studies (Ayranci et al, 2015;Capar & Aydinbelge, 2014;Caron et al, 2010;Castagna et al, 2013;Mancini et al, 2013;Saber Sel & Hashem, 2011), and due to be a subjective analysis, nonparametric statistical test was used for comparison.…”

Influence of passive ultrasonic irrigation on the efficiency of various irrigation solutions in removing smear layer: a scanning electron microscope study

“…Different techniques have been proposed to improve irrigant distribution within the root canal system (Çapar & Aydinbelge, , Lee, Wu, & Wesselink, , Saber Sel & Hashem, ). Passive ultrasonic irrigation (PUI) is a non‐invasive irrigation protocol applied with ultrasonically activated files, and could be used with a continuous or intermittent flow of irrigant (Van Der Sluis, Wu, & Wesselink, 2007a).…”

A eficácia da solução de EDTA na remoção de smear layer e sua relação com o tempo de uso: uma revisão integrativa

“…Frente a esses achados e aos diversos novos mé-todos coadjuvantes de agitação da irrigação, recomenda-se a agitação do EDTA, por um minuto, seguido da agitação do NaOCl, para a remoção efetiva de ambos os componentes, orgânicos e inorgânicos, da camada de smear layer após o preparo biomecâ-nico dos canais radiculares, o que permite uma adequada desinfecção do SCR, sem no entanto alterar a estrutura dentinária 63,64 . Uma nova proposta de ativação do EDTA, por meio da utilização de LASER de baixa potência, também foi avaliada 27,58,[65][66][67][68][69] .…”