Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: an in vitro study

Abstract

BackgroundThe purpose of this study was to investigate the smear layer removal and erosive capacity of various irrigation solutions with sequential use of NaOCl on instrumented root canal walls.MethodsThe root canals of single-rooted teeth were instrumented with ProTaper rotary instrument. Then, the teeth were randomly divided into five experimental groups. The root canals were irrigated with one of the following solutions (5 mL/1 min): 5 % EDTA, 5 % boric acid (BA), a mixture of BA and CA, 2.5 % citric acid (CA) and 5 % Desy Clean. After irrigating with 2.5 % NaOCl and distilled water, the roots were split into two halves and each half was prepared for SEM examination. Representative photographs were taken from each third at x500 and x1000 magnifications. Double blind scoring was performed by two calibrated observers for smear layer and erosion. The scores were statistically analyzed using Kruskal-Wallis, Dunn’s post hoc and Spearman’s correlation tests (p = 0.05).ResultsThere were statistically significant differences among the solutions by means of smear layer and erosion (p < 0.05). While 2.5 % CA solution was the most effective solution in removal of smear layer, it was also the most erosive solution (p < 0.05). 5 % Desy Clean removed smear layer effectively and caused less erosion. There was a negative, but statistically significant correlation between presence of smear layer and erosion (r = −0.684; p < 0.0001).ConclusionDesy Clean can be a promising agent as an irrigation solution with optimal smear layer removal capacity and less erosive effects.

Efecto del EDTAC y del ácido cítrico sobre la pared dentinaria. Variación del tiempo de exposición y la edad dentaria

“…In 2015, Turk, Kaval, & Sen also observed erosion, despite using EDTA and citric acid for 1 minute, at lower concentrations than in this study, 5% and 2.5% respectively (27) .…”

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

“…Apesar dessa informação, a maioria dos estudos aqui pesquisados 20 Quando as soluções testadas foram analisadas em diferentes segmentos do dente -terço cervical, médio, e apical-os autores verificaram que a eficiência está diretamente relacionada com: a profundidade de penetração da agulha de irrigação no interior do canal, a curvatura apical e o tamanho do diâmetro apical. Portanto, os terços, cervical e mé-dio, apresentaram-se mais limpos, enquanto que o terço apical, demonstrou-se com maior quantidade de smear layer e menor número de túbulos desobstruídos 30,79,80 .…”

“…A concentração de 5% foi utilizada em um único caso 20 , assim como a concentração de 15% 21 e as concentrações 10 e 20% 22,23 . Em todos os artigos, o EDTA foi conduzido por meio de irrigação com seringa, sendo que em um único estudo, o EDTA entrou em contato com a superfície do dente, por meio de imersão.…”

The Effect of Boric Acid on Root Dentin Mineral Content and Bond Strength of AH-Plus: A SEM-EDX Study

“…A recent study indicated that 2.5% citric acid solution was the most effective solution in removal of smear layer, 5 % boric acid showed the least effective. 44 Turk et al, has recommended that a combination of boric and citric acid solutions can be mixed for clinical use in order to achieve antimicrobial effect and smear layer removal capacity at the same time. 44 When compared to citric acid and EDTA, boric acid might be considered as alternative chelating agent on the other hand previous studies indicated that very high intakes of boron induced reproductive and developmental toxicity in mice and rats.…”

“…44 Turk et al, has recommended that a combination of boric and citric acid solutions can be mixed for clinical use in order to achieve antimicrobial effect and smear layer removal capacity at the same time. 44 When compared to citric acid and EDTA, boric acid might be considered as alternative chelating agent on the other hand previous studies indicated that very high intakes of boron induced reproductive and developmental toxicity in mice and rats. 45 Consequently, further experimental and clinical evaluations are needed to use the material safely.…”