Ex-vivo Smear Layer Removal Efficacy of Two Activated Irrigation Techniques After Reciprocating Instrumentation in Curved Canals

Abstract

Introduction:This study aimed to compare the effectiveness of two activated irrigation techniques in removing the smear layer after single-file reciprocating instrumentation in curved canals.Materials and Methods:Sixty distobuccal roots of maxillary molars were standardized to create a closed system, and then instrumented using WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland) instruments. Fifty-four specimens were randomly distributed into 3 groups for final irrigation: Non-activated irrigation, passive ultrasonic irrigation (PUI), and EndoActivator (EA;Dentsply Maillefer, Tulsa, USA) irrigation. All specimens received 3 mL of 17% EDTA for 1 minute, followed by irrigation with 6 mL of 2.5% NaOCl. The apical, middle and cervical thirds of the specimens were analyzed using scanning electronic microscopy (SEM), and the amount of remaining smear layer on the canal walls was rated by three examiners using a five-category scoring system. Kendall’s concordance coefficient was used to assess inter-rater agreement. Kruskal-Wallis and Mann-Whitney (Bonferroni) tests were used to compare the scores.Results:Kendall’s concordance coefficient was ≥ 0.7, indicating an excellent level of agreement between the raters. No statistically significant difference in irrigation techniques efficacy for removal of the smear layer (p=0.061) was found for the apical third. The scores attributed to the specimens irrigated with the EA system were significantly lower than those of the other groups in the cervical and middle thirds (p< 0.05).Conclusions:The efficacy of the EA system in removing the smear layer in the cervical and middle thirds of root canals instrumented with reciprocating motion was significantly higher than that of either PUI or non-activated irrigation. Both EA and PUI performed similarly in apical third.

Removal of Accumulated Hard Tissue Debris (AHTD) from Root Canals with an Electric Current Device: A MicroCT Preliminary Report

“…In contrast to our findings, many studies have confirmed that irrigant activation with sonic devices (EA-EDDY) performed better than others irrigant activation protocols [49,50]. Urban et al, in an in vitro study, using scanning electron microscopy, evaluated the efficacy of different final irrigation activation methods (manual irrigation, EndoActivator, PUI, EDDY) in removing debris and smear layer in the apical, middle and coronal portions of straight root canals.…”

Effectiveness of different irrigation systems in the presence of intracanal‐separated file

“…The contact with the entire root canal wall, especially in the apical region, is crucial for the effectiveness of irrigation solutions in root canal treatment (Torabinejad et al, ). The smear layer removal effectiveness has been investigated for single or combined use of irrigant activation/delivery systems and was shown to be more effective than CSI (Kumar, Bahuguna, & Manan, ; Mancini et al, ; Rödig et al, ; Schiavotelo et al, ), but the smear layer was not completely removed by any irrigation system. Considering that the recent literature lacks any reports about the smear removal effectiveness of syringe irrigation and irrigant activation systems in the event of file separation, this study aimed to investigate the effectiveness of CSI, PUI, Vibringe, and EndoActivator in the presence of SF.…”

Effektivität schall- und ultraschallaktivierter Wurzelkanalspültechniken zur Entfernung von Debris aus dem Isthmus unterer Molaren - Eine Mikro-CT-Studie

“…Im Vergleich zur Ultraschallaktivierung wird bei der Schallaktivierung mit niedrigeren Frequenzen von 166 Hz (EndoActivator) bis zu 6000 Hz (EDDY) gearbeitet (Ahmad et al 1987a;Gu et al 2009b;Urban et al 2017). (Schiavotelo et al 2017). Im apikalen Bereich zeigten sich allerdings keine Unterschiede (Caron et al 2010;Rödig et al 2010;Schiavotelo et al 2017).…”

“…(Schiavotelo et al 2017). Im apikalen Bereich zeigten sich allerdings keine Unterschiede (Caron et al 2010;Rödig et al 2010;Schiavotelo et al 2017).…”

“…In einer weiteren Studie wurde eine vermehrte Debris-und Schmierschicht-Entfernung im apikalen Drittel des Wurzelkanals bei der Ultraschall-im Vergleich zu Schallaktivierung beobachtet (Sabins et al 2003). Schiavotelo et al (2017) stellten allerdings fest, dass der EndoActivator der Ultraschallaktivierung im mittleren und koronalen Anteil des Wurzelkanalsystems hinsichtlich der Debris-und Schmierschicht-Entfernung überlegen ist.…”