Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations

Abstract

The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin-based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples.Eighty-two roots were filled with AH Plus and gutta-percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p < 0.05). Higher smear layer scores in the coronal and middle thirds were obtained from 0.5%, 1% PAA groups. Regarding marginal adaptation, 18% HEBP group showed the lowest gap size values (p < 0.05), and better marginal adaptation. Etidronic acid is a promising candidate for final irrigation of root canals.

The efficacy of different irrigation protocols in removing tricalcium silicate‐based sealers from simulated root canal irregularities

“…In the present study, the least amount of sealer remnants was observed in the samples irrigated with maleic acid and DualRinse HEDP. The higher smear layer removal capacity of maleic acid and HEBP compared to EDTA has been reported in the previous studies (Ballal et al, 2009;Ulusoy, Zeyrek, & Çelik, 2017). These results can support the present ones, although the chemical composition of tricalcium-silicate cements and smear layer are different.…”

Effect of the combination of several irrigants on dentine surface properties, adsorption of chlorhexidine and adhesion of microorganisms to dentine

“…The high surface Gibbs free energy gives rise to low contact angles, which express high wettability of the dentine that facilitates molecular attraction between materials. This explains the lowest gap size values and better marginal adaptation of AH Plus sealer observed on the dentine walls irrigated with HEDP compared with other irrigants (Ulusoy et al 2017), as well as the high push-out bond strength values for the groups irrigated with HEDP (De-Deus et al 2008a, Neelakantan et al 2012. Another example that the components of the dentine surface influence the wettability more than the roughness is the groups with CHX final flushes (G6, G7 and G8).…”

“…This explains the lowest gap size values and better marginal adaptation of AH Plus sealer observed on the dentine walls irrigated with HEDP compared with other irrigants (Ulusoy et al . ), as well as the high push‐out bond strength values for the groups irrigated with HEDP (De‐Deus et al . , Neelakantan et al .…”

“…The irrigants used in root canal procedures can modify the physicochemical characteristics of dentine (Ari et al 2004, Ari & Erdemir 2005, Ballal et al 2010, Hu et al 2010a,b, Cobankara et al 2011, Tartari et al 2013a,b, 2017 and consequently influence the adhesion of microorganisms to this substratum in cases of secondary infections (Ates et al 2005, Kishen et al 2008, Jaramillo et al 2012. Since there is no single irrigation solution that has all the desired properties of an ideal irrigant, it is necessary to use more than one solution to better clean and disinfect the root canal system during root canal treatment (Zehnder 2006, Haapasalo et al 2014.…”

Dentine tubule disinfection by different irrigation protocols

“…Although there is no clear consensus on the sequence of irrigation, the most common protocol is to use sodium hypochlorite (NaOCl) during mechanical preparation to dissolve the organic matter and kill microorganisms, then a strong chelating agent like ethylenediaminetetraacetic acid (EDTA) to remove the smear layer inorganic components and to promote sealer penetration into dentinal tubules (Baca, Junco, Arias‐Moliz, González‐Rodríguez, & Ferrer‐Luque, ; Jardine et al, ; Mancini, Cerroni, Iorio, Dall'Asta, & Cianconi, ; Zehnder, ). Alternatively, the use of a weak chelating agent such as etidronic acid (HEBP) (Tartari et al, ; Ulusoy, Zeyrek, & Çelik, ; Zehnder, Schmidlin, Sener, & Waltimo, ) in combination with NaOCl has been proposed as a single irrigating solution to be used during root canal preparation and as the final solution. The antimicrobial and organic dissolution properties of this combined solution are similar to those of NaOCl alone (Arias‐Moliz, Ordinola‐Zapata, Baca, Ruiz‐Linares, & Ferrer‐Luque, ; Tartari et al, ; Zehnder et al, ), while its advantages during instrumentation are reduced smear layer formation (Lottanti, Gautschi, Sener, & Zehnder, ) and debris accumulation (Paque, Rechenberg, & Zehnder, ).…”