The effects of various irrigating solutions on intra-radicular dentinal surface: An SEM analysis

Abstract

Aim:The action of irrigant solutions on intra- radicular dentinal surface were evaluated in an in vitro setting using a scanning electron microscope (SEM) and it was observed that sodium hypochlorite and MTAD produced the cleanest surface and that none of the irrigants were able to produce an ideal preparation of the dentinal surface when used individually. The primary objective of endodontic therapy is to achieve a clean, optimal environment in root canals to avoid unsuccessful treatment outcomes. The complexities of the root canal system necessitate the use of irrigating solutions which act on radicular dentin surface, modifying it. The action of irrigants can be beneficial, and yet at the same time, as they modify the surface structure of dentin, they can have an adverse impact on the properties of dentin. The present study was undertaken to assess the effect of various irrigants on the dentinal surface using an SEM.Materials and Methods:Forty-five roots were randomly divided into nine groups (n=5) and prepared by sectioning at the level of cemento-enamel junction (CEJ) and 10 mm from the CEJ and split longitudinally. The dentin surface was prepared and the cemental surfaces were coated with double layer of varnish. The irrigants tested were normal saline, de-ionized water, 17% ethylenediaminetetraacetic acid (EDTA), 5% sodium hypochlorite (NaOCl), 5% NaOCl with ultrasonic agitation, 3% hydrogen peroxide, 2% chlorhexidine (CHX), MTAD, and MTAD with ultrasonic agitation. The prepared samples were placed in the irrigant solution for 3 min, subsequently dehydrated, sputter coated, and observed under SEM. The images were subsequently analyzed for dentinal surface changes.Results:17% EDTA and MTAD produced the cleanest dentinal surface. Ultrasonic agitation enhanced the effect of irrigants. 5% NaOCl and 3% hydrogen peroxide were efficient at removal of organic debris, but were unable to remove the smear layer. De-ionized water, normal saline, and 2% chlorhexidine were not effective at removing the debris or the smear layer.Conclusion:None of the irrigants individually were able to achieve conditions of an ideal dentinal surface preparation.

The effects of alternate irrigation of root canals with chelating agents and sodium hypochlorite on the effectiveness of smear layer removal

“…7 The conclusion is that NaOCl should be used after chelating agents to dissolve the exposed protein matrix and ensure penetration into open dentinal tubules. 7,[10][11][12] Therefore, in this study, each irrigation protocol was completed with NaOCl.…”

“…Thanks to alternating acoustic waves and vibrations, the liquids penetrate the canal grooves and irregularities. 11 A very large number of studies concerning the effectiveness of smear layer removal did not employ Table 1. Examples of the scoring calculation method: (a) score 1: a clean canal wall with no smear layer; (b) score 2: most of the tubules opened with a small partial area covered with the smear layer; (c) score 3: most of the surface covered with the smear layer, with few tubules opened; (d) score 4 ultrasound activation.…”

Effect of different final irrigating solutions on smear layer removal in apical third of root canal: A scanning electron microscope study

“…Irrigation is an important step during and after instrumentation for effective removal of smear layer and also for lubrication of root canal system. [ 9 ]…”

A comparative evaluation of phytic acid as final rinse solution with other chelating agents for elimination of intraradicular smear: A scanning electron microscope study

“…A total of 5% sodium hypochlorite solution and 17% EDTA were found to be most effective when used as initial and final rinses. [ 27 ] Irrigant solution must be in contact with entire canal wall for a sufficient period to be effective. This study used a side-vent needle for delivery of irrigant with vent placed at 1 mm from tip in a customized irrigant protocol.…”