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A Comparative Scanning Electron Microscopy Evaluation of Smear Layer Removal from Teeth with Different Irrigation Solutions and Lasers

Published online by Cambridge University Press:  09 August 2013

Elif Kalyoncuoğlu*
Affiliation:
Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun 55139, Turkey
Ebru Özsezer Demiryürek
Affiliation:
Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun 55139, Turkey
*
*Corresponding author. E-mail: [email protected]
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Abstract

The aim of this study was to evaluate the efficacy of smear layer removal from teeth following root canals using lasers (Er:YAG and Nd:YAG), NaOCl, 17% EDTA, and MTAD by scanning electron microscopy (SEM). Root canals were irrigated with 3 mL of 5.25% NaOCl after each file. Teeth were randomly divided into five groups. In the final irrigation, canals were irrigated with 5.25% NaOCl (Group 1, control), 17% EDTA (Group 2), or BioPure MTAD (Group 3). Laser groups were irradiated with Er:YAG laser (1.8 W, 120 mJ, 15 Hz) (Group 4) or Nd:YAG laser (1 W, 100 mJ, 15 Hz) (Group 5). The smear layer at the apical, middle, and coronal thirds of each root canal was imaged using SEM. Smear layer removal by EDTA was the most effective in all regions. The difference between EDTA and MTAD was statistically significant in the coronal and middle (p < 0.05), but not the apical (p > 0.05), regions. The difference between the control and laser groups was not statistically significant (p > 0.05). In all regions, the difference between 17% EDTA–MTAD and the control–laser groups was statistically significant (p < 0.05). Although improvement was observed in removal of the smear layer using alternative materials and techniques, application of a combination of EDTA and NaOCl remains an effective technique.

Type
Biomedical and Biological Applications
Copyright
Copyright © Microscopy Society of America 2013 

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References

Aktener, B.O. & Bilkay, U. (1993). Smear layer removal with different concentrations of EDTA-ethylenediamine mixtures. J Endod 19, 228231.Google Scholar
Altundaşar, E., Ozcelik, B., Cehreli, Z.C. & Matsumoto, K. (2006). Ultramorphological and histochemical changes after ER,CR:YSGG laser irradiation and two different irrigation regimes. J Endod 32, 465468.CrossRefGoogle ScholarPubMed
Anic, I., Segovic, S., Katanec, D., Prskalo, K. & Najzar-Fleger, D. (1998). Scanning electron microscopic study of dentin lased with argon, CO2, and Nd:YAG laser. J Endod 24, 7781.CrossRefGoogle ScholarPubMed
Barbakow, F., Peters, O. & Havranek, L. (1999). Effects of Nd:YAG lasers on root canal walls: A light and scanning electron microscopic study. Quintessence Int 30, 837845.Google Scholar
Barbosa, S.V., Safavi, K.E. & Spangberg, S.W. (1994). Influence of sodium hypochlorite on the permeability and structure of cervical human dentine. Int Endod J 27, 309312.Google Scholar
Berry, E.A., von der Lehr, W.N. & Herrin, H.K. (1987). Dentin surface treatments for the removal of the smear layer: A SEM study. J Am Dent Assoc 115, 6567.Google Scholar
Bitter, N.C. (1989). A 25% tannic acid solution as a root canal irrigant cleanser: A scanning electron microscope study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 67, 333337.Google Scholar
Dederich, D.N., Zakariasen, K.L. & Tulip, J. (1984). Scanning electron microscopic analysis of canal wall dentin following neodymium-yttrium-aluminum-garnet laser irradiation. J Endod 10, 428431.Google Scholar
De-deus, G., Paciornic, S. & Mauricio, M.H. (2006). Evaluation of the effect of EDTA, EDTAC and citric acid on the microhardness of root dentine. Int Endod J 39, 401407.Google Scholar
Demiryürek, E.O., Kulunk, S., Sarac, D., Yuksel, G. & Bulucu, B. (2009). Effect of different surface treatments on the push-out bond strength of fiber post to root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108, 7480.Google Scholar
Deutsch, A.S., Cohen, B.I. & Musikant, B.L. (2003). Inductively coupled plasma-emission spectroscopy and atomic absorption for the use of elemental analysis of a root canal after lasing with a holmium:YAG laser. J Endod 29, 404406.Google Scholar
Garberoglio, R. & Becce, C. (1994). Smear layer removal by root canal irrigants: A comparative scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 78, 359367.Google Scholar
Khedmat, S. & Shokouhinejad, N. (2008). Comparison of the efficacy of three chelating agents in smear layer removal. J Endod 34, 599602.Google Scholar
Kivanç, B.H., Ulusoy, O.I. & Gorgul, G. (2008). Effects of Er:YAG laser and Nd:YAG laser treatment on the root canal dentin of human teeth: A SEM study. Lasers Med Sci 23, 247252.CrossRefGoogle ScholarPubMed
Mancini, M., Amellin, E., Casaglia, A., Cerroni, L. & Cianconi, L. (2009). A comparative study of smear layer removal and erosion in apical intraradicular dentine with three irrigating solutions: A scanning electron microscopy evaluation. J Endod 35, 900903.Google Scholar
Mozayeni, M.A., Javaheri, G.H., Poorroosta, P., Ashari, M.A. & Javaheri, H.H. (2009). Effect of %17 EDTA and MTAD on intracanal smear layer removal: A scanning electron microscopic study. Aust Endod J 35, 1317.CrossRefGoogle ScholarPubMed
Peters, O.A. & Barbakow, F. (2000). Effect of irrigation on debris and smear layer on canal walls prepared by two rotary techniques: A scanning electron microscopic study. J Endod 26, 610.Google Scholar
Sayin, T.C., Serper, A., Cehreli, Z.C. & Otlu, H.G. (2007). The effect of EDTA, EGTA, EDTAC, and tetracycline-HCl with and without subsequent NaOCl treatment on the microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104, 418424.Google Scholar
Shabahang, S. & Torabinejad, M. (2003). Effect of MTAD on Enterococcus faecalis-contaminated root canals of extracted human teeth. J Endod 29, 576579.CrossRefGoogle ScholarPubMed
Singla, M.G., Garg, A. & Gupta, S. (2011). MTAD in endodontics: An update review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112, 7076.Google Scholar
Stabholz, A., Khayat, A., Weeks, D.A., Neev, J. & Torabinejad, M. (1992). Scanning electron microscopic study of the apical dentine surfaces lased with ND:YAG laser following apicectomy and retrofill. Int Endod J 25, 288291.CrossRefGoogle Scholar
Takeda, F.H., Harashima, T., Kimura, Y. & Matsumoto, K. (1998). Efficacy of Er:YAG laser irradiation in removing debris and smear layer on root canal walls. J Endod 24, 548551.Google Scholar
Takeda, F.H., Harashima, T., Kimura, Y. & Matsumoto, K. (1999). A comparative study of the removal of smear layer by three endodontic irrigants and two types of laser. Int Endod J 32, 3239.Google Scholar
Tay, F.R., Pashley, D.H., Loushine, R.J., Doyle, M.D., Gillespie, W.T., Weller, R.N. & King, N.M. (2006). Ultrastructure of smear layer-covered intraradicular dentin after irrigation with BioPure MTAD. J Endod 32, 218221.Google Scholar
Torabinejad, M., Khademi, A.A., Babagoli, J., Cho, Y., Johnson, W.B., Bozhilow, K., Kim, J. & Shabahang, S. (2003). A new solution for the removal of the smear layer. J Endod 29, 170175.Google Scholar
Wayman, B.E., Kopp, W.M., Pinero, G.J. & Lazzari, E.P. (1979). Citric and lactic acids as root canal irrigants in vitro. J Endod 5, 258265.CrossRefGoogle ScholarPubMed
Wu, L., Mu, Y., Deng, X., Zhang, S. & Zhou, D. (2012). Comparison of the effect of four decalcifying agents combined with 60°C 3% sodium hypochlorite on smear layer removal. J Endod 38, 381384.Google Scholar
Yamada, R.S., Armas, A., Goldman, M. & Lin, P.S. (1983). A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. J Endod 9, 137142.Google Scholar
Zhang, C., Kimura, Y., Matsumoto, K., Harashima, T. & Zhou, H. (1998). Effects of pulsed Nd:YAG laser irradiation on root canal wall dentin with different laser initiators. J Endod 24, 352355.Google Scholar