Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer

The aim of the present study was to evaluate the efficacy of QMiX, SmearClear, and 17% EDTA for the debris and smear layer removal from the root canal and its effects on the push-out bond strength of an epoxy-based sealer by scanning electron microscopy (SEM). Forty extracted human canines (n=10) were assigned to the following final rinse protocols: G1-distilled water (control), G2-17% EDTA, G3-SmearClear, and G4-QMiX. The specimens were submitted to a SEM analysis to evaluate the presence of debris and smear layer, respectively, in the apical or cervical segments. In sequence, forty extracted human maxillary canines with the root canals instrumented were divided into four groups (n=10) similar to the SEM analysis study. After the filling with AH Plus, the roots were transversally sectioned to obtain dentinal slices. The specimens were submitted to a push-out bond strength test using an electromechanical testing machine. The statistical analysis for the SEM and push-out bond strength studies were performed using the Kruskal-Wallis and Dunn tests (α=5%). There was no difference among the G2, G3, and G4 efficacy in removing the debris and smear layer (P>0.05). The efficacy of these groups was superior to the control group. The push-out bond strength values of G2, G3, and G4 were superior to the control group. The ability to remove the debris and smear layer by SmearClear and QMiX was as effective as the 17% EDTA. The final rinse with these solutions promoted similar push-out bond strength values. © 2013 Wiley Periodicals, Inc.

Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer

The aim of the present study was to evaluate the efficacy of QMiX, SmearClear, and 17% EDTA for the debris and smear layer removal from the root canal and its effects on the push-out bond strength of an epoxy-based sealer by scanning electron microscopy (SEM). Forty extracted human canines (n = 10) were assigned to the following final rinse protocols: G1-distilled water (control), G2–17% EDTA, G3-SmearClear, and G4-QMiX. The specimens were submitted to a SEM analysis to evaluate the presence of debris and smear layer, respectively, in the apical or cervical segments. In sequence, forty extracted human maxillary canines with the root canals instrumented were divided into four groups (n = 10) similar to the SEM analysis study. After the filling with AH Plus, the roots were transversally sectioned to obtain dentinal slices. The specimens were submitted to a push-out bond strength test using an electromechanical testing machine. The statistical analysis for the SEM and push-out bond strength studies were performed using the Kruskal–Wallis and Dunn tests (α = 5%). There was no difference among the G2, G3, and G4 efficacy in removing the debris and smear layer (P > 0.05). The efficacy of these groups was superior to the control group. The push-out bond strength values of G2, G3, and G4 were superior to the control group. The ability to remove the debris and smear layer by SmearClear and QMiX was as effective as the 17% EDTA. The final rinse with these solutions promoted similar push-out bond strength values.

Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal

This study sought to evaluate the efficacy of passive ultrasonic irrigation (PUI) on removing the smear layer and debris from root dentin using scanning electron microscopy (SEM). Twenty-five bovine incisors were manually prepared and divided into three groups according to the final irrigation protocol: EDTA, final irrigation with 12 mL of 17% EDTA for 3 minutes followed by 5 mL of 2.5% NaOCl; EDTA=PUI, final flush with 4 mL of 17% EDTA and PUI for 30 seconds. These procedures were repeated three times to standardize the volume of the irrigant. Control group, after preparation, the specimens were irrigated only with 17 mL of 2.5% NaOCl. The roots were fractured and analyzed using SEM. The intragroup analysis revealed that the EDTA=PUI protocol removed a higher amount of debris at the cervical third (P 5 0.03). The intergroup analysis revealed that EDTA=PUI presented the lowest amount of debris at the cervical third (P 5 0.007). Smear layer scores were higher in the control group compared with the EDTA and EDTA=PUI groups, but only at the cervical third (P 50.02). None of the final irrigant protocols completely removed the smear layer and debris. EDTA=PUI only improved the removal of debris at the cervical third.

Influence of ultrasonic activation in association with different final irrigants on intracanal smear layer removal

Aim: To evaluate the influence of ultrasonic activation (US) with different irrigant regimens in smear layer removal. Methods: One hundred bovine incisors were instrumented and divided into ten groups (n=10) according to final irrigation protocols: distilled water (DW); DW+US; 17% EDTA; QMix; 10% citric acid; 37% phosphoric acid; 17% EDTA+US; QMix+US; 10% citric acid+US; 37% phosphoric acid+US. The samples were then submitted to scanning electron microscopy where a score system was used to evaluate the images and effectiveness of proposed treatments. The data were statistically analyzed by Kruskal-Wallis and Mann-Whitney U tests for intergroup comparisons as well as the Wilcoxon and Friedman tests for intragroup comparisons at 5% significance level. Results: In the cervical third, groups 17% EDTA, QMix, 10% citric acid, 17% EDTA+US, QMix+US and 10% citric acid+US were more effective in smear layer removal (p<0.05); in the middle third, groups 17% EDTA+US and QMix+US were more effective in smear layer removal (p<0.05); in the apical third, groups 17% EDTA,17% EDTA+US and QMix+US were more effective in smear layer removal (p<0.05). Conclusions: US can aid 17% EDTA and QMix in smear layer removal at the middle third and QMix at the apical third, contributing to the cleaning of root canal system.

Qualitative Analysis of the Removal of the Smear Layer in the Apical Third of Curved Roots: Conventional Irrigation versus Activation Systems

Introduction: The aim of this study was to evaluate the effectiveness of different irrigant agitation techniques on smear layer removal in curved root canals. Methods: Mesiobuccal canals of 62 extracted lower molars with a curvature of 33 degrees were used and instrumented up to Pro Taper F2. The samples were divided into 3 experimental groups according to the final irrigation: conventional irrigation, ultrasonic irrigation, and sonic irrigation by using the Endo Activator system. The control group was composed of 2 specimens without any final irrigation. In all of the experimental groups, 5 mL of 17% ethylenediaminetetraacetic acid was used for 1 minute, and 5 mL of 2.5% NaOCl was used for 30 seconds. The analysis of the apical region was performed via scanning electron microscopy by 3 examiners. The data were submitted to the Kruskal-Wallis and Dunn tests (P<.05). Results: The activation systems removed significantly more smear layer than did conventional irrigation. Conclusions: Sonic and ultrasonic irrigation resulted in better removal of the smear layer in the apical third of curved root canals than did conventional irrigation. (J Endod 2011;37:1268-1271)

Effectiveness of EDTA and EDTA-T brushing on the removal of root surface smear layer.

The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p > 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.

Influence of Final Rinse Technique on Ability of Ethylenediaminetetraacetic Acid of Removing Smear Layer

Introduction: There is ongoing debate regarding the ideal sequence, volume, and concentration of irrigants, length of time for irrigation, and irrigation technique to achieve debridement of the root canal system. The aim of this study was to verify the impact of the final rinse technique on smear layer removal ability of 17% ethylenediaminetetraacetic acid (EDTA). Methods: Sixteen single-rooted human teeth were instrumented and divided into 2 groups at the final rinse step according to the following final rinse techniques used: continuous rinse group, continuous rinse with EDTA during 3 minutes, and rinse and soaking group, rinse with 1 mL of EDTA, soaking of the canal for 2 minutes and 30 seconds, and rinse completion with the remaining 4 mL for 30 seconds. The specimens were split lengthwise and observed under scanning electron microscope. Results: Data were analyzed with Kruskal-Wallis and Dunn tests. The continuous rinse group presented more debris-free surfaces when compared with the rinse and soaking group (P <. 01). When the root canal areas were compared within the groups, no statistical differences were found (P > .05). Conclusions: It can be concluded that a continuous rinse with 5 mL of EDTA for 3 minutes can more efficiently remove the smear layer from root canal walls. (J Endod 2010;36:512-514)

Does a final rinse to remove smear layer interfere on dentin permeability of root canals?

Objective. The objective of this study was to assess the influence of different final irrigating solutions on dentin permeability and smear layer removal using the same specimens and relate the results obtained. Study design. Forty anterior human teeth were instrumented and divided into 4 groups (n = 10) at the final rinse step, according to the irrigant used: G I (control) - 1% NaOCl; G II - 17% EDTA; G III - 17% EDTAT; and G IV - Biopure MTAD. The canals were filled with 0.5% methylene blue and maintained in bottles for 48 hours. The roots were transversally split in coronal, middle, and apical fragments. The specimens were photographed and analyzed regarding dye penetration. The fragments were then axially split and prepared for SEM. The photomicrographs were analyzed and qualified by scores. Results. Only the EDTA-T group exhibited statistical difference in which the apical third had less dentin permeability (P < .05). When a decalcifying agent was used, smear layer was removed, which did not happen in the NaOCl group. Regarding smear layer removal, differences were found only in the EDTA group in which the apical third presented more smear layer (P < .05). No correlation was found for both studies (r = 0.4207). Conclusions. There was not an even relationship between the results from both studies, which inferes that higher or lower dentinal permeability does not necessarily correspond to a higher or lower amount of smear layer. The analysis of dentin permeability and smear layer removal was shown to be a feasible procedure using the same specimens. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e47-e51)

Evaluation of the Smear Layer and Hybrid Layer in Noncarious and Carious Dentin Prepared by Air Abrasion System and Diamond Tips

Purpose: To analyze the smear layer and the hybrid layer in noncarious and carious dentin prepared by different cutting instruments and restored with composite resin. Study design: Cavities were randomly prepared in 160 specimens (noncarious and artificial carious dentin) by high-speed diamond tips (KG Sorensen 1013), air abrasion system (Prepstart, Danville Engineering), ultrasonic tip (CVDentus 8.3231-1), and ultrasonic tip associated with ultrasonic cavitation by water for 10 s. Half of the cavities in each group were conditioned with 37% phosphoric acid for 15 s. The amount of smear layer and dentinal tubules present were analyzed using scanning electron microscopy and graded from 0 to 3. Cavities were prepared in another 20 noncarious specimens and 20 carious specimens and restored with adhesive composite resin system. The restorations were hemisected longitudinally and analyzed using scanning electron microscopy to evaluate the hybrid layer and resinous prolongation characteristics, using scores ranging from 1 to 6. Results: The data were statistically analyzed using Kruskal-Wallis and Dunn tests at 5% of significance level. There was evidence that the most efficient smear layer removal was the acid etching in the noncarious dentin and the water ultrasonic cavitation in the carious dentin. The hybrid layer formed on the noncarious and carious dentin prepared by the ultrasonic tip was more regular than in the specimens prepared by high-speed diamond tip, with many resinous prolongations. Conclusion: The ultrasonic tip seems to be a promising tool for carious dentin cavity preparation. Microsc. Res. Tech. 73:597-605, 2010. (C) 2009 Wiley-Liss, Inc.

Influence of natural fruit juices in removing the smear layer from root surfaces - An in vitro study

Certain elements of a patient's diet may be associated with dentin hypersensitivity. The intent of this study was to evaluate the degree of removal of the smear layer from dentin surfaces by various fruit juices. A smear layer was created on extracted human teeth by manual scaling. The roots were reduced and distributed into 8 experimental groups. Distilled water was the negative control. The juices were applied by 2 methods: topical application and topical application with friction. Specimens were photomicrographed and graded according to an index of smear layer removal. With topical application, all but 2 of the tested substances resulted in significantly greater removal of the smear layer and opening of dentinal tubules than was the case with the negative control (p = 0.05); the exceptions were Gala apple and Italian grape juices, which were no different from the control. For the active application (with friction), most substances removed more smear layer than the control (p < 0.05); Gala apple, Italian grape and orange juices were similar to the control. For each of the tested substances, removal of the smear layer did not differ with the method of application (topical vs. friction; p > 0.05). It is concluded that natural fruit juices can remove the smear layer from dentin surfaces, and the efficacy of this removal varies with the type of juice. © J Can Dent Assoc 2004.

Influência da smear layer e da condição de tratamento da dentina (in vivo e in vitro), sobre a resistência de união

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo in vitro da eficácia de um gel de EDTA-T na remoção da smear layer da superfície radicular

Pós-graduação em Odontologia - FOAR

Eficácia do cloridrato de tetraciclina na remoção da smear layer e na exposição do colágeno da matriz dentinária

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Eficácia do cloridrato de tetraciclina em diversas concentrações na remoção de smear layer e exposição de fibras colágenas da superfície radicular

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Eficiência de detergentes e EDTA na remoção da smear layer de superfícies radiculares submetidas a raspagem e aplainamento: análise através da microscopia eletrônica de varredura

A remoção da smear layer é um procedimento importante para a regeneração periodontal e para o tratamento da sensibilidade dentinária. Diversos tratamentos tem sido realizados para sua remoção, porém, mostrando resultados conflitantes ou insatisfatórios. No presente estudo nos propomos a analisar através do microscópio eletrônico de varredura a eficiência dos detergentes: lauril sulfato de sódio, Plax e de mamona assim como o EDTA 24% na remoção da smear layer. Todos os produtos testados foram aplicados com bolinha de algodão, renovada a cada 30 segundos, a qual era esfregada na superfície radicular por diferentes períodos. As fotomicrografias foram analisadas através da aplicação de um índice de remoção da smear layer por três examinadores calibrados e os resultados analisados estatisticamente. De acordo com nossos resultados pudemos chegar as seguintes conclusões: 1- a instrumentação com curetas de Gracey provocou a formação da smear layer; 2- o detergente lauril sulfato de sódio não removeu a smear layer, tendo sido o pior resultado entre os detergentes testados; 3- Os detergentes Plax e de mamona mostraram resultados semelhantes entre si e superiores ao controle negativo e ao lauril sulfato de sódio, porém, não removeram a smear layer satisfatoriamente; 4- O EDTA 24% neutro mostrou ser eficiente para a remoção da smear layer.