A comparative scanning electron microscopy evaluation of smear layer removal with apple vinegar and sodium hypochlorite associated with EDTA

Abstract

ObjectiveThe purpose of this study was to evaluate by scanning electron microscopy (SEM) the removal of smear layer from the middle and apical root thirds after use of different irrigating solutions. Material and MethodsForty roots of permanent human teeth had their canals instrumented and were randomly assigned to 4 groups (n=10), according to the irrigating solution: apple vinegar (group A), apple vinegar finished with 17% ethylenediaminetetraacetic acid (EDTA) (group B), 1% sodium hypochlorite (NaOCl) finished with 17% EDTA (group C) and saline (group D - control). After chemomechanical preparation, the roots were cleaved longitudinally and their middle and apical thirds were examined by SEM at ×1,000 magnification. Two calibrated examiners (kappa=0.92) analyzed the SEM micrographs qualitatively attributing scores that indicated the efficacy of the solutions in removing the smear layer from the surface of the dentin tubules (1 - poor, 2 - good and 3 - excellent). Data from the control and experimental groups were analyzed by the Kruskal-Wallis and Dunn's test, while the Wilcoxon test was used to compare the middle and apical thirds of the canals within the same group (α=0.05). ResultsThe middle third presented less amount of smear layer than the apical third, regardless of the irrigant. There was statistically significant difference (p=0.0402) among the groups in the middle third. In the apical third, the apple vinegar/EDTA group showed the greatest removal of smear layer (p=0.0373). ConclusionApple vinegar associated or not with EDTA was effective in removing smear layer when used as an endodontic irrigant.

Antifungal Activity of Apple Cider Vinegar on Candida Species Involved in Denture Stomatitis

“…This study corroborates the findings of the literature, reinforcing the possibility of adopting vinegars as antifungal agents . However, clinical studies using a standard protocol as a reference, in addition to information obtained in in vitro tests are required so that the test product is evaluated in the challenges of the oral environment.…”

“…Among the new alternatives under study for the treatment of denture stomatitis, maleic acid has been addressed as an important element contained in apple cider vinegar, with bactericidal and fungicidal activity. It has already been employed in dentistry as an antimicrobial solution used during chemomechanical preparation of root canals, alone or in combination with ethylenediamine tetra‐acetic acid …”

Evaluation of Smear Layer Removal and Calcium Ions Concentration in Intraradicular Dentin Treated with Apple Vinegar (SEM Study)

“…The search for a chelating agent that was more efficient and biocompatible than EDTA has resulted in various solutions being researched over the last few years. Accordingly, apple vinegar was used in the present study due to its biocompatibility, chelating capacity, antimicrobial potential and its cost-effectiveness (7,9,24) .…”

“…The smear layer removal with several root canal chelators (15% EDTA, 10% citric acid, 10% sodium citrate, apple vinegar, 5% acetic acid, 5% malic acid, and 1% NaOCl) has been verified and concluded that EDTA and citric acid were the most efficient solutions in removing smear layer (8) . It has been concluded that the apple vinegar associated or not with EDTA was more effective in removing smear layer from the root canals than NaOCl associated with EDTA (9) .…”

Influência de soluções irrigadoras e de materiais obturadores na infiltração apical – análise pelo método de filtração de fluidos

“…O hipoclorito de sódio é a principal solução irrigadora em tratamentos endodônticos, e recentes estudos verificaram uma possível influência negativa quando utilizados os sistemas adesivos 7,8 . O vinagre de maçã tem sido proposto como solução irrigante, possuindo uma biocompatibilidade adequada e considerável capacidade de remover a camada de smear layer presente na superfície dos túbulos dentinários [9][10][11] . No entanto, ainda não foi avaliado o efeito do vinagre de maça como solução irrigadora no selamento apical, quando associado à guta-percha e ao sistema Resilon/Epiphany.…”