Comparative evaluation of efficacy of EndoVac irrigation system to Max-I probe in removing smear layer in apical 1 mm and 3 mm of root canal: An in vitro scanning electron microscope study

Abstract

Background:The purpose of this study was to compare the efficacy of EndoVac irrigation system and side-vented closed ended needle (Max-I probe) in removing smear layer from root canals at 1 mm and 3 mm from working length using ProTaper rotary instrumentation.Materials and Methods:A total of 50 freshly extracted maxillary central incisors were randomly divided into two groups after complete cleaning and shaping with ProTaper rotary files. In one group, final irrigation was performed with EndoVac system while in other group, final irrigation was done with a 30 gauge Max-I probe. 3% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetracetic acid were used as final irrigants in all teeth. During instrumentation, 1 ml of 3% NaOCl was used for irrigation after each rotary instrument in the similar manner as in final irrigation. After instrumentation and irrigation, teeth were sectioned longitudinally into buccal and palatal halves and viewed under scanning electron microscope for evaluation of smear layer. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-test. (P < 0.05)Results:At 3 mm level, there was no significant difference between two groups. At 1 mm level, EndoVac group showed significantly better smear layer removal compared with Max-I probe (P = 0.0001).Conclusion:EndoVac system results in better smear layer removal at 1 mm from working length when compared to Max-I probe irrigation.

Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta‐analysis

“…Furthermore, only two studies (Mancini et al . , Dua & Dua ) reported on the apical 1 mm of the canal and not all IATs were tested. Hence, the volume of evidence is considerably low in this region and further investigations are needed before any clinical recommendations can be made for this region.…”

“…In the two studies that inspected the apical 1 mm (Mancini et al . , Dua & Dua ), only smear removal was evaluated and MDA was not tested. Predominately, 5‐point semi‐quantitative scoring systems (Hülsmann et al .…”

Apical Negative Pressure irrigation presents tissue compatibility in immature teeth

“…This system enables the circulation of irrigant solution to all working lengths (WL) 2 and facilitates microbiological control 13 , 23 . The ANP is also efficient in removing the “smear layer" 10 , 18 and debris, mostly at the apical third of a root canal 1 , 4 , 10 , 11 .…”

Management of an internal root resorption on a permanent tooth. A case report.

“…The Max-i-probe cannula was used for irrigation. The advantage of this cannula is its hermetic end and its side opening that allows the irrigant to come out without overreaching the apex 18 .…”

“…Upon dissociation CH produces high pH (12.5-12.8) preventing the dissolution of mineral components of dentin, in addition to activating alkaline phosphatase, which plays an important role in the formation of hard tissue [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] .…”