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

Abstract

Aim: This study was conducted to evaluate the smear layer removal efficiency of apple vinegar and EDTA when used as final rinse using scanning electron microscope (SEM) and to quantify the calcium content of intraradicular dentin after being treated with apple vinegar or EDTA using energy dispersive X-ray microanalyzer (EDX). Materials and methods: Fifty palatal roots of extracted human permanent maxillary molars with completely formed were selected and prepared with Universal Protaper rotary files. After using each file, canals were irrigated with 2 ml of 2.6% NaOCl for 1 minute. The samples were divided into 4 groups according to the final rinse used and the application time: (10 samples each), Group I: 17% EDTA for 1 minute.Group II: Apple vinegar for 1 minute. Group III: 17% EDTA for 3 minutes.Group IV: Apple vinegar for 3 minutes.Group V: control group is divided into: GV(A), Five samples where the root canals were irrigated with sterile saline and GV(B), Five samples were used to assess the calcium content with energy dispersive X-ray microanalyzer (EDX), where the root canals will not receive any treatment. Results: Regarding smear layer removal, at coronal and middle thirds there was no statistically significant difference in the mean scores of smear layer produced by the tested groups.At the apical third the lowest mean smear layer score was recorded in specimens treated with apple vinegar for 1 minute (Group II) with a statistical significant difference from specimens treated with 17% EDTA for 1 minute (Group I). Regarding the calcium content, the highest mean value was recorded in specimens treated with apple vinegar for 1 minute (Group II) with statistically significant difference from that recorded in specimens treated with 17% EDTA for 1 minute (Group I) and specimens treated with apple vinegar for 3 minutes (Group IV). Conclusion: Apple vinegar was capable of adequately removing smear layer from intraradicular dentin when used as final rinse.Apple vinegar was more effective in removing smear layer from intraradicular dentin at the apical third compared to 17% EDTA. Apple vinegar was more effective when used for one minute as final rinse in the removal of smear layer without affecting the calcium content of intraradicular dentin compared to 17% EDTA.

Effect of Using Boswellia Sacra Extract as Final Irrigant on Removal of Smear Layer

“…The irrigation protocol used for the tested solutions was using 5ml for 1 minute (11) . Studies had reported that using EDTA irrigant for more than a minute resulted in erosion of dentinal tubules, which consequently reduced dentin microhardness (36,37) .…”

Efficacy of Apple vinegar as Final Irrigating Solution in Removing Smear Layer Using XP-Endo Finisher File

“…It has been reported that, coronal and middle levels have less challenge in smear layer removal in comparable with the apical level. That is due to the size of the canal in these thirds is larger than in the apical which enhance the irrigating solution efficiency (14) .…”

“…Several studies evaluated the efficacy of apple vinegar on removing smear layer and they concluded that apple vinegar was more effective when used for one minute as final rinse in removing smear layer without affecting the calcium content of intraradicular dentin compared to 17% EDTA (11)(12)(13)(14) .…”

Survival and Adherence of Apical Stem Cells to Root Canal Dentin after Conditioning with Apple Vinegar

“…The use of apple vinegar as a final irrigant has been proposed and proved better results than 17%EDTA regarding the removal of smear layer especially in the apical third (18,19) . Apple vinegar use deserves special attention due to its antimicrobial effect (20) , its biocompatibility and its cost effectiveness. It is formed of acetic, citric, formic, lactic, succinate and tartaric acids with small amounts of alcohol that results from the fermentation process.…”