Qualitative analysis of smear layer treated with different etidronate concentrations: A scanning electron microscopy study

Abstract

The aim of this study was to examine the smear layer removal capacity of various etidronate treatments. Seventy‐eight roots were instrumented up to apical size X4 and randomly divided into five treatment groups and a positive control group (n = 13). Groups were as follows: irrigation with 5 ml of sterile saline (control) for 3 min, 5 ml of 17% ethylenediaminetetraacetic acid (EDTA) for 3 min, 5 ml of 9% A1‐hydroxyethylidene‐1,1‐bisphosphonate (HEBP) for 3 min, 5 ml of 18% HEBP for 3 min, irrigation with 5 ml of 1% sodium hypochlorite (NaOCl) + 9% HEBP for 3 min, and 5 ml of 2% NaOCl + 18% HEBP for 3 min. The roots were examined using a scanning electron microscope. The smear layer scores in the 2% NaOCl + 18% HEBP group were lower than those in the other treatment groups and the control group (p < .05). There were no significant differences among the treatment groups in the smear layer scores of the coronal and middle thirds. However, the smear layer scores in the 2% NaOCl + 18% HEBP treatment group were lower those in the 9% HEBP and 18% HEBP treatment groups in the apical third (p < .05). In the clinical setting, the recommended concentration of HEBP is 18%, and it should be used with an oxidizing agent to ensure optimum smear layer removal.

Effect of continuous chelation irrigation using DualRinse HEDP/3% NaOCL with or without high-power sonic activation on debris and smear layer removal.

“…However, the results of this study are not in accordance with the findings of Kfir et al ( 13 ), which did not detect any significant difference in debris and smear layer removal between DualRinse HEDP+NaOCl and NaOCl-EDTA-NaOCl without activation. In contrast, studies by Ulusoy et al and Erik et al ( 23 , 24 ) confirmed that the use of 9% HEDP and 18% HEDP resulted in increased removal of the smear layer than EDTA at the apical third, which is comparable to the results of the present study. Additionally, it is important to note the limitations present in this study.…”

Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study

“…Calcified and necrotic tissue debris, odontoblastic processes and microbes in the tubules of the dentin are the constituents of the smear layer. [ 1 ] This smear layer formed during biomechanical preparation gets smeared on the wall of the root canal, thereby inhibiting the complete locking and adhesion of the canal-filling materials into the tubules of dentin[ 1 3 4 ]…”

“…It has its own limitations while dealing with inorganic component of the smear layer. [ 4 ] Literature supports that a canal, in which the apical third is covered with a smear layer and contains an abundance of inorganic debris which can be a constraint for NaOCl. [ 5 ] It has been suggested that to remove the smear layer, a final flush with 17% ethylenediaminetetraacetic acid (EDTA) may be helpful.…”

“…To prevail over the drawbacks of EDTA, a new endodontic chelating irrigating solution called 1-hydroxyethylidene 1, 1-diphosphonate (HEDP) was introduced in 2005. [ 4 ] When compared with the administration of EDTA, HEDP has less detrimental effects on the root dentin. The smear layer treatment efficacy of HEDP is comparable to EDTA, without affecting the organic tissue dissolution potential of NaOCl.…”

“…The smear layer treatment efficacy of HEDP is comparable to EDTA, without affecting the organic tissue dissolution potential of NaOCl. [ 4 ] The unique short-term compatibility of HEDP with NaOCl makes it possible to use a combined NaOCl/HEDP irrigant during chemomehanical root canal preparation and for the final irrigation. The smear layer can be effectively removed by the combined application of HEDP and NaOCl with minimal effect on the root dentin wall.…”