Evaluation of the effect of SmearOFF on Smear Layer Removal and Erosion of Root Canal Dentin
An in Vitro Study
Keywords:SmearOFF, endodontics, irrigation, smear layer, erosion
Background and Objectives: Root canal instrumentation produces a smear layer that covers the root canal walls and may have adverse effects on endodontic treatment. SmearOFF is a new endodontic irrigant, which proposes smear layer removal and microbial elimination in one step. The aim of the present study was to evaluate and compare the effect of SmearOFF with other final irrigants regarding smear layer removal and degree of erosion from the apical third of root canals.
Methods: Forty mandibular premolar roots with single canals were selected. The teeth were randomly divided into 4 groups of 10 teeth each according to the type of final irrigants used during and after instrumentation: G1 6% NaOCl/ distilled water (control), G2 6% NaOCl/Qmix, G3 6% NaOCL/SmearOFF, G4 6% NaOCL/ 17% EDTA. All teeth were shaped by using ProTaper NEXT rotary system till X2. 6% NaOCl was applied with a 27-G side-vented syringe needle as an initial irrigant followed by the final irrigants. Endoultra ultrasonic device was used for irrigation activation. The samples were then submitted to scanning electron microscopy to evaluate the effectiveness of proposed treatments.
Results: In smear layer variables score 2 was the most occurred value for G2 (QMIX) and G3 (SmearOFF), whereas in G1 (Distilled water) and G4 (17% EDTA) are 3 and 1 respectively. For erosion variable, erosion was most evident in G4 (6% NaOCL/ 17% EDTA). There were no significant differences between G2 and G3 and also between G3 and G4 in both smear layers and erosion.
Conclusion: 17% EDTA, SmearOFF, and QMix using PUI can remove smear layer effectively from the apical third. In the future, SmearOFF may act as a promising chelating agent as well as an antimicrobial irrigant.
2. Souza MA, Motter FT, Fontana TP, Ribeiro MB, Miyagaki DC, Cecchin D. Influence of ultrasonic activation in association with different final irrigants on intracanal smear layer removal.Braz J Oral Sci 2016;15(1):16-20.
3. Torabinejad M, Handysides R, Khademi AA, Bakland LK.Clinical implications of the smear layer in endodontics: a review. Oral surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 658-66.
4. Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysis. Int Endod J. 2005 May;38(5):285-90.
5. Prado MC, Leal F, Gusman H, Simão RA, Prado M. Effects of auxiliary device use on smear layer removal Journal of Oral Science 2016; 58(4): 561-567.
6. Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root canal irrigation regimens. J Endod 1987;13:147–57.
7. Zehnder M. Root canal irrigants. J Endod 2006;32:389–98.
8. Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant, QMiX. International Endodontic Journal 2012; 45: 363–371.
9. Vista Dental Products: SmearOFF. [Cited 22 Oct 2018]; [1 paragraph]; Available from: https:// vista-dental.com/content/pdfproductsheets/ SmearOFF.pdf
10. George S, Kishen A, Song KP. The role of environmental changes on monospecies biofilm formation on root canal wall by Enterococcus faecalis. J Endod. 2005 Dec;31(12):867-72.
11. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007 Jun;40(6):415-26. Epub 2007 Apr 17.
12. Vista Dental Products: Endoultra. [Cited 22 Oct 2018]; [1 paragraph]; Available from: https:// vista-dental.com/content/pdfproductsheets/ EndoUltra_Ultrasonic_Activation.pdf
13. Vujaskovic M and Teodorovic N. Analysis of sealing ability of root canal sealers using scanning electron microscopy technique. Srp Arh Celok Lek 2010; 138(11): 694-8.
14. Adarsh V, Madhu Kiran MK, Jamsheed ET, Thomas G, Jose S, Shetty RS. A Comparative Evaluation of Smear Layer Removal by using Three Different Irrigating Systems in Endodontics: An In-Vitro Scanning Electron Microscopic Study. Journal of International Oral Health 2016; 8 (1):80-85.
15. Niu LN, Luo XJ, Li GH, Bortoluzzi EA, Mao J, Chen JH, et al. Effects of different sonic activation protocolson debridement efficacy in teeth with single-rooted canals. J Dent. 2014; 42: 1001-9.
16. Ruddle CJ. DENTSPLY Tulsa’s ProTaper NEXT A New Standard in Safety and Efficiency;.[Cited 22 OCT 2018]; [1 Paragraph]; Available from: https://www.dentsplysirona.com/content/dam/ dentsply/pim/manufacturer/Endodontics/ Glide_Path__Shaping/ Rotary__Reciprocating_Files/Shaping/ ProTaper_Next_Rotary_Files/PTNEXT% 20Ruddle%20Quick%20Technique.pdf
17. Ulusoy OIA, Görgül G. Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. AustEndod J. 2013; 39: 66–72.
18. Darrag AM. Effectiveness of different final irrigation solutions on smear layer removal in intraradicular dentin. Tanta Dental Journal 2014; 11: 93-99.
19. Torabinejad M, Khademi AA, Babagoli J, et al. A new solution for the removal of the smear layer. J Endod 2003; 29: 170–5.
20. van der Sluis LW, Gambarini G, Wu MK, Wesselink PR. The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J 2006;39: 472–6.
21. Suchithra MS, Kuriakose S, Sreedharan S. Effectiveness of Different Irrigation Regimes on the Removal of Smear Layer in the Middle And Apical Thirds of Root Canals – A Scanning Electron Microscopic Study. IOSR-JDMS 2017; 16(8): 38-46.
22. Monea MD, Olah P, Cerghizan D, Earar K, Budacu CC, Bica CI. The Effectiveness of Endodontic Irrigating Solutions: on Smear Layer Removal from Radicular Dentin: A scanning electron microscopic study. MATERIALE PLASTICE 2016; 53(2): 339-341.
23. Ulusoy OIA, Görgül G. Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. Aust Endod J.2013; 39: 66–72.
24. Baumgartner JC, Mader CL. A scanning electron microscope evaluation of four root canal irrigation regimes. J Endod. 1987;13:147-57.
25. Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant, QMiX. Int Endod J. 2012;45 (4):363-71.
26. Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent 2010; 13(4): 256-64.
27. Ingle JI, Bakland LK. Endodontics 4th Edition, Baltimore: Williams & Wilkins; 1994.
28. Serper A, Calt S. The Demineralizing Effects of EDTA at Different Concentrations and pH. J Endod. 2002;28(7):501-2.
29. Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in Endodontics. Dent Clin N Am 2010; 54: 291–312.
30. Peters CA, Barbakow F. Effect of irrigation on debris and smear layer on canal walls prepared by two rotary techniques: a scanning electron microscopic study. J Endod 2000;25:6–10.
31. Banode AM, Gade V, Patil S, Gade J, Chandhok D, Sinkar R. Comparative Scanning Electron Microscopy Evaluation of Smear Layer Removal with 17% Ethylenediaminetetraacetic Acid, 10% Citric Acid and Newer Irrigant QMix: In Vitro Study. IJOHR 2015; 1(2): 56-61.
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