Smear layer removal comparing conventional irrigation, passive ultrasonic irrigation, EndoActivator System, and a new sonic device (Perfect Clean System) by scanning electron microscopy: An ex vivo study.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Microscopy, Electron, Scanning*/methods ; Therapeutic Irrigation*/instrumentation ; Therapeutic Irrigation*/methods ; Smear Layer*; Humans ; Root Canal Preparation/instrumentation ; Root Canal Preparation/methods ; Bicuspid ; Ultrasonics ; Root Canal Irrigants/administration & dosage ; Sodium Hypochlorite ; Sonication/methods

Aim: This study evaluated the smear layer removal provided by conventional, sonic, and ultrasonic irrigation techniques.
Methodology: Forty extracted human mandibular first premolars were selected and instrumented using the ProTaper Next System files and 2.5% sodium hypochlorite. Afterward, they were divided into 4 groups (n. 10) according to the irrigation technique used to perform the final irrigation with a chelating solution (17% EDTA): conventional irrigation (CI), passive ultrasonic irrigation (PUI), EndoActivator System (EAS), and Perfect Clean System (PCS). The smear layer removal was determined through a score after evaluating scanning electron microscope images (1.000x) obtained at 1, 5, 8, and 12mm from the working length (WL). Statistical analyses were carried out by the Kruskal-Wallis and Dunn's tests with a significance level of 5% (P < 0.05).
Results: All irrigation techniques were unable to promote an effective smear layer removal at 1mm from the WL in comparison with the other locations (P < .05). At 5, 8, and 12mm from the WL, no statistically significant differences were observed among CI, PUI, EAS, and PCS (P > 0.05). At 12mm from the WL, statistically significant differences were only identified after comparing PCS and CI (P < .05).
Conclusion: The smear layer removal was only efficient at 5, 8, and 12 from the WL with no significant statistical differences among CI, PUI, EAS, and PCS (P > 0.05).
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Gonçalves et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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0 (Root Canal Irrigants)
DY38VHM5OD (Sodium Hypochlorite)

Date Created: 20241227 Date Completed: 20241227 Latest Revision: 20250104

20250104

PMC11676573

10.1371/journal.pone.0314940

39729517