Removal of Smear Layer by Two Endodontic Irrigation Solutions and Erbium: Yttrium, Aluminum, Garnet (Er:YAG)Laser. A Scanning Electron Microscope (SEM) Study
Journal of Lasers in Medical Sciences,
Vol. 3 No. 4 (2012),
22 September 2012
,
Page 147-152
Abstract
INTRODUCTION: The purpose of the present study was to determine the effect of 17% Ethylene,di-amine, tetra-acetic acid (EDTA), 6% phosphoric acid and Erbium: Yttrium, Aluminum, Garnet (Er:YAG) Laser in removing the smear layer by scanning electron microscopy.
METHODS: In this study, 80 single-rooted human teeth were selected. Instrumentation was done by use of hand files and step-back technique up to file #40 at apical and file #80 at coronal area. During instrumentation, 1ml of 5.25% sodium hypochlorite (NaOCl) was used as irrigation between each file. The teeth were randomly divided into four groups with different methods of smear removal.17% Ethylene, di-amine, tetra-acetic acid was used in group 1, 6% Phosphoric acid in group 2, Erbium: Yttrium, Aluminum, Garnet laser in group 3, and no intervention in group 4 (as control). Roots were then longitudinally sectioned and prepared for scanning electron micrograph in cervical, middle and apical areas. Data were analyzed by Kruskal-Walis, Mann-Whitney, Friedman and Wilcoxson tests (P<0.05).
RESULTS: The results showed a significant difference in smear layer removal between three methods in favor of the EDTA (P<0.001) and Phosphoric groups (P<0.001) with no significant difference between them (P=0.49). Although Er:YAG laser showed some limited ability to remove the smear layer, the effectiveness was not significantly different from the control group (P=0.157).
CONCLUSION: Based on the findings of this study, EDTA and Phosphoric acid were effective methods to remove smear layer from the root canal walls but Er:YAG laser showed less efficacy compared to the other experimental groups.
- layer
- smear
- EDTA
- Phosphoric acid
- Er
- YAG
How to Cite
References
McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975;1(7):238-42.
Moodnik RM, Dorn SO, Feldman MJ, Levey M, Borden BG. Efficacy of biomechanical instrumentation: a scanning electron microscopic study. J Endod 1976;2(9):261-6.
Mader CL, Baumgartner JC, Peters DD. Scanning electron microscopic investigation of the smeared layer on root canal walls. J Endod 1984;10(10):477-83.
Cengiz T, Aktener BO, Piskin B. Effect of dentinal tubule orientation on the removal of smear layer by root canal irrigants. A scanning electron microscopic study. Int Endod J 1990;23(3):163-71.
Pashley DH. Smear layer: overview of structure and function. Proc Finn Dent Soc 1992; 88(l):215-24.
Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965;20:340-9.
Eick JD, Wilko RA, Anderson CH, Sorensen SE. Scanning electron microscopy of cut tooth surfaces and identification of debris by use of the electron microprobe. J Dent Res 1970;49(6):1359-68.
Hata G, Hayami S, Weine FS, Toda T. Effectiveness of oxidative potential water as a root canal irrigant. Int Endod J 2001;34,308-17.
Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007;33,472-5.
Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. J Endod 1983;9(4):137-42.
Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root canal irrigation regimens. J Endod 1987;13(4):147-57.
Prati C, Selighini M, Ferrieri P, Mongiorgi R. Scanning electron microscopic evaluation of different endodontic procedures on dentine morphology of human teeth. J Endod 1994;20(4):174-9.
Wayman BE, Kopp WM, Pinero GJ, Lazzari EP. Citric and lactic acids as root canal irrigants in vitro. J Endod 1979;5(9):258-65.
Aktener BO, Bilkay U. Smear layer removal with different concentrations of EDTA-ethylenediamine mixtures. J Endod 1993;19(5):228-31.
Pashley DH. Smear layer: physiological considerations. Oper Dent Suppl 1984;3:13-29.
Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP. The effectiveness of different acid irrigating solutions in root canal cleaning after hand and rotary instrumentation. J Endod 2006;32(10):993-7.
Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP, Martín-Peinado FJ, González-López S. Decalcifying effect of 15% EDTA, 15% citric acid, 5% phosphoric acid and 2.5% sodium hypochlorite on root canal dentine. Int Endod J. 2008;41:418-23.
Takeda FH, Harashima T, Kimura Y, Matsumoto K. Efficacy of Er:YAG Laser irradiation in removing debris and smear layer on root canal walls. J Endod 1998;24(8):548-51.
Takeda FH, Harashima T, Eto JN, Kimura Y, Matsumoto K. Effect of Er:YAG laser treatment on the root canal walls of human teeth: an SEM study. Endod Dent Traumatol 1998 Dec;14(6):270-3.
Harashima T, Takeda FH, Zhang C, Kimura Y, Matsumoto K. Effect of argon laser irradiation on instrumented root canal walls. Endod Dent Traumatol 1998;14(1):26-30.
Onal B, Ertl T, Siebert G, Muller G. Preliminary report on the application of pulsed CO2 laser radiation on root canals with AgCl fibers: a scanning and transmission electron microscopic study. J Endod 1993;19:272–6. 22. Dederich DN, Zakariasen KL, Tulip J. Scanning electron microscopic analysis of canal wall dentin following neodymium- yttrium-aluminum-garnet laser irradiation. J Endod 1984;10:428-31.
Takahashi K, Machida T, Kimura Y, Matsumoto K. The morphological study of root canal walls with Er:YAG laser. J Jpn Endod Assoc 1996;17:197-203.
Khademi AA, Faizianfard M. The effect of EDTA and citric acid on smear layer removal mesial canals of first mandibular molars: A SEM study. J Res In Med Sci 2004; 9(2):27-35.
Takeda FH, Harashima T, Kimura Y, Matsumoto K. A comparative study of the removal of smear layer by three endodontic irrigants and two types of laser. Int Endod J 1999;32(1):32-9.
Theodoro LH, Zezell DM, Garcia VG, Haypek P, Nagata MJ, de Almeida JM, et al. Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium-aluminum-garnet Laser irradiation. A scanning electron microscopy study. Laser Med Sci 2010; 25(4):485-91.
Kivanç BH, Ulusoy OI, Görgül G. Effects of Er:YAG laser and Nd:YAG laser treatment on the root canal dentin of human teeth: a SEM study. Laser Med Sci 2008; 23:247-52.
Dostalva T, Jelinkova H, Housova D, Sule J, Nemec M, Duskova J, Mivagi M, Kratky M: Endodontic treatment with application of Er:YAG Laser waveguide radiation disinfection. J Clin Laser Med Surg; 20(3):135-9.
Perin FM, Franca SC, Silva-Sousa YT, Alfredo E, Saquy PC, Estrela C, et al. Evaluation of the antimicrobial effect of Er:YAG Laser irradiation versus 1% sodium hypochlorite irrigation for root canal disinfection. Aust Endod J 2004;30(1):20-2.
Schoop U, Goharkhay K, Klimscha J, Zagler M, Wernisch J, Georgopoulos A, et al. The use of Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser in endodontic treatment: the results of an in vitro study. J Am Dent Assoc 2007;138(7):949-55.
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