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The purpose of this study was to compare the efficacy of different chelating solutions (17% EDTA and 10% citric acid) on the smear layer removal, and their effect on tubular dentin sealer penetration. Sixty root canals were prepared and distributed into four groups (n = 15) according to the final irrigation protocol: G1, final irrigation with 2.5 mL of distilled water; G2, final irrigation with 2.5 mL of 2.5% sodium hypochlorite solution; G3, final irrigation with 2.5 mL of 17% EDTA; and G4, final irrigation with 2.5 mL of 10% citric acid. Five specimens from each group were not filled to assess smear layer removal by scanning electron microscopy. Ten specimens from each group were filled for analysis of sealer penetration into dentinal tubules by confocal laser scanning microscopy. Smear layer removal (Kruskal-Wallis and Dunn's tests) and sealer penetration (F and Tukey's tests) were statistically analyzed with 95% of significance level. G3 and G4 had greater smear layer removal rates in the cervical and middle thirds, in comparison with G1 and G2 (p < .05). G3 and G4 had the highest percentages of sealer penetration in all thirds, in comparison with G1 and G2 (p < .05). Smear layer removal was effective only at the cervical and middle thirds when the chelating solutions were used. Sealer penetration into the dentinal tubules significantly increased in all root thirds when the specimens were treated with both chelating solutions., (© 2017 Wiley Periodicals, Inc.)

Innovative file systems have been recently introduced, claiming improved effectiveness and superior ability to preserve the tooth structure, still allowing an efficient preparation and disinfection up to the apical region. Regardless, few data are available on the comparative effectiveness of the most recently developed systems. Thus, this ex vivo study aimed to comparatively evaluate, for the first time, the functionality of WaveOne Gold (WOG), TruNatomy (TN), and ProTaper Ultimate (PU) file systems regarding canal shaping, dentin preservation, and smear layer removal ability. Human maxillary incisors were randomly divided for instrumentation with one of the assayed systems. Canal shaping ability and pericervical dentin preservation were characterized through microtomographic evaluation and morphometric assessment (n = 15). Smear layer removal ability was evaluated by scanning electron microscopy (SEM) (n = 6). TN and PU presented the lowest canal volume variation upon instrumentation, found to be significantly lower than that attained with WOG (P <.05). Pericervical dentin was reduced in all groups upon instrumentation, with TN evidencing the highest preservation, quantitatively similar to PU, and significantly higher than that attained with WOG (P <.05). SEM imaging revealed the presence of scattered remnants of the smear layer and partially opened dentinal tubules at the apical portion, with no significant differences between systems. TN and PU allowed for the highest tissue preservation, reporting the lowest volume variation and the highest preservation of the pericervical dentin. None of the assessed systems provided a complete removal of the smear layer in the apical region. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the two nickel–titanium (NiTi) instruments on root dentin thickness using cone-beam computed tomography (CBCT) and ability to remove the smear layer using scanning electron microscope (SEM). Materials and Methods: The effect of two NiTi rotary instruments such as XP Endo shaper and ProTaper Gold (PTG) in retaining adequate dentin thickness and debridement (i.e., removal of smear layer) was evaluated in vitro using CBCT and SEM. After cleaning and shaping of the root canal with adequate irrigation, the effect of two NiTi instrument systems at 3 mm (apical), 6 mm (middle), and 9 mm (coronal) levels on buccal, lingual, mesial, and distal aspects in terms of amount of dentin removal and smear layer removal was evaluated. The data were analyzed using student's unpaired t-test with a significance of P ≤ 0.05. Results: Both NiTi instrument systems had no statistically significant difference in amount of dentin removal at all three levels and on all four aspects. In smear layer removal, PTG had significantly better efficacy compared to XP Endo shaper at the coronal third of root canal. Conclusion: Instrumentation with XP Endo Shaper and PTG showed a similar amount of dentin removal. PTG has a significant effect on smear layer removal compared to XP Endo Shaper only at the coronal third of root canal. [ABSTRACT FROM AUTHOR]

Introductio: Healing potential of plants is an age-old idea that has recently attained renewed interest. Considering the ineffectiveness, potentially harmful effects, and safety concerns of commonly used synthetic irrigants, the herbal alternatives for endodontic usage might prove to be advantageous.Aim: The aim of this study was to evaluate the adequacy of smear layer removal and cytotoxicity potential of triphala in comparison to sodium hypochlorite.Materials and Methods: The study was conducted in two parts: the first part of the study was cytotoxicity assessment studied using Alamar blue assay. L929 mouse fibroblasts were seeded in 96-well plates at a density of 5000 cells/well and treated with different concentrations of triphala and NaOCl for a period of 24 and 48 h. The percentage of cell viability was then quantified using an Alamar blue assay. The optical density was measured at 570 nm and compared with 620 nm, which was considered as a reference wavelength. The second part of the study was smear layer assessment at the coronal, middle, and apical third of twenty human premolar teeth using scanning electron microscope.Results: The Alamar blue reagent cytotoxicity study suggested that triphala showed no cytotoxic properties against the normal mouse fibroblast cells whereas sodium hypochlorite showed a significant cytotoxic effect against the L929 cell lines with the IC50 concentration at 1.8%, respectively, after the treatment of 24 h of incubation at 37°C temperature. Triphala was as effective as sodium hypochlorite in smear layer removal in the coronal and middle third of the root, but sodium hypochlorite showed better smear layer removal in the apical third.Conclusion: Triphala can be considered as a superior irrigant with good antibacterial efficacy and least cytotoxicity potential compared to conventional hypochlorite irrigating agent and provide adequate clearing of smear layer in the coronal and middle third, and further studies are warranted to alter the properties of liquid to make it more cleansable in the apical third of the root. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of Caffeic Acid Phenethyl Ester (CAPE) and its combination with EDTA and NaOCl on the surface of root canal dentine. Material and Methods: Ninety human extracted central anterior teeth were instrumented. Teeth were divided into six groups according to irrigation regime: (n=15). Group 0 (negative control) saline; group 1: 5.25% NaOCl/ distilled water (positive control); group 2: 0.5% CAPE; group 3: 5.25% NaOCl/17% EDTA; group 4: 5.25% NaOCl/0.5% CAPE and group 5: 0.5% CAPE/17% EDTA. Roots were splitted longitudinally and examined under scanning electron microscopy. Energy Dispersive X-Ray (EDX) method was used to analyse the root dentine mineral content. Results: A significant difference in smear layer (SR) was found between group 3 and group 4 (P<0.05), but no significant difference in SR was found between group 3 and group 5 (P>0.05). Conclusions: In this study, CAPE did not result in better SR removal compared to NaOCl at all levels of the root canals. Overall, Group 5 was as effective as group 3 in SR removal. The mineral content of root dentin has changed. [ABSTRACT FROM AUTHOR]

Objective: This study was done to evaluate the effect of the prepared Moringa oleifera-based root canal irrigant compared to conventionally used irrigants on the microhardness of root dentin and smear layer removal. Materials and methods: One hundred freshly extracted teeth with single root were divided into 5 groups according to the irrigant used: group 1, saline; group 2, Moringa oleifera; group 3, Moringa oleifera + chlorhexidine; group 4, chlorhexidine; and group 5, sodium hypochlorite. Root canal preparation was done using Protaper universal system till size F5 using one of the irrigants after each file. Fifty teeth were prepared to measure dentin microhardness, while the remaining fifty were prepared for evaluation of the remaining debris and smear layer using stereomicroscope and scanning electron microscope (SEM) in each third of the canal. Results: Chlorhexidine alone and combined with Moringa oleifera showed higher microhardness values in apical and coronal parts. In the middle parts, chlorhexidine followed by Moringa oleifera showed the highest results. SEM examination showed that none of the used irrigants has the ability to completely remove smear layer. However, Moringa oleifera group showed the least amount of smear layer on canal wall. Conclusions: Moringa oleifera is a promising final irrigant solution alone or combined with chlorhexidine throughout the instrumentation. Moringa oleifera was proved to have a high effect as a chelating agent. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate and compare the ability of a mixture of tetracycline isomer, citric acid and detergent (MTAD) and ethylene diamine tetra-acetic acid (EDTA) in removing the smear layer along with their effects on peritubular and intertubular dentinal structures by scanning electron microscopic (SEM) examination. Materials and Methods: Thirty recently extracted maxillary and mandibular single-rooted human teeth were divided into 3 groups and prepared to an apical size of 30. In Group 1, 2, and 3, MTAD, EDTA, and distilled water were used, respectively, as a final rinse solution to remove the smear layer. The specimens were subjected to SEM evaluation for the presence or absence of the smear layer and degree of erosion using a scoring system. Results: The result showed that MTAD shows better smear layer removing ability and does not significantly change the structure of dentinal tubules. Conclusion: MTAD is an efficient solution for the removal of the smear layer, especially in the apical third of root canals, and does not signi? cantly change the structure of the dentinal tubules. [ABSTRACT FROM AUTHOR]