Canal Cleanliness and Smear Layer Removal Using Different Irrigant Activation Methods - A Scanning Electron Microscopy Study

Abstract

BACKGROUND Irrigation is one the most important aspects during root canal treatment of the teeth which can be achieved by mechanical cleaning and shaping with the aid of irrigants. However, the irrigant does not travel to all the places of the root canal especially the apical third. Hence, to make this irrigant reach the apical third, we need irrigant activation methods which will agitate the irrigant and help in accessing the places which are difficult to reach in the root canal system. The objective of this research was to check the canal cleanliness and the removal of the debris after irrigant activation using manual dynamic agitation (MDA), plastic F file, sonic irrigation (SI) and conventional syringe irrigation (CSI). METHODS Sixty single rooted teeth were chosen for this study which were biomechanically prepared using ProTaper system (Dentsply Maillefer, USA) up to a preparation of F2 and 3 % NaOCl and 17 % EDTA were used as irrigants. All the samples were equally divided into groups of fifteen each depending on the mode of irrigant activation method used - Group 1, Manual Dynamic Agitation (MDA); Group 2, plastic F file; Group 3, EndoActivator (SI); and Group 4, control group (C). These teeth were then split along the long axis and were observed under the SEM for any debris and to determine the degree of canal cleanliness. RESULTS Group 4 (control group) showed the maximum debris under SEM with a statistically significant difference with a P value less than 0.05; next was the manual dynamic agitation group. Plastic F file group and sonic irrigation groups showed almost similar results in terms of debris. CONCLUSIONS Irrigant activated using sonic mode and plastic F file efficiently removed the debris in comparison to the other two groups of syringe irrigation and manual dynamic agitation.