Master of Science (M.S.) in Dentistry
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College of Dental Medicine
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Nova Southeastern University
Ramzi Walid Alhashimi. 2016. A Comparative Evaluation of Endodontic Irrigation Methods for Removal of the Smear Layer. Master's thesis. Nova Southeastern University. Retrieved from NSUWorks, College of Dental Medicine. (102)
The purpose of this in vitro study is to compare the effect of various irrigation systems on smear layer removal in curved root canals. Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. It has been well documented that the flushing component of the irrigants is as important as the tissue dissolving capability. Therefore, the efficacy of the irrigant might also be influenced by the method by which it is introduced. Fifty-one recently extracted molar teeth with root curvatures of more than 30° were selected according to Schneider's method. The teeth were decoronated to obtain a standardized root length of 12 mm. The root tips were sealed with hot glue and embedded into a silicone mold. The canal preparations were performed by using ProTaper™ and ProFile™ systems up to #35,04. Sodium hypochlorite (NaOCl 6%) and ethylenediaminetetraacetic acid (EDTA 17%) were used as root canal irrigants according to Yamada protocol. To maintain irrigation consistency, a programmable syringe pump was connected to each system. After finishing the cleaning and shaping of the curved canals, the final cleansing of the root canal space, with proper irrigation solutions, were accompanied by activation systems. Five different treatment modalities were tested; Group 1: Traditional irrigation, Group 2: EndoActivator™, Group 3: Passive ultrasonic irrigation (PUI), Group 4: EndoVac™, Group 5: Saline. The root halves (n=102) were imaged with the FEI Quanta 200 scanning electron microscope™ (SEM). Over 7000 magnified images were reviewed and scored by three board certified Endodontists in a double-blind manner. The data was analyzed by using the Cochran-Mantel-Haenszel method, Pairwise Comparisons and Intra-class correlation coefficients. The EndoVac™ system (an apical negative pressure irrigation system) was found to be significantly more effective (p<0.05) than the other groups in all sections observed, this would include the apical, middle and coronal sections for the elimination of the smear layer as well as the debris removal and improved tubule visibility. The negative pressure delivery systems may provide cleaner surfaces in the canals of curved roots of at least 30 degree or more.
Health and environmental sciences
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