A Newly Prepared Solution for the Removal of the Smear Layer

Nawfal A. A. Zakarea¹, Talal H. Mohamad¹, Amer A. Taqa^2, , Scott Chumbley³, Salih Al-Juaid⁴ and Hanan Balto⁵

¹Department of Conservative Dentistry College of Dentistry University of Mosul

²Department of Basic Science, College of Dentistry University of Mosul

³Collage of engineering Materials Science and engineering Department, Iowa State University, USA

⁴Chemistry Department, Faculty of Science, King Abdulaziz Univesity, Saudi Arabia

⁵Department of Restorative Dental Sciences, Dental Caries Research Chair, College of Dentistry, King Saud University, Saudi Arabia

Cite this paper:
Nawfal A. A. Zakarea, Talal H. Mohamad, Amer A. Taqa, Scott Chumbley, Salih Al-Juaid and Hanan Balto. A Newly Prepared Solution for the Removal of the Smear Layer. International Journal of Dental Sciences and Research. 2014; 2(1):19-26. doi: 10.12691/ijdsr-2-1-6

Abstract

Aims: The aim of the study was to evaluate the ability of a mixture of (castor detergent and papain enzyme) MCP to remove the smear layer by using scanning electron microscope. Materials and Methods: Samples of 45 human extracted was divided in to 3 groups (A, B, and C) n = 15 and prepared endodontically using pro taper system up to size F 3, each group was irrigated with corresponding solution 3 ml in between each file size and 5 minutes as a final irrigant as following: Group A irrigated with distilled water (control negative). Group B irrigated with 2.5% (Sodium hypo chloride) NaOCL and 17% (Ethylene di amine tetra acetic acid) EDTA (control positive). Group C irrigated with 20% castor detergent and 4% papain enzyme as a mixture (MCP). Each sample was irrigated with 15 ml of distilled water and dried with paper points. The samples were sent for SEM photograph. Each sample was evaluated at three levels (apical, middle, and cervical part of the canal) Results: MCP solution showed partial removal of both organic and inorganic parts (dual action) of smear layer from the 3 levels of root canals, but the apical one was significantly less clean than the other two, also it has a more gentle effect of erosion than EDTA with NaOCl. EDTA with NaOCl has the ability to remove the smear layer completely from the canal, but still the apical third was significantly less clean than that of other two. It is impossible to remove the smear layer completely by NaOCl and EDTA without erosion of the inner surface of irrigated canal when EDTA was used as a final irrigant for 5 minutes. Conclusion: solution had the ability to remove the smear layer partially at the three levels of a root canal without dentin erosion. While EDTA had the ability to remove the smear layer completely at the three levels of canal with obvious dentinal erosion. Still the apical area has mechanical and anatomical limitation in root canal irrigation.

Keywords:
new endodontic solution smear layer removal SEM

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References:

[1]	Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endodon. 1997; 23 (12): 725-7.
[2]	Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endod Dent Traumatol. 1990; 6 (4): 142-9.
[3]	Shahravan A, Haghdoost AA, Adl A, Rahimi H, Shadifar F. Effect of smear layer on sealing ability of canal obturation: a systematic review and meta-analysis. J Endod. 2007; 33 (2): 96-105.
[4]	Torabinejad M, Handysides R, Khademi A, Bakland LK. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2002; 94 (6): 658-66.
[5]	Torabinejad M, Khademi AA, Babagoli J. A new solution for the removal of the smear layer. JEndod. 2003; 29 (3): 170-5.
[6]	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.
[7]	PrabhakarJ, Senthikumar M, PriyaM.S, Evaluation of Antimicrobial Efficacy of Herbal Alternatives (Triphala and Green Tea Polyphenols), MTAD, and 5% Sodium Hypochlorite against Enterococcus faecalis Biofilm Formed on Tooth Substrate: An In Vitro Study. J Endod. 2010; 36: 83-86.
[8]	Barkhordar RA, Watanabe LG, Marshall GW, Hussain MZ Removal of intracanal smear by doxycycline in vitro. Oral Surg, Oral Me, and Oral Pathol. 1997; 84 (4): 420-3.
[9]	Dogan H, Calt S. Effects of chelating agents and sodium hypochlorite on mineral content of root dentin. J Endod. 2001; 27 (9): 578-80.
[10]	Hulsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J. 2003; 36 (12): 810-30.
[11]	Sayin TC, Serper A, Cehreli ZC, Otlu HG, Turkey A. The effect of EDTA, EGTA, EDTAC, and tetracycline-HC with and without subsequent NaOCL treatment on the microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2007; 104 (3): 418-24.
[12]	Silva PV, Guedes DF, Nakadi FV, Pécora JD, Cruz-Filho AM. Chitosan: a new solution for removal of smear layer after root canal instrumentation. Int. Endod J. 2013; 46 (4): 332-8.
[13]	Morgental RD, Singh A, Sappal H, Kopper PMP, Vier-Pelisser FV, Peters OA, Dentin Inhibits the Antibacterial Effect of New and Conventional Endodontic Irrigants. JEndodon. 2013; 39 (3): 406-10.
[14]	Maragakis GM, Hahn P, Hellwig E. Chemomechanical caries removal; a comprehensive review of literature. Int Dent J. 2001; 51 (4): 291-9.
[15]	Bhardwaj A, Ballal S, Velmurugan N. Comparative evaluation of the antimicrobial activity of natural extracts of Morindacitrifolia, papain and aloe vera (all in gel formulation), 2% chlorhexidine gel and calcium hydroxide, against Enterococcus faecalis: An in vitro study. J Cons Dent. 2012; 15 (3): 293-7.
[16]	Ferreira CM, Bonifacio KC, Froner IC, Ito IY. Evaluation of the antimicrobial activity of three irrigation solutions in teeth with pulpal necrosis. Braz. Dent J. 1999; 10: 15-21.
[17]	Aguiar LM, Maekawa LE, Chung A, Nassri MRG. Evaluation of dentin cleansing by a detergent derived from castor oil (Ricinuscommunis) used as root canal irrigant: a scanning electron miscroscopy study. Rev Sul-Bras Odontol. 2010; 7 (4): 445-9.
[18]	Pécora JD, Marchesan M, Souza Neto M, Guerisoli DMZ, Da Silva RS. Effects of Ricinuscommunis detergent and pain gel on radicular permeability. J Israel Dent Assoc. 2000; 17 (2): 9-11.
[19]	Ito I, Froner IC, Mian H, Chierece GO. Castor oil: antimicrobial activity of detergent derived from ricinolic acid. J Dent Res. 1999; 78: 344-345.
[20]	Mônika C M, Fröner IC, A scanning electron microscopic evaluation of different root canal irrigation regimens. Braz. oral res. 2006; 20 (3): 235-40.
[21]	Lotfi M, Vosoughhosseini S, Saghiri MA, Zand V, Ranjkesh B, Ghasemi N. Effect of MTAD as a final rinse on removal of smear layer in ten minutes preparation time. J Endod. 2012; 38 (10): 1391-1394.
[22]	Peeters HH, and Suardita K. Efficacy of smear layer removal at the root tip by using ethylenedia minetetraaceticacid and erbium, chromium: yttrium, scandium, gallium garnet laser. J Endod. 2011; 37 (11).
[23]	Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod. 2006; 32: 1091-3.
[24]	Sampaio JE, Theodoro LH, Correa MA, Mendes AJA Comparative SEM study of smear layer removal by detergents and EDTA on the root surface. Int J PeriodontolRestoDent. 2005; 25 (2): 157-63.
[25]	Bolhari B, SharifianMR, Aminsobhani M, Esfehani HRM, and Tavakolian P. Assessing the Efficacy of Citrus Aurantifolia Extract on Smear Layer Removal with Scanning Electron Microscope. Iran Endod J. 2012; 7 (2): 88-97.
[26]	Arnon, R (1970) In: Methods Enzymol 19 (EdsPerlmannLorand, L) Academic Press New York p 228. (Perman, G.E. and Lorand L., eds.) 19: 226-44. Cited by Chu C.M., Awang B., Duduku K., Tie S.H. Effect of ionic and non ionic surfactants on papain activity. Borneo Sci. 2002; 12: 71-77.
[27]	Ahlquist M., Henningsson O., Hultenby K., Ohlin J. The effectiveness of manual and rotary techniques in the cleaning of root canals: a scanning electron microscopy study. Interna Endo J. 2001; 34 (7): 533-537.
[28]	Uroz-Torres D, González-Rodríguez, M P, Ferrer-Luque, CM. Effectiveness of the EndoActivator System in Removing the Smear Layer after Root Canal Instrumentation. JEndodon. 2010; 36 (2): 308-311.
[29]	Saito K, Webb TD, Imamura GM, Goodell GG. Effect of shortened irrigation times with 17% ethylene diamine tetra-acetic acid on smear layer removal after rotary canal instrumentation. J Endod. 2008; 34 (8): 1011-4.