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Smear Layer Removal and Apical Extrusion Evaluation Among Different Irrigating Techniques and Solutions (In vitro Comparative study)

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Abstract

Objectives: The aim of the present study was to compare the effectiveness ofEndovac, Vibringe and needle with different irrigation solutions on removal ofsmear layer and apical extrusion of irrigating solution.Methods: Seventy-two sound human premolar teeth were used and divided into threeexperimental groups (n=24) according to the type of irrigation technique used: Ingroup1 irrigation was performed with Vibringe. In-group 2 irrigation wasperformed with a 30-gauge side-vented irrigation needle. In-group 3 irrigation wasperformed with Endovac. Instrumentation was performed by using the ProTaperfiles. Each main group divided into three sub-groups (n=8) according to irrigationsolution used: In sub-group 1 Irrigation was performed with 5.25% Sodiumhypochlorite (NaOCL). In sub-group 2 Irrigation was performed with 17%Ethylene Diamin Tetra Acidic Acid (EDTA). In sub-group 3 Irrigation wasperformed with 5.25% NaOCL and 17 % EDTA. The amount of extrudedirrigating solution was then measured by subtracting the weight before finalirrigation from the weight after final irrigation using the electronic balance. Thecleanliness of smear layer removal was evaluated using scanning electronmicroscopy.Results: The results showed that the group that resulted in more irrigation extrusionwas as follow from highest to lowest: side-vented >Vibringe> Endovac. Thedifference among all groups was significant. As for cleaning results, smear layercollection in both EndoVac and Vibringe groups were less than side-vented groupand these differences were significant. When the three irrigating solutionscompared the differences among all the groups were significant and combinationof (5.25% NaOCL and 17 % EDTA) resulted in more smear layer removal.Conclusion: In conclusion, the EndoVac irrigation system extruded significantly lessirrigant solution than both the Vibringe and needle irrigation systems. Smear layercollection was least in the apical third regarding the EndoVac irrigation systemand resulted in more Smear layer removal. And combination of NaOCL andEDTA group was more effective on smear layer removal than other two groups.

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