The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study

Akif Demirel

doi:10.7126/cumudj.829414

TR EN

Süt Dişlerinde Farklı EDTA Konsantrasyonlarının Smear Tabakasını Uzaklaştırma Etkinliği: Bir SEM Çalışması

Abstract

Amaç: Bu çalışma farklı konsantrasyonlardaki etilendiamin tetraasetik asitin (EDTA), süt dişlerinde smear tabakasının uzaklaştırılmasına olan etkilerini tarama elektron mikroskopu (TEM) ile değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Bu çalışma 28 adet çekilmiş üst süt kesici diş ile gerçekleştirilmiş ve bu dişler %5, %10, %17 EDTA ve %1 sodyum hipoklorit (NaOCl) olacak şekilde dört ana gruba (n=7) atanmıştır. Kök kanal irrigasyon prosedürlerinin ardından, kök kanal yüzeyleri (koronal, orta ve apikal) SEM ile taranmış ve smear tabakası uzaklaştırma skorları kaydedilmiş ve karşılaştırılmıştır. Sonuçlar Kruskal–Wallis, Friedman ve Dunn testleri kullanılarak analiz edilmiştir. Bulgular: Tüm kök bölümlerinde, EDTA gruplarının smear tabakasını NaOCl’den daha efektif uzaklaştırmasına rağmen, sadece orta üçlüde %17 EDTA ile %1 NaOCl arasında istatistiksel anlamlı fark gözlenmiştir (p<0.05). Smear tabakası, birçok grupta (%10 EDTA, %17 EDTA ve %1 NaOCl) koronalde apikale göre daha efektif uzaklaştırılmıştır (p<0.05). Eroziv defektler en çok %17 EDTA, daha az olarak da %10 EDTA grubunda görülmüş ve bu bulgulara %5 EDTA ve %1 NaOCl gruplarında saptanmamıştır. Sonuç: Smear tabakası uzaklaştırılmasında, NaOCl ve yüksek konsantrasyondaki EDTA grupları ile benzer etkinlik sunması, düşük eroziv potansiyeli ve periapikal güvenlik için düşük konsantrasyonu nedeniyle süt dişi kanal tedavilerinde irrigasyon solüsyonu olarak %5 EDTA kullanımını önermek mümkündür.

Keywords

The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study

Abstract

Objectives: The present study aims to evaluate the effects of different concentrations of ethylenediamine tetraacetic acid (EDTA) on smear layer removal in primary teeth by using scanning electron microscopy (SEM). Materials and Methods: The present study was performed with 28 extracted upper primary incisors assigned into four main groups (n=7) as 5%, 10% and 17% EDTA, and 1% sodium hypochlorite (NaOCl). The root canal surfaces (coronal, middle and apical) were scanned by SEM and scores of smear layer removal were recorded and compared after the root canal irrigation procedures. The results were analyzed using Kruskal–Wallis, Friedman and Dunn tests. Results: In all the root portions, although EDTA groups removed the smear layer more effectively than NaOCl, a statistically significant difference was observed between 17% EDTA and 1% NaOCl only in middle third (p <0.05). Also, smear layer was removed more effectively in coronal than apical in most of the groups (10% EDTA, 17% EDTA and 1% NaOCl) (p <0.05). Erosive defects were mostly seen in 17% EDTA and less than 10% EDTA group. These findings were not detected in 5% EDTA and 1% NaOCl group. Conclusions: It is possible to recommend the use of 5% EDTA irrigation solution in root canal treatment of primary teeth due to its similar smear layer removal efficacy with NaOCl and high concentration EDTA groups, low erosive potential and low concentration for periapical safety.

Keywords

Thanks

The author would like to thank Prof.Dr.Şaziye Sarı for her precious contributions to the present study and thank to Assoc.Prof.Dr.Salih Doğan for his valuable technical assistance.

References

Pascon FM, Kantovitz KR, Puppin- Rontani RM. Influence of cleansers and irrigation methods on primary and permanent root dentin permeability: a literature review. Braz J Oral Sci 2006;5:1063-1069
Hariharan VS, Nandlal B, Srilatha KT. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: a scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2010;28:271-277
Pitoni CM, Figueiredo MC, Araujo FB, et al. Ethylenediaminetetraacetic acid and citric acid solutions for smear layer removal in primary tooth root canals. J Dent Child (Chic) 2011;78:131-137
Guler C, Gurbuz T, Yilmaz Y, Guler MS. Evaluation of canal cleanliness and tubular penetration of root canal sealers in extracted primary second molars: a SEM study. Cumhuriyet Dent J 2013;16:116-124
Toyota Y, Yoshihara T, Hisada A, Yawaka Y. Removal of smear layer by various root canal irrigations in primary teeth. Pediatr Dent J 2017;27:8-13
Demirel A, Yüksel BN, Ziya M, Gümüş H, Doğan S, Sari S. The effect of different irrigation protocols on smear layer removal in root canals of primary teeth: a SEM study. Acta Odontol Scand 2019;77:380-385
Tannure PN, Azevedo CP, Barcelos R, Gleiser R, Primo LG. Long-term outcomes of primary tooth pulpectomy with and without smear layer removal: a randomized split-mouth clinical trial. Pediatr Dent 2011;33:316-320
Kaur R, Singh R, Sethi K, Garg S, Miglani S, Vats S. Irrigating solutions in pediatric dentistry: literature review and update. J Adv Med Dent Scie 2014;2:104-115

Kumar P, Prasad N, Darawade A, Bhagat SK, Narayana N, Darawade P. The effect of four commonly used root canal irrigants on the removal of smear layer: an in-vitro scanning electron microscope study. J Int Oral Health 2015;7:88-93
Gupta PK, Mahajan UP, Gupta K. Comparative evaluation of a new endodontic irrigant - mixture of a tetracycline isomer, an acid, and a detergent to remove the intracanal smear layer: a scanning electron microscopic study. J Int Oral Health 2015;7:1-6
Pintor AV, Dos Santos MR, Ferreira DM, Barcelos R, Primo LG, Maia LC. Does smear layer removal influence root canal therapy outcome? A systematic review. J Clin Pediatr Dent 2016;40:1-7
Buldur B, Kapdan A. Comparison of the EndoVac system and conventional needle irrigation on removal of the smear layer in primary molar root canals. Niger J Clin Pract 2017;20:1168-1174
Pozos-Guillen A, Garcia-Flores A, Esparza-Villalpando V, Garrocho-Rangel A. Intracanal irrigants for pulpectomy in primary teeth: a systematic review and meta-analysis. Int J Paediatr Dent 2016;26:412-425
Demirel A, Sarı Ş. Primary Teeth Root Canal Treatment: Why, When, How? Turkiye Klinikleri J Pediatr Dent-Special Topics 2017;3:99-112
Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand 2020;78:321-326
Vallabhaneni K, Kakarla P, Avula SSJ, Reddy NVG, Gowd MP, Vardhan KR. Comparative analyses of smear layer removal using four different irrigant solutions in the primary root canals – a scanning electron microscopic study. J Clin Diagn Res 2017;11:ZC64–ZC67
Krithikadatta J, Gopikrishna V, Datta M. CRIS Guidelines (Checklist for Reporting In-vitro Studies): A concept note on the need for standardized guidelines for improving quality and transparency in reporting in-vitro studies in experimental dental research. J Conserv Dent 2014;17:301-304
Kramer WS, Ireland RL. Measurements of the Primary Teeth. J Dent Child 1959;26:252-261
Barcelos R, Tannure PN, Gleiser R, Luiz RR, Primo LG. The influence of smear layer removal on primary tooth pulpectomy outcome: a 24- month, double-blind, randomized, and controlled clinical trial evaluation. Int J Paediatr Dent 2012;22:369-381.
Sarı Ş, Aras Ş. Root Canal Morphology of Primary Molar Teeth. A.Ü Diş Hek Fak Derg 2004;31:157-167
Katge F, Wakpanjar MM. Root canal morphology of primary molars by clearing technique: An in vitro study. J Indian Soc Pedod Prev Dent 2018;36:151-157
Ziya M, Yüksel BN, Sarı Ş. Root Canal Morphology of Mandibular Primary Molars: A Micro-CT Study. Cumhuriyet Dent J 2019;22:382-389
Ximenes M, Triches TC, Beltrame AP, Hilgert LA, Cardoso M. Effect of endodontic irrigation with 1% sodium hypochlorite and 17% EDTA on primary teeth: a scanning electron microscope analysis. Gen Dent 2013;61:24-27
Ramachandra JA, Nihal NK, Nagarathna C, Vora MS. Root canal irrigants in primary teeth. World J Dent 2015;6:229-234
Moskovitz M, Tickotsky N. Pulpectomy and Root Canal Treatment (RCT) in Primary Teeth: Techniques and Materials. In: Fuks AB, Peretz B (eds). Pediatric Endodontics: Current Concepts in Pulp Therapy for Primary and Young Permanent Teeth. Switzerland: Springer International Publishing 2016:71- 101.
Calt S, Serper A. Smear layer removal by EGTA. J Endod 2000;26:459-461
Ozcan G, Sekerci AE, Cantekin K, Aydinbelge A, Dogan S. Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature. Acta Odontol Scand 2016;74:250-258
Zeren AE, Demirel A, Kamburoğlu K, Sarı Ş. The evaluation of the correlation between coronal movement of permanent tooth germ and displacement of apical foramen of the primary molars. Selçuk Dent J 2020;7:59-65
Curtis TO, Sedgley CM. Comparison of a continuous ultrasonic irrigation device and conventional needle irrigation in the removal of root canal debris. J Endod 2012;38:1261-1264
Nör JE, Feigal RJ, Dennison JB, Edwards CA. Dentin bonding: SEM comparison of the resin-dentin interface in primary and permanent teeth. J Dent Res 1996;75:1396-1403
Dadresanfar B, Khalilak Z, Delvarani A, Mehrvarzfar P, Vatanpour M, Pourassadollah M. Effect of ultrasonication with EDTA or MTAD on smear layer, debris and erosion scores. J Oral Sci 2011;53:31-36
Botton G, Pires CW, Cadoná FC, Machado AK, Azzolin VF, Cruz IBM, Sagrillo MR, Praetzel JR. Toxicity of irrigating solutions and pharmacological associations used in pulpectomy of primary teeth. Int Endod J 2016; 49:746-754

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Akif Demirel ^*
0000-0002-1433-0452
Türkiye

Publication Date

February 24, 2021

Submission Date

November 21, 2020

Acceptance Date

December 18, 2020

Published in Issue

Year 2021 Volume: 24 Number: 1

DOI

https://doi.org/10.7126/cumudj.829414

IZ

https://izlik.org/JA96TL65ZZ

Cite

RIS / Bibtex

APA

Demirel, A. (2021). The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study. Cumhuriyet Dental Journal, 24(1), 57-65. https://doi.org/10.7126/cumudj.829414

AMA

1.Demirel A. The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study. Cumhuriyet Dent J. 2021;24(1):57-65. doi:10.7126/cumudj.829414

Chicago

Demirel, Akif. 2021. “The Smear Layer Removal Efficiency of Different Concentrations of EDTA in Primary Teeth: A SEM Study”. Cumhuriyet Dental Journal 24 (1): 57-65. https://doi.org/10.7126/cumudj.829414.

EndNote

Demirel A (February 1, 2021) The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study. Cumhuriyet Dental Journal 24 1 57–65.

IEEE

[1]A. Demirel, “The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study”, Cumhuriyet Dent J, vol. 24, no. 1, pp. 57–65, Feb. 2021, doi: 10.7126/cumudj.829414.

ISNAD

Demirel, Akif. “The Smear Layer Removal Efficiency of Different Concentrations of EDTA in Primary Teeth: A SEM Study”. Cumhuriyet Dental Journal 24/1 (February 1, 2021): 57-65. https://doi.org/10.7126/cumudj.829414.

JAMA

1.Demirel A. The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study. Cumhuriyet Dent J. 2021;24:57–65.

MLA

Demirel, Akif. “The Smear Layer Removal Efficiency of Different Concentrations of EDTA in Primary Teeth: A SEM Study”. Cumhuriyet Dental Journal, vol. 24, no. 1, Feb. 2021, pp. 57-65, doi:10.7126/cumudj.829414.

Vancouver

1.Akif Demirel. The Smear Layer Removal Efficiency of Different Concentrations of EDTA in primary teeth: A SEM Study. Cumhuriyet Dent J. 2021 Feb. 1;24(1):57-65. doi:10.7126/cumudj.829414

Cited By

Characterization of pulp calcifications and changes in their composition after treatments with citric acid and ethylenediaminetetraacetic acid solutions

Microscopy Research and Technique

https://doi.org/10.1002/jemt.24255

Effect of Different Irrigating Solutions on Pushout Bond Strength of Composite Posts in Primary Teeth: An In Vitro Study

Journal of Research in Dental and Maxillofacial Sciences

https://doi.org/10.66224/jrdms.11.1.22

Effect of Different Sealers and Irrigants on the Push-Out Bond Strength of Fiber Posts to The Root Canal

Journal of Dental Research, Dental Clinics, Dental Prospects

https://doi.org/10.34172/joddd.44101