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
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
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 | Original Research Articles |
| Authors | |
| Publication Date | February 24, 2021 |
| Submission Date | November 21, 2020 |
| Published in Issue | Year 2021Volume: 24 Issue: 1 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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