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

Abstract

Objectives: The aim of the present study was to compare the effectiveness of
Endovac, Vibringe and needle with different irrigation solutions on removal of
smear layer and apical extrusion of irrigating solution.
Methods: Seventy-two sound human premolar teeth were used and divided into three
experimental groups (n=24) according to the type of irrigation technique used: Ingroup
1 irrigation was performed with Vibringe. In-group 2 irrigation was
performed with a 30-gauge side-vented irrigation needle. In-group 3 irrigation was
performed with Endovac. Instrumentation was performed by using the ProTaper
files. Each main group divided into three sub-groups (n=8) according to irrigation
solution used: In sub-group 1 Irrigation was performed with 5.25% Sodium
hypochlorite (NaOCL). In sub-group 2 Irrigation was performed with 17%
Ethylene Diamin Tetra Acidic Acid (EDTA). In sub-group 3 Irrigation was
performed with 5.25% NaOCL and 17 % EDTA. The amount of extruded
irrigating solution was then measured by subtracting the weight before final
irrigation from the weight after final irrigation using the electronic balance. The
cleanliness of smear layer removal was evaluated using scanning electron
microscopy.
Results: The results showed that the group that resulted in more irrigation extrusion
was as follow from highest to lowest: side-vented >Vibringe> Endovac. The
difference among all groups was significant. As for cleaning results, smear layer
collection in both EndoVac and Vibringe groups were less than side-vented group
and these differences were significant. When the three irrigating solutions
compared the differences among all the groups were significant and combination
of (5.25% NaOCL and 17 % EDTA) resulted in more smear layer removal.
Conclusion: In conclusion, the EndoVac irrigation system extruded significantly less
irrigant solution than both the Vibringe and needle irrigation systems. Smear layer
collection was least in the apical third regarding the EndoVac irrigation system
and resulted in more Smear layer removal. And combination of NaOCL and
EDTA group was more effective on smear layer removal than other two groups.