Smear Layer Removal by 1% Phytic Acid after Root Canal Preparation with Three Different Rotary Systems

Ali  Soliman; Mohamed Rabie; Hayam Y. Hassan

doi:10.3889/oamjms.2022.9524

Authors

Ali Soliman Department of Endodontic, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt https://orcid.org/0000-0002-5037-3951
Mohamed Rabie Department of Endodontic, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
Hayam Y. Hassan Department of Endodontic https://orcid.org/0000-0002-4111-3541

DOI:

https://doi.org/10.3889/oamjms.2022.9524

Keywords:

Phytic acid, Ethylenediaminetetraacetic acid, Smear layer, SmartTrack X3, Endo*star E3, ProTaper Gold

Abstract

AIM: This study compared the removal of the smear layer using 1% phytic acid or 17% ethylenediaminetetraacetic acid (EDTA) after root canal instrumentation with SmartTrack X3, Endo*star E, and ProTaper Gold rotary systems using an environmental scanning electron microscope (ESEM).

METHODS: Sixty single-rooted unidentified extracted human maxillary anterior teeth were selected. The length of all the roots used was adjusted to 16 mm from the apex. Modified access cavities were done. Roots were equally and randomly allocated to three main groups (n = 20) corresponding to the rotary systems: group A1, SmartTrack X3; group A2, Endo*star E3; and group A3, ProTaper Gold. Each group was divided into two equal subgroups (n = 10), corresponding to the chelating agents applied as a final rinse: subgroup B1, 1% phytic acid, and subgroup B2, 17% EDTA. Roots were split in a buccolingual direction into two equal halves and examined under ESEM in the presence or absence of a smear layer at the cervical, middle, and apical segments.

RESULTS: 1% Phytic acid and 17% EDTA recorded no statistically significant for removing the smear layer. For all subgroups, there was a significant difference in smear layer removal and more open dentinal tubules in the cervical segment versus the apical segment.

CONCLUSION: In smear layer removal from root canals, 1% phytic acid was effective as 17% EDTA in smear layer removal form root canals after SmartTrack X3, Endo*star E3, or ProTaper Gold rotary systems instrumentation.

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References

Violich D, Chandler N. The smear layer in endodontics a review. Int Endod J. 2010;43(1):2-15. https://doi.org/10.1111/j.1365-2591.2009.01627.x PMid:20002799 DOI: https://doi.org/10.1111/j.1365-2591.2009.01627.x

Peters OA, Koka RS. Preparation of coronal and radicular spaces: In: Ingle JI, Bakland LK, Baumgartner J, editors. Ingle’s Endodontics. 6th ed. Hamilton, Ontario: BC Decker Inc.; 2008. p. 877-991.

Gutarts R, Nusstein J, Reader Al. In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 2005;31:166-70. https://doi.org/10.1097/01.don.0000137651.01496.48 PMid:15735461 DOI: https://doi.org/10.1097/01.don.0000137651.01496.48

Zmener O, Pameijer CH, Banegas G. Effectiveness in cleaning oval-shaped root canals using anatomic endodontic technology, ProFile and manual instrumentation: A scanning electron microscopic study. Int Endod J. 2005;38(6):356-63. https://doi.org/10.1111/j.1365-2591.2005.00938.x PMid:15910470 DOI: https://doi.org/10.1111/j.1365-2591.2005.00938.x

Peters OA. Current challenges and concepts in the preparation of root canal systems: A review. J Endod. 2004;30(8):559-67. https://doi.org/10.1097/01.don.0000129039.59003.9d PMid:15273636 DOI: https://doi.org/10.1097/01.DON.0000129039.59003.9D

Wu MK, Van der Sluis LW, Wesselink PR. A preliminary study of the percentage of gutta-percha-filled area in the apical canal filled with vertically compacted warm guttapercha. Int Endod J. 2002;35(6):527-35. https://doi.org/10.1046/j.1365-2591.2002.00522.x PMid:12190910 DOI: https://doi.org/10.1046/j.1365-2591.2002.00522.x

Gulabivala K, Patel B, Evans G. Effects of mechanical and chemical procedures on root canal surfaces. Endod Top. 2005;10:103-22. https://https://doi.org/10.1111/j.1601-1546.2005.00133.x DOI: https://doi.org/10.1111/j.1601-1546.2005.00133.x

Jeon IS, Spanberg LS, Yoon TC. Smear layer production by 3 rotary reamers with different cutting blade design in straight root canals: A scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):601-7. https://doi.org/10.1016/s1079-2104(03)00303-2 PMid:14600696 DOI: https://doi.org/10.1016/S1079-2104(03)00303-2

Khedmat S, Shokouhinejad N. Comparison of the efficacy of three chelating agents in smear layer removal. J Endod. 2008;34:599-602. https://doi.org/10.1016/j.joen.2008.02.023 PMid:18436043 DOI: https://doi.org/10.1016/j.joen.2008.02.023

Fachin EV, Scarparo RK, Massoni LI. Influence of smear layer removal on the obturation of root canal ramifications. J Appl Oral Sci. 2009;17(3):240-3. https://doi.org/10.1590/S1678-77572009000300021 PMid:19466259 DOI: https://doi.org/10.1590/S1678-77572009000300021

Zehnder M. Root canal irrigants. J Endod. 2006;32(5):389-98. https://doi.org/10.1016/j.joen.2005.09.014 PMid:16631834 DOI: https://doi.org/10.1016/j.joen.2005.09.014

Garcia F, Murray P, Franklin GG, Namerow K. Effect of aquatine endodontic cleanser on smear layer removal in the root canals of ex-vivo human teeth. J Appl Oral Sci. 2010;18(4):403-8. https://doi.org/10.1590/s1678-77572010000400014 PMid:20835577 DOI: https://doi.org/10.1590/S1678-77572010000400014

Mancini M, Armellin E, Casaglia A. A comparative study of smear layer removal and erosion in apical intraradicular dentine with three irrigating solutions: A scanning electron microscopy evaluation. J Endod. 2009;35(6):900-3. https://doi.org/10.1016/j.joen.2009.03.052 PMid:19482195 DOI: https://doi.org/10.1016/j.joen.2009.03.052

Nygaard-Ostby B. Chelation in root canal therapy: Ethylenediamine tetraacetic acid for cleansing and widening of root canals. Odontol Tidskr. 1957;65:3-11.

Rotstein I, Dankner E, Goldman A, Heling I, Stabholz A, Zalkind M. Histochemical analysis of dental hard tissues following bleaching. J Endod. 1996;22(1):23-6. https://doi.org/10.1016/S0099-2399(96)80231-7 PMid:8618081 DOI: https://doi.org/10.1016/S0099-2399(96)80231-7

Pérez-Heredia M, Ferrer-Luque CM, González-Rodríguez MP, Martín-Peinado FJ, González-López S. Decalcifying effect of 15% EDTA, 15% citric acid, 5% phosphoric acid and 2.5% sodium hypochlorite on root canal dentine. Int Endod J. 2008;41(5):418-23. https://doi.org/10.1111/j.1365-2591.2007.01371.x PMid:18298573 DOI: https://doi.org/10.1111/j.1365-2591.2007.01371.x

Ciucchi B, Khettabi M, Holz J. The effectiveness of different endodontic irrigation procedures on the removal of the smear layer: A scanning electron microscopic study. Int Endod J. 1989;22(1):21-8. https://doi.org/10.1111/j.1365-2591.1989.tb00501.x PMid:2513277 DOI: https://doi.org/10.1111/j.1365-2591.1989.tb00501.x

Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod. 2002;28(1):17-9. https://doi.org/10.1097/00004770-200201000-00004 PMid:11806642 DOI: https://doi.org/10.1097/00004770-200201000-00004

Niu W, Yoshioka T, Kobayashi C, Suda H. A scanning electron microscopic study of dentinal erosion by final irrigation with EDTA and NaOCl solutions. Int Endod J. 2002;35(11):934-9. https://doi.org/10.1046/j.1365-2591.2002.00594.x PMid:12453023 DOI: https://doi.org/10.1046/j.1365-2591.2002.00594.x

Cruz-Filho AM, Paula EA, Pécora JD, Sousa-Neto MD. Effect of different EDTA concentrations on dentin micro hardness. Braz Dent J. 2002;13(3):188-90. https://doi.org/10.1590/s0103-64402002000300009 PMid:12428594 DOI: https://doi.org/10.1590/S0103-64402002000300009

Cruz-Filho AM, Sousa-Neto MD, Savioli RN, Silva RG, Vansan LP, Pécora JD. Effect of chelating solutions on the microhardness of root canal lumen dentin. J Endod. 2011;37(3):358-62. https://doi.org/10.1016/j.joen.2010.12.001 PMid:21329821 DOI: https://doi.org/10.1016/j.joen.2010.12.001

Afshan Z, Jat SA, Khan JA, Hasan A, Qazi FU. Erosive potential of 1% Phytic acid on radicular dentine at different time intervals. Eur Endod J. 2020;5(1):28-34. https://doi.org/10.14744/eej.2019.02411 PMid:32342035 DOI: https://doi.org/10.14744/eej.2019.02411

Shamsuddin AM. Anti-cancer function of phytic acid. Int J Food Sci Technol. 2002;37(7):769-82. https://doi.org/10.1046/j.1365-2621.2002.00620.x DOI: https://doi.org/10.1046/j.1365-2621.2002.00620.x

Nassar M, Hiraishi N, Tamura Y, Otsuki M, Aoki K, Tagami J. Phytic acid: An alternative root canal chelating agent. J Endod. 2015;41(2):242-7. https://doi.org/10.1016/j.joen.2014.09.029 PMid:25453568 DOI: https://doi.org/10.1016/j.joen.2014.09.029

Pandis N, Polychronopoulou A, Eliades T. Randomization in clinical trials in orthodontics: Its significance in research design and methods to achieve it. Eur J Orthod. 2011;33(6):684-90. https://doi.org/10.1093/ejo/cjq141 PMid:21320892 DOI: https://doi.org/10.1093/ejo/cjq141

Bhushan J, Gupta G, Gupta A. The ability of different nickeltitanium rotary instruments to induce dentinal micro-cracks during root canal preparation. Dent J Adv Stud. 2018;6:71-5. DOI: https://doi.org/10.1055/s-0038-1676917

Jakupovic S, Konjhodzic A, Brankovic L, Korac S, Tahmiscija I, Dzankovic A, et al. Canal aberration assessment in simulated root canals: A comparative study. Med Arch. 2017;71(3):204-7. https://doi.org/10.5455/medarh.2017.71.204-207 PMid:28974834 DOI: https://doi.org/10.5455/medarh.2017.71.204-207

Kim H, Jeon SJ, Seo MS. Comparison of the canal transportation of ProTaper GOLD, WaveOne GOLD, and TruNatomy in simulated double-curved canals. BMC Oral Health. 2021;21(1):533. https://doi.org/10.1186/s12903-021-01854-z PMid:34656099 DOI: https://doi.org/10.1186/s12903-021-01854-z

Faisal I, Saif R, Alsulaiman M, Natto ZS. Shaping ability of 2Shape and NeoNiTi rotary instruments in preparation of curved canals using micro-computed tomography. BMC Oral Health. 2021;21(1):595. https://doi.org/10.1186/s12903-021-01961-x PMid:34798874 DOI: https://doi.org/10.1186/s12903-021-01961-x

Suman S, Verma P, Prakash-Tikku A, Bains R, Kumar-Shakya V. A comparative evaluation of smear layer removal using apical negative pressure (endovac), sonic irrigation (endoactivator) and Er: YAG laser -An in vitro sem study. J Clin Exp Dent. 2017;9(8):e981-7. https://doi.org/10.4317/jced.53881 PMid:28936288 DOI: https://doi.org/10.4317/jced.53881

Parente JM, Loushine RJ, Susin L, Gu L, Looney SW, Weller RN, et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J. 2010;43(11):1001-12. https://doi.org/10.1111/j.1365-2591.2010.01755.x PMid:20722753 DOI: https://doi.org/10.1111/j.1365-2591.2010.01755.x

Saber S, Hashem A. Efficacy of different final irrigation activation techniques on smear layer removal. J Endod. 2011;37(9):1272-75. https://doi.org/10.1016/j.joen.2011.06.007 PMid:21846546 DOI: https://doi.org/10.1016/j.joen.2011.06.007

Yilmaz A, Yalcin TY, Helvacioglu-Yigit D. Effectiveness of various final irrigation techniques on sealer penetration in curved roots: A confocal laser scanning microscopy study. Biomed Res Int. 2020;2020:8060489. https://doi.org/10.1155/2020/8060489 PMid:32352008 DOI: https://doi.org/10.1155/2020/8060489

Kaushal R, Bansal R, Malhan S. A comparative evaluation of smear layer removal by using ethylenediamine tetraacetic acid, citric acid, and maleic acid as root canal irrigants: An in vitro scanning electron microscopic study. J Conserv Dent. 2020;23(1):71-8. https://doi.org/10.4103/JCD.JCD_43_2 PMid:33223646 DOI: https://doi.org/10.4103/JCD.JCD_43_20

Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, et al. Effect of vapor lock on root canal debridement by using a sidevented needle for positive-pressure irrigant delivery. J Endod. 2010;36(4):745-50. https://doi.org/10.1016/j.joen.2009.11.022 PMid:20307757 DOI: https://doi.org/10.1016/j.joen.2009.11.022

Abraham S, Vaswani SD, Najan HB, Mehta DL, Kamble AB, Chaudhari SD. Scanning electron microscopic evaluation of smear layer removal at the apical third of root canals using diode laser, endoActivator, and ultrasonic with chitosan: An in vitro study. J Conserv Dent. 2019;22(2):149-54. https://doi.org/10.4103/JCD.JCD_337_18 PMid:31142984 DOI: https://doi.org/10.4103/JCD.JCD_337_18

Kokkas AB, Boutsioukis A, Vassiliadis LP, Stavrianos CK. The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: An in vitro study. J Endod. 2004;30(2):100-2. https://doi.org/10.1097/00004770-200402000-00009 PMid:14977306 DOI: https://doi.org/10.1097/00004770-200402000-00009

Cobankara FK, Adanr N, Belli S. Evaluation of the influence of smear layer on the apical and coronal sealing ability of two sealers. J Endod. 2004;30(6):406-9. https://doi.org/10.1097/00004770-200406000-00007 PMid:15167467 DOI: https://doi.org/10.1097/00004770-200406000-00007

Das A, Kottoor J, Mathew J, Kumar S, George S. Dentine microhardness changes following conventional and alternate irrigation regimens: An in vitro study. J Conserv Dent. 2014;17(6):546-9. https://doi.org/10.4103/0972-0707.144592 PMid:25506142 DOI: https://doi.org/10.4103/0972-0707.144592

Timpawat S, Sripanaratanakul S. Apical sealing ability of glass ionomer sealer with and without smear layer. J Endod. 1998;24(5):343-5. DOI: https://doi.org/10.1016/S0099-2399(98)80131-3

Kamble AB, Abraham S, Kakde DD, Shashidhar C, Mehta DL. Scanning electron microscopic evaluation of efficacy of 17% ethylenediaminetetra acetic acid and chitosan for smear layer removal with ultrasonic: An in vitro study. Contemp Clin Dent. 2017;8(4):621-6. https://doi.org/10.4103/ccd.ccd_745_17 PMid:29326515 DOI: https://doi.org/10.4103/ccd.ccd_745_17

Prabhakaran P, Mariswamy AB. A scanning electron microscope evaluation of efficacy of sodium hypochlorite and Allium sativum in smear layer removal in root canals with the use of modified evacuation system: An ex vivo study. J Conserv Dent. 2018;21(4):401-7. https://doi.org/10.4103/JCD.JCD_373_16 PMid:30122821 DOI: https://doi.org/10.4103/JCD.JCD_373_16

Paque F, Luder HU, Sener B, Zehnder M. Tubular sclerosis rather than the smear layer impedes dye penetration into the dentin of endodontically instrumented root canals. Int Endod J. 2006;39:18-25. https://doi.org/10.1111/j.1365-2591.2005.01042.x PMid:16409324 DOI: https://doi.org/10.1111/j.1365-2591.2005.01042.x

Schäfer E, Tepel J, Hoppe W. Properties of endodontic hand instruments used in rotary motion. Part2. Instrumentation of curved canals. J Endod. 1995;21(8):493-7. https://doi.org/10.1016/S0099-2399(06)80828-9 PMid:7595156 DOI: https://doi.org/10.1016/S0099-2399(06)80519-4

Ali M, El Ashry S, Ismail AG. Comparative evaluation of smear layer Formation of WaveOne Gold, Protaper Gold and manual files: An in vitro SEM study. Curr Sci Int. 2020;9(2):381-6. https://doi.org/10.36632/csi/2020.9.2.33 DOI: https://doi.org/10.36632/csi/2020.9.2.33

Reddy GS, Kalaiselvam R, Rajakumaran A, Kuzhanchinathan M, Sabarish R, Ganesh A. Evaluation of root dentin thickness and smear layer removal efficacy of two novel nickel titanium rotary instruments an in vitro cone-beam computed tomography and scanning electron microscopy study. J Pharm Bioallied Sci. 2021;13(Suppl 1):S1628-32. https://doi.org/10.4103/jpbs.jpbs_346_21 PMid:35018043

Elnaghy A, Elsaka S. Mechanical properties of ProTaper Gold nickel‐titanium rotary instruments. Int Endod J. 2016;49(11):1073-8. https://doi.org/10.1111/iej.12557 PMid:26426295 DOI: https://doi.org/10.1111/iej.12557

Podili S, Prasad PK, Raju T, Nadimpalli MV, Dondapati GD, Sowjanya T. Comparative evaluation of the efficacy of newer irrigating solutions in the removal of smear layer using SEM. Int J Pharm Res. 2021;32(41):76-83. https://doi.org/10.9734/jpri/2020/v32i4131045 DOI: https://doi.org/10.9734/jpri/2020/v32i4131045