Efficacy of MTAD solution and Er:YAG laser in smear layer removal from extracted root canals: a sem evaluation.

Year 2021, Volume: 11 Issue: 1, 1 - 8, 31.03.2021

Işıl Kalyoncu , Figen Eren Giray , Basak Durmus , Yildiz Garip Berker , İlknur Tanboğa

https://doi.org/10.33808/clinexphealthsci.794726

Abstract

Objective: The aim of this study was to compare the efficacy of MTAD (a mixture of a tetracycline isomer, an acid, and a detergent), Er:YAG laser, 17% EDTA, and 5.25% NaOCl in removing the smear layer from the surface of instrumented root canals.
Materials and Methods: Various organic acids, instruments and lasers have been used to remove the smear layer from the surface of instrumented root canals. Twenty-eight extracted maxillary and mandibular incisors were prepared with rotary files. The teeth were randomly allocated to four treatment groups for final irrigation as follows: (1) 17% EDTA (followed by NaOCl), (2) 5.25% NaOCl, (3) Er:YAG laser, and (4) MTAD. All teeth were processed for scanning electron microscopy (SEM) and the removal of the smear layer was examined in the apical, middle and coronal thirds.
Results: At coronal location, NaOCl(2.2±0.4) group had significantly higher scores than MTAD(0.0±0.0), EDTA(0.6±0.4) and Er:YAG laser(0.6±0.4) groups (p<0.001, p=0.039, and p=0.039, respectively). At the middle third, NaOCl(2.6±0.5) scores were significantly higher than MTAD(0.0±0.0) and EDTA(0.8±0.4) groups (p<0.001 and p=0.036 respectively). At apical MTAD (0.4±0.3) group had significantly better scores (p<0.001).
Conclusion: The results of this suggest that MTAD is an effective final irrigator agent, particularly in the apical segment of the root canal, which presents challenges during cleaning.

Keywords

MTAD, Er:YAG laser, smear layer, scanning electron microscope

References

• 1. Gupta PK, Mahajan UP, Gupta K, Sheela NV. 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 Apr 2015;7(4):1-6.
• 2. Susila A, Minu J. Activated Irrigation vs. Conventional non-activated Irrigation in Endodontics - A Systematic Review. Eur Endod J 2019;4(3):96-110.
• 3. Charlie KM, Kuttappa MA, George L, Manoj KV, Joseph B, John NK. A Scanning Electron Microscope Evaluation of Smear Layer Removal and Antimicrobial Action of Mixture of Tetracycline, Acid and Detergent, Sodium Hypochlorite, Ethylenediaminetetraacetic Acid, and Chlorhexidine Gluconate: An In vitro Study. J Int Soc Prev Community Dent Jan-Feb 2018;8(1):62-69.
• 4. 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 Sep 2015;7(9):88-93.
• 5. Karunakaran JV, Kumar SS, Kumar M, Chandrasekhar S, Namitha D. The effects of various irrigating solutions on intra-radicular dentinal surface: An SEM analysis. J Pharm Bioallied Sci Aug 2012;4(Suppl 2):S125-130.
• 6. Dotto L, Sarkis Onofre R, Bacchi A, Rocha Pereira GK. Effect of Root Canal Irrigants on the Mechanical Properties of Endodontically Treated Teeth: A Scoping Review. J Endod May 2020;46(5):596-604.e593.
• 7. Kalyoncuoglu E, Demiryurek EO. A comparative scanning electron microscopy evaluation of smear layer removal from teeth with different irrigation solutions and lasers. Microsc Microanal Dec 2013;19(6):1465-1469.
• 8. Torabinejad M, Khademi AA, Babagoli J, et al. A new solution for the removal of the smear layer. J Endod Mar 2003;29(3):170-175.
• 9. Zhou H, Li Q, Wei L, Huang S, Zhao S. A comparative scanning electron microscopy evaluation of smear layer removal with chitosan and MTAD. Niger J Clin Pract Jan 2018;21(1):76-80.
• 10. Mohammadi Z, Shalavi S, Yaripour S, et al. Smear Layer Removing Ability of Root Canal Irrigation Solutions: A Review. J Contemp Dent Pract Mar 1 2019;20(3):395-402.
• 11. Deari S, Mohn D, Zehnder M. Dentine decalcification and smear layer removal by different ethylenediaminetetraacetic acid and 1-hydroxyethane-1,1-diphosphonic acid species. Int Endod J Feb 2019;52(2):237-243.
• 12. Zehnder M, Kosicki D, Luder H, Sener B, Waltimo T. Tissue-dissolving capacity and antibacterial effect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Dec 2002;94(6):756-762.
• 13. Andrabi SM, Kumar A, Kumar Tewari R, Kumar Mishra S, Iftekhar H. An In Vitro SEM Study on the Effectiveness of Smear Layer Removal of Four Different Irrigations. Iran Endod J Fall 2012;7(4):171-176.
• 14. Yadav HK, Yadav RK, Chandra A, Tikku AP. A Scanning Electron Microscopic Evaluation of the Effectiveness of Etidronic Acid, SmearClear and MTAD in Removing the Intracanal Smear Layer. J Dent (Shiraz) Jun 2017;18(2):118-126.
• 15. Paul ML, Mazumdar D, Niyogi A, Baranwal AK. Comparative evaluation of the efficacy of different irrigants including MTAD under SEM. J Conserv Dent Jul 2013;16(4):336-341.
• 16. Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part 3. J Endod Apr 1983;9(4):137-142.
• 17. Teixeira CS, Felippe MC, Felippe WT. The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysis. Int Endod J May 2005;38(5):285-290.
• 18. Ashraf H, Asnaashari M, Darmiani S, Birang R. Smear Layer Removal in the Apical Third of Root Canals by Two Chelating Agents and Laser: A Comparative in vitro Study. Iran Endod J Summer 2014;9(3):210-214.
• 19. Guidotti R, Merigo E, Fornaini C, Rocca JP, Medioni E, Vescovi P. Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer. Lasers Med Sci Jan 2014;29(1):69-75.