Citation Information :
Vineetha CS, Vaiyapuri R, Sivakumar AA, Sivakumar JS, Prasad AS, Soundappan S. Electron Microscopic Comparative Analysis of Smear Layer Removal by Ethylenediaminetetraacetic Acid and Chitosan Using Ultrasonic Activation: An In Vitro Study. J Oper Dent Endod 2019; 4 (1):37-41.
Aim: To compare the ability of smear layer removal by ultrasonic activation of ethylenediaminetetraacetic acid (EDTA) and chitosan.
Materials and methods: Forty-five freshly extracted human mandibular single-rooted premolars were collected and stored in distilled water. Teeth were radiographed to confirm the existence of a single canal. The crowns were sectioned to standardize the length of the root samples to 14 mm using a diamond disk under constant irrigation. Cleaning and shaping were done up to ProTaper F3, and the specimens were randomly divided into three groups of 15 samples each—group I-control group (ultrasonically activated-normal saline), groups II (ultrasonically activated-EDTA), and group III (ultrasonically activated-chitosan). After this, the roots of the teeth were split longitudinally, and the samples were placed in 2% glutaraldehyde for 24 hours. The samples were then desiccated, mounted, and scanning electron microscopic (SEM) photographs were taken at coronal, middle, and apical levels. Data were collected based on Gutmann's scoring criteria, and statistical analysis was carried out using one-way ANOVA and Tukey's post hoc test (p < 0.05).
Results: Ultrasonic activation of EDTA had the highest ability of smear layer removal.
Conclusion: Ultrasonically activated EDTA and chitosan showed significant difference in smear layer removal compared to normal saline; EDTA was found to be better than chitosan.
McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975;1(7):238–242. DOI: 10.1016/S0099-2399(75)80226-3.
Moodnik RM, Dorn SO, et al. Efficacy of biomechanical instrumentation: a scanning electron microscopic study. J Endod 1976;2(9):261–266. DOI: 10.1016/S0099-2399(76)80086-6.
Mader CL, Baumgartner JC, et al. Scanning electron microscopic investigation of the smeared layer on root canal walls. J Endod 1984;10(10):477–483. DOI: 10.1016/S0099-2399(84)80204-6.
Torabinejad M, Handysides R, et al. Clinical implications of the smear layer in endodontics: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94(6):658–666. DOI: 10.1067/moe.2002.128962.
Kokkas AB, Boutsioukis A, et al. 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):100–102. DOI: 10.1097/00004770-200402000-00009.
Cobankara FK, Adanr N, et al. Evaluation of the influence of smear layer on the apical and coronal sealing ability of two sealers. J Endod 2004;30(6):406–409. DOI: 10.1097/00004770-200406000-00007.
Shahravan A, Haghdoost AA, et al. Effect of smear layer on sealing ability of canal obturation: a systematic review and meta-analysis. J Endod 2007;33(2):96–105. DOI: 10.1016/j.joen.2006.10.007.
Baumgartner JC Mader CL. A scanning electron microscopic evaluation of four root canal irrigation regimens. J Endod 1987;13:147–157. DOI: 10.1016/S0099-2399(87)80132-2.
Mohammadi Z, Shalavi S, et al. Ethylenediaminetetraacetic acid in endodontics. Eur J Dent 2013;7:135–142. DOI: 10.4103/1305-7456.119091.
Kishen A, Shi Z, et al. An investigation on the antibacterial and antibiofilm efficacy of cationic nanoparticulates for root canal disinfection. J Endod 2008;34:1515–1520. DOI: 10.1016/j.joen.2008.08.035.
Silva PV, Guedes DF, et al. Chitosan: a new solution for removal of smear layer after root canal instrumentation. Int Endod J 2013;46:332–338. DOI: 10.1111/j.1365-2591.2012.02119.x.
Amin K, Masoodi A, et al. Effect of diode laser and ultrasonics with and without ethylenediaminetetraacetic acid on smear layer removal from the root canals: A scanning electron microscope study. J Conserv Dent 2016;19:424–427. DOI: 10.4103/0972-0707.190005.
Baumgartner JC, Cuenin PR. Efficacy of several concentrations of sodium hypochloritefor root canal irrigation. J Endod 1992;18: 605–612. DOI: 10.1016/S0099-2399(06)81331-2.
Cameron JA. The use of ultrasonics in the removal of smear layer: a scanning electronmicroscope study. J Endod 1983;9:289–292. DOI: 10.1016/S0099-2399(83)80119-8.
Cameron JA. The use of ultrasound for the removal of the smear layer. The effect of sodium hypochlorite concentration: SEM study. Aus Dent J 1988;33:193–200. DOI: 10.1111/j.1834-7819.1988.tb01313.x.
Lui JN, Kuah HG, et al. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007;33:472–475. DOI: 10.1016/j.joen.2006.12.007.
De-Deus G, Souza EM, et al. Smear layer dissolution by peracetic acid of low concentration. Inter Endod J 2011;44:485–490. DOI: 10.1111/j.1365-2591.2010.01847.x.
Gopikrishna V, Venkateshbabu N, et al. Evaluation of the effect of MTAD in comparison with EDTA when employed as the final rinse on the shear bond strength of three endodontic sealers to dentine. Aust Endod J 2011;37(1):12–17. DOI: 10.1111/j.1747-4477.2010.00261.x.
Gutmann JL, Saunders WP, et al. Ultrasonic root-end preparation. Part 1. SEM analysis. Int Endod J 1994;27:318–324. DOI: 10.1111/j.1365-2591.1994.tb00276.x.
Baumgartner JC, Brown CM, et al. A scanning electron microscopic evaluation of root canal debridement using saline, sodium hypochlorite, and citric acid. J Endod 1984;10(11):525–531. DOI: 10.1016/S0099-2399(84)80137-5.
Economides N, Liolios E, et al. Long-term evaluation of the influence of smear layer removal on the sealing ability of different sealers. J Endod 1999;25:123–125. DOI: 10.1016/S0099-2399(99)80010-7.
Saunders WP, Saunders EM. Influence of smear layer on the coronal leakage of thermafil and laterally condensed gutta-percha root fillings with a glass ionomer sealer. J Endod 1994;20:155–158. DOI: 10.1016/S0099-2399(06)80325-0.
Ahmad M, Pitt Ford TR, et al. Ultrasonic debridement of root canals: an insight into the mechanisms involved. J Endod 1987;13:93–101. DOI: 10.1016/S0099-2399(87)80173-5.
Walmsley AD, Williams AR. Effects of constraint on the oscillatory pattern of endosonic files. J Endod 1989;15:189–194. DOI: 10.1016/S0099-2399(89)80233-X.
Silva PV, Guedes DF, et al. Time dependent effects of chitosan on dentin structures. Braz Dent J 2012;23:357–361. DOI: 10.1590/S0103-64402012000400008.
Von der Fehr FR, Nygaard-Ostby B. Effect of EDTAC and sulfuric acid on root canal dentine. Oral Surg Oral Med Oral Pathol 1963;16:199–205. DOI: 10.1016/0030-4220(63)90033-1.
Pimenta JA, Zaparolli D, et al. Chitosan: effect of a new chelating agent on the microhardness of root dentin. Braz Dent J 2012;23(3):212–217. DOI: 10.1590/S0103-64402012000300005.
Shenoy A, AhmaduddinBolla N, et al. Effect of final irrigating solution on smear layer removal and penetrability of the root canal sealer. J Conserv Dent 2014;17:40–44. DOI: 10.4103/0972-0707.124132.
Zhang J, Xia Z, et al. Chitosan modification and pharmaceutical/biomedical applications. Mar Drugs 2010;8:1962–1987. DOI: 10.3390/md8071962.
Xu Z, Neoh KG, et al. Biomimetic deposition of calcium phosphate minerals on the surface of partially demineralized dentin modified with phosphorylated chitosan. J Biomed Mater Res B Appl Biomater 2011;98:150–159. DOI: 10.1002/jbm.b.31844.
Shrestha A, Friedman S, et al. Photodynamically crosslinked and chitosan-incorporated dentin collagen. J Dent Res 2011;90:1346–1351. DOI: 10.1177/0022034511421928.
No HK, Park NY, et al. Antibacterial activity of chitosans and chitosan oligomers with different molecular weights. Int J Food Microbiol 2002;74:65–72. DOI: 10.1016/S0168-1605(01)00717-6.
Calamari SE, Bojanich MA, et al. Antifungal and post-antifungal effects of chlorhexidine, fluconazole, chitosan and its combinations on Candida albicans. Med Oral Patol Oral Cir Bucal 2011;16:e23–e28. DOI: 10.4317/medoral.16.e23.
Kamble AB, Abraham S, et al. Scanning electron microscopic evaluation of efficacy of 17% ethylenediaminetetraacetic acid and chitosan for smear layer removal with ultrasonics: An In vitro study. Contemp Clin Dent 2017;8:621–626.
Shashidhar C, Mehta DL. Scanning Electron Microscopic Evaluation of Efficacy of 17% Ethylenediaminetetraacetic Acid and Chitosan for Smear Layer Removal with Ultrasonics: An In vitro Study. Contemp Clin Dent 2017;8(4):621–626. DOI: 10.4103/ccd.ccd_745_17.
Mancini M, Cerroni L, et al. Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): Field emission scanning electron microscopic evaluation in an in vitro study. J Endod 2013;39: 1456–1460. DOI: 10.1016/j.joen.2013.07.028.
Yang G, Wu H, et al. Scanning electron microscopic evaluation of debris and smear layer remaining following use of ProTaper and Hero Shaper instruments in combination with NaOCl and EDTA irrigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e63–e71. DOI: 10.1016/j.tripleo.2008.04.032.
Darrag AM. Effectiveness of different final irrigation solutions on smear layer removal in intraradicular dentin. Tanta Den J 2014;11: 93–99. DOI: 10.1016/j.tdj.2014.06.002.
Gulabivala K, Ng Y-L, et al. The fluid mechanics of root canal irrigation. Physiol Meas 2010;31:R49–R84. DOI: 10.1088/0967-3334/31/12/R01.
Geethapriya N, Subbya A, et al. Effect Of Chitosan-Ethylenediamine Tetraacetic Acid On Enterococcus Faecalis Dentinal Biofilm And Smear Layer Removal. J Conserv Dent 2016;19:472–477. DOI: 10.4103/0972-0707.190022.
Raafat D, von Bargen K, et al. Insights into the mode of action of chitosan as an antibacterial compound. Appl Environ Microbiol 2008;74:3764–3773. DOI: 10.1128/AEM.00453-08.
Banin E, Brady KM, et al. Chelator-induced dispersal and killing of Pseudomonas aeruginosa cells in a biofilm. Appl Environ Microbiol 2006;72:2064–2069. DOI: 10.1128/AEM.72.3.2064-2069.2006.
Bernkop-Schnürch A, Scerbe-Saiko A. Synthesis and In Vitro Evaluation of Chitosan-EDTA-Protease-Inhibitor Conjugates Which Might Be Useful in Oral Delivery of Peptides and Proteins. Pharmaceutical Research 1998;15:263–269. DOI: 10.1023/A:1011970703087.