In vitro techniques for evaluating smear layer removal by root canal irrigants: a literature review

Authors

  • Luis Hernán Carrillo Varguez Universidad Autonoma de Baja California
  • Aracely Serrano-Medina
  • Eduardo Alberto López Maldonado
  • Eustolia Rodríguez Velázquez
  • José Manuel Cornejo-Bravo

DOI:

https://doi.org/10.56935/hij.v1i2.16

Keywords:

Smear layer removal, root canal irrigants, evaluation techniques, chelating capacity, calcium chelation

Abstract

Introduction: The purpose of this review is to address the most commonly used techniques for evaluating smear layer removal ability or chelating capacity of root canal irrigants, including Energy Dispersive X-Ray Spectroscopy (EDS or EDX), Atomic Absorption Flame Spectrometry (AASF), wavelength dispersive X-ray fluorescence spectrometry (WDXRF), inductive coupled plasma emission spectroscopy (ICP-AES), Scanning Electron Microscopy (SEM), and Fourier Transform Infrared Spectroscopy (FTIR). Methods: An electronic literature search was conducted in the Pub Med / MEDLINE database of indexed journals from 1992 to 2020. The search terms included chelating, chelation, calcium chelation, smear layer, smear layer removal, and demineralizing effect. Results: All the techniques were classified in terms of their results, both quantitatively and qualitatively. Even though smear layer removal and chelating capacity are not the same parameters, most of the studies included both techniques to correlate their results. SEM is the most commonly used technique for evaluating smear layer removal using various root canal irrigants. Ethylenediaminetetraacetic acid (EDTA) (17%) was the most widely studied root canal irrigant. Conclusion: Different techniques can be used to evaluate smear layer removal and chelating capacity of root canal irrigants. All of these methods have their corresponding advantages and disadvantages. This study aimed to provide researchers with a background for the selection of technique(s) to study the irrigant´s capacity for calcium chelation, which is applicable to smear layer removal.

References

Ari, H., & Erdemir, A. (2005). Effects of Endodontic Irrigation Solutions on Mineral Content of Root Canal Dentin Using ICP-AES Technique. Journal of Endodontics, 31(3), 187–189.

Arslan, D., Guneser, M. B., Dincer, A. N., Kustarci, A., Er, K., & Siso, S. H. (2016). Comparison of Smear Layer Removal Ability of QMix with Different Activation Techniques. Journal of Endodontics, 42(8), 1279–1285. https://doi.org/10.1016/j.joen.2016.04.022

Cobankara, F. K., Erdogan, H., & Hamurcu, M. (2011). Effects of chelating agents on the mineral content of root canal dentin. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 112(6), e149–e154. https://doi.org/10.1016/j.tripleo.2011.06.037

Connell, M. S. O., Morgan, L. A., Beeler, W. J., & Baumgartner, J. C. (2000). A Comparative Study of Smear Layer Removal Using Different Salts of EDTA.

Da Costa Lima, G. A., Aguiar, C. M., Câmara, A. C., Alves, L. C., Dos Santos, F. A. B., & Do Nascimento, A. E. (2015). Comparison of smear layer removal using the Nd:YAG laser, ultrasound, ProTaper universal system, and CanalBrush methods: An in vitro study. Journal of Endodontics, 41(3), 400–404. https://doi.org/10.1016/j.joen.2014.11.004

del Carpio-Perochena, A., Bramante, C. M., Duarte, M. A. H., de Moura, M. R., Aouada, F. A., Kishen, A., Clovis, M., Hungaro, M., Moura, M. de, Ahmad, F., & Kishen, A. (2015). Chelating and antibacterial properties of chitosan nanoparticles on dentin. Restor Dent Endod, 40(3), 195–201. https://doi.org/10.5395/rde.2015.40.3.195

Doǧan, H. (2001). Effects of chelating agents and sodium hypochlorite on mineral content of root dentin. Journal of Endodontics, 27(9), 578–580. https://doi.org/10.1097/00004770-200109000-00006

Erdemir, A., Eldeniz, A. Ü., & Belli, S. (2004). Effect of gutta-percha solvents on mineral contents of human root dentin using ICP-AES technique. Journal of Endodontics, 30(1), 54–56. https://doi.org/10.1097/00004770-200401000-00012

Geethapriya, N., Subbiya, A., Padmavathy, K., Mahalakshmi, K., Vivekanandan, P., & Ganapathy Sukumaran, V. (2015). Effect of chitosan-ethylenediamine tetraacetic acid on Enterococcus faecalis dentinal biofilm and smear layer removal. Iranian Endodontic Journal, 10(1), 39–43. https://doi.org/10.4103/0972

Ghisi, A. C., Kopper, P. M. P., Baldasso, F. E. R., Stürmer, C. P., Rossi-Fedele, G., Steier, L., De Figueiredo, J. A. P., Morgental, R. D., & Vier-Pelisser, F. V. (2015). Effect of superoxidized water and sodium hypochlorite, associated or not with EDTA, on organic and inorganic components of bovine root dentin. Journal of Endodontics, 41(6), 925–930. https://doi.org/10.1016/j.joen.2015.01.039

Gurbuz, T., Ozdemir, Y., Kara, N., Zehir, C., & Kurudirek, M. (2008). Evaluation of Root Canal Dentin after Nd:YAG Laser Irradiation and Treatment with Five Different Irrigation Solutions: A Preliminary Study. Journal of Endodontics, 34(3), 318–321. https://doi.org/10.1016/j.joen.2007.12.016

Hennequin, M., & Douillard, Y. (1995). Effects of citric acid treatment on the Ca, P and Mg contents of human dental roots. Journal of Clinical Periodontology, 22(7), 550–557. https://doi.org/10.1111/j.1600-051X.1995.tb00804.x

Hennequin, M., Pajot, J., & Avignant, D. (1994). Effects of different pH values of citric acid solutions on the calcium and phosphorus contents of human root dentin. Journal of Endodontics, 20(11), 551–554. https://doi.org/10.1016/S0099-2399(06)80071-3

Kaufman, D., Mor, C., Stabholz, A., & Rotstein, I. (1997). Effect of gutta-percha solvents on calcium and phosphorus levels of cut human dentin. Journal of Endodontics, 23(10), 614–615. https://doi.org/10.1016/S0099-2399(97)80171-9

Kim, H. J., Park, S. J., Park, S. H., Hwang, Y. C., Yu, M. K., & Min, K. S. (2013). Efficacy of flowable gel-type EDTA at removing the smear layer and inorganic debris under manual dynamic activation. Journal of Endodontics, 39(7), 910–914. https://doi.org/10.1016/j.joen.2013.04.018

Mancini, M., Cerroni, L., Iorio, L., Armellin, E., Conte, G., & Cianconi, L. (2013). 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. Journal of Endodontics, 39(11), 1456–1460. https://doi.org/10.1016/j.joen.2013.07.028

Mathew, S. P., Pai, V. S., Usha, G., & Nadig, R. R. (2017). Comparative evaluation of smear layer removal by chitosan and ethylenediaminetetraacetic acid when used as irrigant and its effect on root dentine: An in vitro atomic force microscopic and energy-dispersive X-ray analysis. Journal of Conservative Dentistry, 20(4), 245–250. https://doi.org/10.4103/JCD.JCD_269_16

Nassar, M., Hiraishi, N., Tamura, Y., Otsuki, M., Aoki, K., & Tagami, J. (2015). Phytic acid: An alternative root canal chelating agent. Journal of Endodontics, 41(2), 242–247. https://doi.org/10.1016/j.joen.2014.09.029

Ozdemir, H. O., Buzoglu, H. D., Çalt, S., Çehreli, Z. C., Varol, E., & Temel, A. (2012). Chemical and ultramorphologic effects of ethylenediaminetetraacetic acid and sodium hypochlorite in young and old root canal dentin. Journal of Endodontics, 38(2), 204–208. https://doi.org/10.1016/j.joen.2011.10.024

Pimenta, J. A., Zaparolli, D., Pécora, J. D., & Cruz-Filho, A. M. (2012). Chitosan: Effect of a new chelating agent on the microhardness of root dentin. Brazilian Dental Journal, 23(3), 212–217. https://doi.org/10.1590/S0103-64402012000300005

Ramírez-Bommer, C., Gulabivala, K., & Y-l, N. (2018). Estimated depth of apatite and collagen degradation in human dentine by sequential exposure to sodium hypochlorite and EDTA : a quantitative FTIR study. International Endodontic Journal, 469–478. https://doi.org/10.1111/iej.12864

Schmidt, T. F., Teixeira, C. S., Felippe, M. C. S., Felippe, W. T., Pashley, D. H., & Bortoluzzi, E. A. (2015). Effect of Ultrasonic Activation of Irrigants on Smear Layer Removal. Journal of Endodontics, 41(8), 1359–1363. https://doi.org/10.1016/j.joen.2015.03.023

Silva, P. V., Guedes, D. F. C., Pécora, J. D., & da Cruz-Filho, A. M. (2012). Time-dependent effects of chitosan on dentin structures. Brazilian Dental Journal, 23(4), 357–361. https://doi.org/10.1590/S0103-64402012000400008

Silva, P. V., Guedes, D. F. C., Nakadi, F. V., Pécora, J. D., & Cruz-Filho, A. M. (2013). Chitosan: A new solution for removal of smear layer after root canal instrumentation. International Endodontic Journal, 46(4), 332–338. https://doi.org/10.1111/j.1365-2591.2012.02119.x

Spanó, J. C. E., Silva, R. G., Guedes, D. F. C., Sousa-Neto, M. D., Estrela, C., & Pécora, J. D. (2009a). Atomic Absorption Spectrometry and Scanning Electron Microscopy Evaluation of Concentration of Calcium Ions and Smear Layer Removal With Root Canal Chelators. Journal of Endodontics, 35(5), 727–730. https://doi.org/10.1016/j.joen.2009.02.008

Spanó, J. C. E., Silva, R. G., Guedes, D. F. C., Sousa-Neto, M. D., Estrela, C., & Pécora, J. D. (2009b). Atomic Absorption Spectrometry and Scanning Electron Microscopy Evaluation of Concentration of Calcium Ions and Smear Layer Removal With Root Canal Chelators. Journal of Endodontics, 35(5), 727–730. https://doi.org/10.1016/j.joen.2009.02.008

Turk, T., Kaval, M. E., & Şen, B. H. (2015). Evaluation of the smear layer removal and erosive capacity of EDTA, boric acid, citric acid and desy clean solutions: An in vitro study. BMC Oral Health, 15(1), 1–5. https://doi.org/10.1186/s12903-015-0090-y

Ulusoy, Ö. I. A., & Görgül, G. (2013). Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. Australian Endodontic Journal, 39(2), 66–72. https://doi.org/10.1111/j.1747-4477.2010.00291.x

Vasudev Ballal, N., Mala, K., & Seetharama Bhat, K. (2011). Evaluation of decalcifying affect of maleic acid and EDTA on root canal dentin using energy dispersive spectrometer. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 112(2), e78–e84. https://doi.org/10.1016/j.tripleo.2011.01.034

Verdelis, K., Eliades, G., Oviir, T., & Effect, M. J. (1999). Effect of chelating agents on the molecular composition and extent of decalcification at cervical , middle and apical root dentin locat ions. 164–170.

Violich, D. R., & Chandler, N. P. (2010). The smear layer in endodontics - A review. International Endodontic Journal, 43(1), 2–15. https://doi.org/10.1111/j.1365-2591.2009.01627.x

Zhou, H., Li, Q., Wei, L., Huang, S., & Zhao, S. (2018). A comparative scanning electron microscopy evaluation of smear layer removal with chitosan and MTAD. Nigerian Journal of Clinical Practice, 21(1), 76–80. https://doi.org/10.4103/1119-3077.224798

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Published

2023-10-11

How to Cite

Carrillo Varguez, L. H., Serrano-Medina, A., López Maldonado, E. A., Rodríguez Velázquez, E., & Cornejo-Bravo, J. M. (2023). In vitro techniques for evaluating smear layer removal by root canal irrigants: a literature review. Horizon Interdisciplinary Journal, 1(2), 58–70. https://doi.org/10.56935/hij.v1i2.16

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