The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 2 ( February, 2021 ) > List of Articles


SEM Evaluation of Various Intracanal Irrigation Devices on Smear Layer Removal: A Comparative Study

Shafait U Khateeb, Sonia P Pathrose, Aparna S Kumar, Sengodan Haribaskar, Gunaranjan Thota

Keywords : Irrigation, Root canal, Scanning electron microscope, Smear Layer

Citation Information : Khateeb SU, Pathrose SP, Kumar AS, Haribaskar S, Thota G. SEM Evaluation of Various Intracanal Irrigation Devices on Smear Layer Removal: A Comparative Study. J Contemp Dent Pract 2021; 22 (2):184-188.

DOI: 10.5005/jp-journals-10024-3002

License: CC BY-NC 4.0

Published Online: 17-12-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: The present study aimed at assessing the effectiveness of different intracanal irrigation devices on the removal of the smear layer. Materials and methods: The recently extracted 80 lower premolars having single canal were chosen for this in vitro study. A round diamond bur was used to gain endodontic access and the root canal was entered with a #15 K-file until the tip was just seen at the apical foramen. Manual instrumentation of root canals of all teeth was done using the step-back method. The samples were later divided randomly into four groups. Later, each sample was exposed to final irrigation by using four different irrigation systems, group 1: conventional needle irrigation, group 2: irrigation with ultrasonic activation, group 3: irrigation with EndoVac system activation, group 4: irrigation with EndoActivator. The samples were next mounted and visualized under scanning electron microscope (SEM) for the absence or presence of the smear layer. Results: Irrigation with EndoVac system activation showed the presence of least smear layer (2.40 ± 0.32), followed next by EndoActivator (3.24 ± 0.46) and ultrasonic activation (4.96 ± 0.54) and conventional needle irrigation (5.20 ± 0.10). No statistically significant difference was found in the apical and coronal thirds of the root canal in removal of the smear layer on an intragroup comparison. However, a statistically significant (p < 0.001) difference was seen between the groups at the apical and coronal thirds on an intergroup comparison. Conclusion: This study demonstrated the EndoVac system group to be efficient in removal of the smear layer when compared to the EndoActivator system, ultrasonic activation, and conventional needle irrigation group. Clinical significance: The definitive objective of endodontic therapy is to transform the affected teeth to a healthy and functional state. The irrigants can reach the working length when delivered by an effective irrigation delivery system. This type of delivery system should deliver adequate volume of irrigants all the way up to the working length and have sufficient flow and be efficient at debridement of complete canal system.

  1. Torabinejad M, Handysides R, Khademi AA, 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.
  2. Violich DR, Chandler NP. The smear layer in endodontics—a review. Int Endod J 2010;43(1):2–15. DOI: 10.1111/j.1365-2591.2009.01627.x.
  3. Boutsioukis C, Lambrianidis T, Kastrinakis E, et al. Measurement of pressure and flow rates during irrigation of a root canal ex vivo with three endodontic needles. Int Endod J 2007;40(7):504–513. DOI: 10.1111/j.1365-2591.2007.01244.x.
  4. Gu L-s, Kim JR, Ling J, et al. Review of contemporary irrigant agitation techniques and devices. J Endod 2009;35(6):791–804. DOI: 10.1016/j.joen.2009.03.010.
  5. Gadaalay S, Hariramani SI, Dhore P, et al. Comparative evaluation of efficacy of three different irrigation activation systems in debridement of root canal isthmus: an in vitro study. Endodontology 2017;29(1):39–42. DOI: 10.4103/endo.endo_4_17.
  6. Saber Sel-D, Hashem AAR. Efficacy of different final irrigation activation techniques on smear layer removal. J Endod 2011;37(9):1272–1275. DOI: 10.1016/j.joen.2011.06.007.
  7. Torabinejad M, Khademi AA, Babagoli J, et al. A new solution for the removal of the smear layer. J Endod 2003;29(3):170–175. DOI: 10.1097/00004770-200303000-00002.
  8. Saini M, Kumari M, Taneja S. Comparative evaluation of the efficacy of three different irrigation devices in removal of debris from root canal at two different levels: an in vitro study. J Conserv Dent 2013;16(6):509–513. DOI: 10.4103/0972-0707.120959.
  9. Goel S, Tewari S. Smear layer removal with passive ultrasonic irrigation and the NaviTip FX: a scanning electron microscopic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108(3):465–470. DOI: 10.1016/j.tripleo.2009.04.023.
  10. Zmener O, Pameijer CH, Serrano SA, et al. Efficacy of the NaviTip FX irrigation needle in removing post instrumentation canal smear layer and debris in curved root canals. J Endod 2009;35(9):1270–1273. DOI: 10.1016/j.joen.2009.05.001.
  11. Nielsen BA, Baumgartner JC. Comparison of the EndoVac system to needle irrigation of root canals. J Endod 2007;33(5):611–615. DOI: 10.1016/j.joen.2007.01.020.
  12. Ribeiro EM, Silva‐Sousa YT, Souza‐Gabriel AE, et al. Debris and smear removal in flattened root canals after use of different irrigant agitation protocols. Microsc Res Tech 2012;75(6):781–790. DOI: 10.1002/jemt.21125.
  13. Siu C, Baumgartner JC. Comparison of the debridement efficacy of the endovac irrigation system and conventional needle root canal irrigation in vivo. J Endod 2010;36(11):1782–1785. DOI: 10.1016/j.joen.2010.08.023.
  14. Brunson M, Heilborn C, Johnson DJ, et al. Effect of apical preparation size and preparation taper on irrigant volume delivered by using negative pressure irrigation system. J Endod 2010;36(4):721–724. DOI: 10.1016/j.joen.2009.11.028.
  15. Jiang LM, Verhaagen B, Versluis M, et al. Evaluation of a sonic device designed to activate irrigant in the root canal. J Endod 2010;36(1):143–146. DOI: 10.1016/j.joen.2009.06.009.
  16. Blank-Gonçalves LM, Nabeshima CK, Martins GH, et al. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: conventional irrigation versus activation systems. J Endod 2011;37(9):1268–1271. DOi: 10.1016/j.joen.2011.06.009.
  17. Jiang LM, Verhaagen B, Versluis M, et al. The influence of the ultrasonic intensity on the cleaning efficacy of passive ultrasonic irrigation. J Endod 2011;37(5):688–692. DOI: 10.1016/j.joen.2011.02.004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.