title: Debris and smear removal in flattened root canals after use of different irrigant agitation protocols.
abstract: Scanning electron microscopy (SEM) can be used to analyze the presence of debris and smear layer on the internal walls of root canal. This study evaluated the debris and smear removal in flattened root canals using SEM after use of different irrigant agitation protocols. Fifty mandibular incisors were distributed into five groups (n = 10) according to the irrigant agitation protocol used during chemomechanical preparation: conventional syringe irrigation with NaviTip needle (no activation), active scrubbing of irrigant with brush-covered NaviTip FX needle, manual dynamic irrigation, continuous passive ultrasonic irrigation, and apical negative pressure irrigation (EndoVac system). Canals were irrigated with 5 mL of 2.5% NaOCl at each change of instrument and received a final flush with 17% EDTA for 1 min. After instrumentation, the roots were split longitudinally and SEM micrographs at ×100 and ×1,000 were taken to evaluate the amount of debris and smear layer, respectively, in each third. Data were analyzed by Kruskal-Wallis and Dunn's post-hoc tests (α = 5%). Manual dynamic activation left significantly (p < 0.05) more debris inside the canals than the other protocols, while ultrasonic irrigation and EndoVac were the most effective (p < 0.05) for debris removal. Regarding the removal of smear layer, there was no statistically significant difference (p > 0.05) either among the irrigant agitation protocols or between the protocol-canal third interactions. Although none of the irrigant agitation protocols completely removed debris and smear layer from flattened root canals, the machine-assisted agitation systems (ultrasound and EndoVac) removed more debris than the manual techniques.
authors: School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors: Eduardo Milani
authors: EM
authors: Ribeiro
authors: Yara T C
authors: YT
authors: Silva-Sousa
authors: Aline Evangelista
authors: AE
authors: Souza-Gabriel
authors: Manoel Damião
authors: MD
authors: Sousa-Neto
authors: Karina Torales
authors: KT
authors: Lorencetti
authors: Silvio Rocha Correa
authors: SR
authors: Silva
mesh_terms: D003646:Debridement / Q000379:methods*; D003786:Dental Pulp Cavity / Q000473:pathology* / Q000601:surgery*; D008855:Microscopy, Electron, Scanning; D012388:Root Canal Irrigants / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D012388:Root Canal Irrigants