Effectiveness of Different Irrigation Techniques on Post Space Smear Layer Removal: SEM Evaluation

Author:

Iandolo Alfredo1,Pisano Massimo1,Abdellatif Dina2ORCID,Amato Alessandra1ORCID,Giordano Francesco1ORCID,Buonavoglia Alessio3ORCID,Sangiovanni Giuseppe1,Caggiano Mario1ORCID

Affiliation:

1. Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy

2. Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21531, Egypt

3. Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy

Abstract

Background: Effective debris and smear layer removal affects post-cementation and bond strength. Aim: The aim was to compare the effectiveness of debris and smear layer removal using standard irrigation and activated irrigation with heated EDTA. Moreover, an irrigant activation technique was chosen in the current research, employing the ultrasonic activation of an EDTA solution after being heated directly inside the post space preparation. Materials and Methods: 30 single-rooted human mandibular premolar teeth were used in the current study to test the proposed techniques. First, the teeth were cut to have standardised roots 18 mm in length and prepared endodontically, and then the post space was carried out on all the samples. Then the specimens were randomly distributed into three study groups according to the post space irrigation technique. In detail, the groups were group 1, where a 3D cleaning technique was used; group 2, where the traditional irrigation with EDTA was applied; and group 3, where only saline as an irrigant was used. The third group was considered the control group. Next, the teeth were segmented and analysed via scanning electron microscopy (SEM). The magnification was used to evaluate and score the smear layer and debris. Statistical analysis was undertaken using the classic statistical software package (SPSS, version 28.0; SPSS IBM, Armonk, NY, USA). Then, the data were interpreted with a non-parametric analysis of variance (Kruskal–Wallis ANOVA) among the experiment groups. The significance level was decided as p < 0.05. In addition, statistically significant (p < 0.05) lower mean smear layer and debris scores were found in both the examination groups compared to the control group. Results: group 1 demonstrated better results compared to group 2 in terms of cleaning the dentinal walls. Conclusions: The current research concluded that the EDTA 3D cleaning technique is an effective irrigation technique for clearing debris and smear layers in the post space. Future research, such as on push-out bond strength, should be used to verify this research’s conclusions. Key findings: The use of ultrasonically activated heated EDTA improved the smear layer removal. The use of the 3D cleaning technique resulted in better post space cleaning.

Publisher

MDPI AG

Subject

General Earth and Planetary Sciences,General Environmental Science

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