Effects of auxiliary device use on smear layer removal

Area of Science:

• Endodontics
• Dental materials science
• Microscopy

Background:

• Smear layer removal is crucial for successful endodontic treatment.
• Chelating solutions like QMix are used to aid smear layer removal.
• The efficacy of auxiliary irrigation devices with QMix requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of different auxiliary irrigation devices on smear layer removal using QMix.
• To compare the performance of QMix with and without auxiliary irrigation methods.
• To determine the optimal irrigation protocol for smear layer removal in root canals.

Main Methods:

• Fifty single-rooted human teeth were instrumented and irrigated with 2% chlorhexidine gel.
• Teeth were divided into five groups with different final irrigation protocols: distilled water, QMix (1 min), QMix + passive ultrasonic irrigation (PUI), QMix + endodontic finishing file (EC), and QMix (3 min).
• Scanning electron microscopy (SEM) was used to evaluate smear layer removal in coronal, middle, and apical root thirds.

Main Results:

• Passive ultrasonic irrigation (PUI) demonstrated superior smear layer removal compared to other groups.
• QMix combined with an endodontic finishing file (EC) and QMix for 3 minutes showed comparable results.
• QMix alone (1 minute) was less effective, but its efficacy improved significantly when used with auxiliary devices like PUI or EC, particularly in the apical third.

Conclusions:

• Passive ultrasonic irrigation (PUI) is the most effective auxiliary method for smear layer removal with QMix.
• Auxiliary irrigation devices enhance the effectiveness of QMix, especially in challenging areas like the apical third.
• Optimized irrigation protocols are essential for thorough root canal cleaning and disinfection.