Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Dec 27;19(12):e0314940.
doi: 10.1371/journal.pone.0314940. eCollection 2024.

Smear layer removal comparing conventional irrigation, passive ultrasonic irrigation, EndoActivator System, and a new sonic device (Perfect Clean System) by scanning electron microscopy: An ex vivo study

Bruna Fernanda Alionço Gonçalves  1 , Divya Reddy  2 , Ricardo Machado  3 , Paulo César Soares Júunior  4 , Sérgio Aparecido Ignácio  5 , Douglas Augusto Fernandes Couto  1 , Karine Santos Frasquetti  1 , Vânia Portela Ditzel Westphalen  1 , Everdan Carneiro  1 , Ulisses Xavier da Silva Neto  1
Affiliations
Comparative Study

Smear layer removal comparing conventional irrigation, passive ultrasonic irrigation, EndoActivator System, and a new sonic device (Perfect Clean System) by scanning electron microscopy: An ex vivo study

Bruna Fernanda Alionço Gonçalves et al. PLoS One. .

Abstract

Aim: This study evaluated the smear layer removal provided by conventional, sonic, and ultrasonic irrigation techniques.

Methodology: Forty extracted human mandibular first premolars were selected and instrumented using the ProTaper Next System files and 2.5% sodium hypochlorite. Afterward, they were divided into 4 groups (n. 10) according to the irrigation technique used to perform the final irrigation with a chelating solution (17% EDTA): conventional irrigation (CI), passive ultrasonic irrigation (PUI), EndoActivator System (EAS), and Perfect Clean System (PCS). The smear layer removal was determined through a score after evaluating scanning electron microscope images (1.000x) obtained at 1, 5, 8, and 12mm from the working length (WL). Statistical analyses were carried out by the Kruskal-Wallis and Dunn's tests with a significance level of 5% (P < 0.05).

Results: All irrigation techniques were unable to promote an effective smear layer removal at 1mm from the WL in comparison with the other locations (P < .05). At 5, 8, and 12mm from the WL, no statistically significant differences were observed among CI, PUI, EAS, and PCS (P > 0.05). At 12mm from the WL, statistically significant differences were only identified after comparing PCS and CI (P < .05).

Conclusion: The smear layer removal was only efficient at 5, 8, and 12 from the WL with no significant statistical differences among CI, PUI, EAS, and PCS (P > 0.05).

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRILE 2021 flowchart.
Fig 2
Fig 2. Representative SEM images of groups and places investigated.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J. 2023;56 Suppl 2:82–115. doi: 10.1111/iej.13897 - DOI - PubMed
    1. Lui K, Liu H, Wang H, Yang X, Huang D, Zhou X, et al.. An application framework of 3D assessment image registration accuracy and untouched surface area in canal instrumentation laboratory research with micro-computed tomography. Clin Oral Investig. 2023;27(2):715–25. doi: 10.1007/s00784-022-04819-w - DOI - PubMed
    1. 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 - DOI - PubMed
    1. Morago A, Ordinola-Zapata R, Ferrer-Luque CM, Baca P, Ruiz-Linares M, Arias-Moliz MT. Influence of Smear Layer on the Antimicrobial Activity of a Sodium Hypochlorite/Etidronic Acid Irrigating Solution in Infected Dentin. J Endod. 2016;42(11):1647–50. - PubMed
    1. Foster KH, Kulild JC, Weller RN. Effect of smear layer removal on the diffusion of calcium hydroxide through radicular dentin. J Endod. 1993;19(3):136–40. doi: 10.1016/S0099-2399(06)80508-X - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources