Efficacy of Smear Layer Removal from Root Canal Surface Using: Sonic, Ultrasonic, Different Lasers as Activation Methods of Irrigant (SEM study)
Background: This study aims to assess the Effectiveness of different irrigation activation techniques in removing smear layer from the confines of root canal using SEM analysis. Subjects/Materials and Methods: A total samples of 80 maxillary first molars with a single straight palatal root canal were prepared to size X4 (protaper Next, Dentsply) and assigned to 2 groups (n=40): normal saline and EDTA 17%, each group subdivided into five subgroups (n=8): conventional needle irrigation (CN), EndoActivator (EA), ultrasonic activated irrigation (UAI), Er.Cr.YSGG 2780nm laser, and Diode 940nm laser. Roots were split longitudinally then each half were divided into three regions corresponding to the apical, middle, and coronal. Scanning electron microscope investigations were accomplished. Three pictures for each region were taken and scored. Presence of smear layer was assessed using (5-grade scoring systems). Data were submitted for statistical analysis using nonparametric tests. Results: Activation of irrigants using Er.Cr.YSGG laser improved smear layer removal significantly (P < 0.05). sonic EndoActivator and ultrasonic show similar results. Lasing EDTA by 940nm Diode laser was more effective for removal of smear layer than normal saline at (P<0.05) and shows similar effect to Er.Cr.YSGG laser. Conclusion: laser activation of irrigation appears to have an interesting application in laser assisted endodontic therapy. Diode laser activation of EDTA provide a beneficial cost-effective choice for smear layer removal with added photothermal disinfection and opened the way for more studies to investigate the effect with different irrigation solution for the benefit of smear layer removal.