SV Satish, Deepa Gandu* and Ashwini M Patil

Department of Conservative Dentistry and Endodontics, Navodaya Dental College, India

*Corresponding Author:Deepa Gandu, Department of Conservative Dentistry and Endodontics, Navodaya Dental College, India.

Received: December 15, 2022; Published: January 16, 2023

Abstract

Aim: The aim of this study is to compare and evaluate the smear layer removing ability of Citric acid and Maleic acid in retrograde preparations using scanning electron microscope.

Materials and Methods: Eighty single-rooted teeth have been chosen and decoronated at cemento-enamel junction. Root canal preparation was completed with ProTaper rotary Ni-Ti files upto F3 size. After each instrumentation, 3% NaOCl was used for irrigating root canals. Canals were obturated with 6% gutta-percha coated with AH plus resin sealer. Apical 3 mm of the root was resected at a plane perpendicular to the long axis of the root. A class I retrograde preparation was carried out using ultrasonic retrotips to a depth of about 3 mm. Debris was initially washed off using a normal saline. The specimens were categorized into four groups (n = 20) based on the irrigating solutions used which are 10% Citric acid and 7% Maleic acid as experimental groups and normal saline, 17% EDTA as control groups. The specimens will be sectioned longitudinally and examined under scanning electron microscope for the evaluation of smear layer.

Statistical Analysis: Statistical analysis was done using Kruskal-Wallis ANOVA and pairwise comparison using Mann-Whitney U-test.

Results: Group I (saline) was least efficient in removing the smear layer and most of the samples were occluded with smear layer. Group II (17% EDTA), Group III (10% Citric acid), and Group IV (7% Maleic acid) resulted in the efficient removal of the smear layer from the retrograde cavity with mean scores of 1.35, 1.60, and 1.35, respectively. Inter group comparisons showed statistically significant difference between Group IV (7% Maleic acid) and all other groups. There is no statistically significant difference found between Group III (10% Citric acid) and Group II (17% EDTA).

Conclusion:Within the limitations of this in vitro study, it can be concluded that irrigation with 7% Maleic acid is more efficacious in removing the smear layer than 17% EDTA and 10% Citric acid during retrograde root canal preparation.

Keywords:Citric Acid; Maleic Acid; Smear Layer; Retrograde Preparation; Ultrasonic Retrotips

References

1. Penumaka R., et al. “Scanning electron microscopy evaluation of chitosan and carboxymethyl chitosan as retrograde smear layer removing agents”. Journal of Conservative Dentistry6 (2019): 573.
2. Shahravan A., et al. “Effect of smear layer on sealing ability of canal obturation: a systematic review and meta-analysis”. Journal of Conservative Dentistry2 (2007): 96-105.
3. Ballal NV., et al. “Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: a scanning electron microscopic study”. Journal of Endodontics11 (2009): 1573-1576.
4. Ferrer-Luque CM., et al. “Antimicrobial activity of maleic acid and combinations of cetrimide with chelating agents against Enterococcus faecalis biofilm”. Journal of Endodontics10 (2010): 1673-1675.
5. Yano N., et al. “A literature review on intracanal irrigants in endodontics”. Indian Journal of Conservative and Endodontics. 6.1 (2021): 21-24.
6. Haznedaroglu F. “Efficacy of various concentrations of citric acid at different pH values for smear layer removal”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology3 (2003): 340-344.
7. Von Arx T. “Apical surgery: A review of current techniques and outcome”. Saudi Endodontic Journal1 (2011): 9-15.
8. Hulsmann M., et al. “Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation”. Journal of Endodontics5 (1997): 301-306.
9. Fabiani C., et al. “Removal of surgical smear layer”. Journal of Endodontics6 (2011): 836-838.
10. Butala R., et al. “Comparative evaluation of ethylenediaminetetraacetic acid, maleic acid, and peracetic acid in smear layer removal from instrumented root canal system: A scanning electron microscopic analysis study”. Saudi Endodontic Journal3 (2017): 170.
11. Kumar Y., et al. “Comparative evaluation of demineralization of radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid, and MTAD at different time intervals: An in vitro study”. International Society of Preventive and Community Dentistry1 (2016): 44.
12. Mashalkar S., et al. “Effect of diode laser irradiation and 10% citric acid conditioning on the sealing ability of mineral trioxide aggregate as a retrograde filling material”. Endodontology4 (2020): 231.
13. Ballal NV., et al. “A comparative evaluation of postobturation apical seal following intracanal irrigation with maleic acid and EDTA: a dye leakage under vacuum study”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology3 (2010): 126-130.
14. Vasiliadis L., et al. “The amount and distribution of sclerotic human root dentine”. Archives of Oral Biology7 (1983): 645-649.
15. Paque F., et al. “Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals”. International Endodontic Journal1 (2006): 18-25.

Citation

Citation: Deepa Gandu., et al. “Comparative Evaluation of Smear Layer Removal in Retrograde Preparation Using 10% Citric Acid And 7% Maleic Acid - An In Vitro Scanning Electron Microscopy Study".Acta Scientific Dental Sciences 7.2 (2023): 149-153.

Copyright

Copyright: © 2023 Deepa Gandu., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.