Scanning electron microscopic evaluation of debris and smear layer remaining following use of ProTaper and Hero Shaper instruments in combination with NaOCl and EDTA irrigation

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Oct;106(4):e63-71. doi: 10.1016/j.tripleo.2008.04.032. Epub 2008 Aug 13.

Abstract

Objective: The purpose of this study was to evaluate the amounts of debris and smear layer remaining on canal walls after preparation with ProTaper and Hero Shaper instruments in combination with NaOCl and EDTA irrigation in curved root canals.

Study design: A total of 55 root canals were randomly divided into 2 instrumentation groups of 20 canals each and 1 negative control group of 15 canals. The canals in each of the 2 instrumentation groups were prepared with ProTaper or Hero Shaper instruments. Irrigation was performed with 5% NaOCl and 17% EDTA solutions. The control group was not instrumented. The remaining debris and smear layer were evaluated from scanning electron photomicrographs at x200 and x1,000 magnification taken in the coronal, middle, and apical thirds of the canals at both inner and outer canal walls. A 5-category scoring system for debris and smear layer was used. Statistical analysis was carried out using the Kruskal-Wallis and Mann-Whitney rank sum tests.

Results: Completely clean root canals were not found in either instrumentation group. In the coronal and middle thirds, the canal walls of both instrumentation groups were clean, with no or only small areas of debris and smear layer. In the apical region, there were higher scores in terms of debris and smear layer in both instrumentation groups. No significant difference was found at the inner wall of the 2 instrumentation groups in terms of debris mean score. However, the outer canal walls prepared with ProTaper showed lower debris score compared with those prepared with Hero Shaper (P < 0.001). Concerning the smear layer, both the inner and outer canal walls prepared with ProTaper showed lower mean scores compared with those prepared with Hero Shaper (P < 0.001).

Conclusions: Within the limitations of this study, both instruments in combination with NaOCl and EDTA irrigation produced a clean and debris-free canal surface in the coronal and middle thirds, but were unable to produce a canal surface free from debris and smear layer in the apical third. However, the canals prepared with ProTaper instruments showed smaller amounts of debris and smear layer remaining in the apical region.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Edetic Acid
  • Humans
  • Microscopy, Electron, Scanning
  • Molar
  • Root Canal Irrigants*
  • Root Canal Preparation / instrumentation*
  • Smear Layer*
  • Sodium Hypochlorite
  • Statistics, Nonparametric

Substances

  • Root Canal Irrigants
  • Edetic Acid
  • Sodium Hypochlorite