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THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE


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THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE

Article information

Restor Dent Endod. 2006;31(5):378-389
Publication date (electronic) : 2006 January 14
doi : https://doi.org/10.5395/JKACD.2006.31.5.378
Jung-Min Lee, Sang-Hyuk Park, Gi-Woon Choi,
Dept. of Conservative Dentistry, Division of Dentistry, Graduate school of KyungHee University
*Corresponding Author: Gi-Woon Choi, Dept. of Conservative Dentistry, Division of Dentistry, Graduate school of KyungHee University, 1, Hoegi Dong, Dongdaemoon Gu, Seoul, 130-702, Korea, Tel: 82-2-958-9336, E-mail: gwchoi@khu.ac.kr
Received 2006 April 04; Revised 2006 September 04; Accepted 2006 September 07.

Abstract

Abstract

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique.

NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0.

  1. The mean leakage ratio was decreased cervically.

  2. NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05).

  3. NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05).

  4. NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05).

  5. EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference.

  6. In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

Keywords: NaOCl; EDTA; Smear layer; Mean leakage; Dentinal tubule
Figure 1.

Mean leakage ratio in NaOCl group and EDTA group.

Figure 2.

Mean leakage ratio in NaOCl-6 group and EDTA-6 group.

Figure 3.

Mean leakage ratio in NaOCl group and NaOCl-6 group.

Figure 4.

Mean leakage ratio in EDTA group and EDTA-6 group.

Figure 5.

Photograph of the NaOCl group Level 1 (× 120).

Figure 6.

Photograph of the NaOCl group Level 2 (× 120).

Figure 7.

Photograph of the NaOCl group Level 3 (× 120).

Figure 8.

Photograph of the EDTA group Level 1 (× 120).

Figure 9.

Photograph of the EDTA group Level 2 (× 120).

Figure 10.

Photograph of the EDTA group Level 3 (× 120).

Figure 11.

Photograph of the NaOCl-6 group Level 1 (× 120).

Figure 12.

Photograph of the NaOCl-6 group Level 2 (× 120).

Figure 13.

Photograph of the NaOCl-6 group Level 3 (× 120).

Figure 14.

Photograph of the EDTA-6 group Level 1 (× 120).

Figure 15.

Photograph of the EDTA-6 group Level 2 (× 120).

Figure 16.

Photograph of the EDTA-6 group Level 3 (× 120).

Figure 17.

Photograph of the NaOCl group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gaps between gutta-percha and the surface of root canals. Surface generally covered with smear layer. Gaps were occuring between the smear layer and the gutta-percha.

Figure 18.

Photograph of the NaOCl group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 19.

Photograph of the EDTA group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin. But, voids were occuring between the sealer and the gutta-percha.

Figure 20.

Photograph of the EDTA group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin.

Figure 21.

Photograph of the NaOCl-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 22.

Photograph of the NaOCl-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 23.

Photograph of the EDTA-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Figure 24.

Photograph of the EDTA-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Irrigation solution to treat the smear layer in this study

Materials and instruments used in this study

Classification of experimental groups

Mean leakage ratio at each level (Mean ± SD)

References

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Article information Continued

Copyright © 2006 The Korean Academy of Conservative Dentistry

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1.

Figure 1.

Mean leakage ratio in NaOCl group and EDTA group.

Figure 2.

Figure 2.

Mean leakage ratio in NaOCl-6 group and EDTA-6 group.

Figure 3.

Figure 3.

Mean leakage ratio in NaOCl group and NaOCl-6 group.

Figure 4.

Figure 4.

Mean leakage ratio in EDTA group and EDTA-6 group.

Figure 5.

Figure 5.

Photograph of the NaOCl group Level 1 (× 120).

Figure 6.

Figure 6.

Photograph of the NaOCl group Level 2 (× 120).

Figure 7.

Figure 7.

Photograph of the NaOCl group Level 3 (× 120).

Figure 8.

Figure 8.

Photograph of the EDTA group Level 1 (× 120).

Figure 9.

Figure 9.

Photograph of the EDTA group Level 2 (× 120).

Figure 10.

Figure 10.

Photograph of the EDTA group Level 3 (× 120).

Figure 11.

Figure 11.

Photograph of the NaOCl-6 group Level 1 (× 120).

Figure 12.

Figure 12.

Photograph of the NaOCl-6 group Level 2 (× 120).

Figure 13.

Figure 13.

Photograph of the NaOCl-6 group Level 3 (× 120).

Figure 14.

Figure 14.

Photograph of the EDTA-6 group Level 1 (× 120).

Figure 15.

Figure 15.

Photograph of the EDTA-6 group Level 2 (× 120).

Figure 16.

Figure 16.

Photograph of the EDTA-6 group Level 3 (× 120).

Figure 17.

Figure 17.

Photograph of the NaOCl group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gaps between gutta-percha and the surface of root canals. Surface generally covered with smear layer. Gaps were occuring between the smear layer and the gutta-percha.

Figure 18.

Figure 18.

Photograph of the NaOCl group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 19.

Figure 19.

Photograph of the EDTA group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin. But, voids were occuring between the sealer and the gutta-percha.

Figure 20.

Figure 20.

Photograph of the EDTA group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin.

Figure 21.

Figure 21.

Photograph of the NaOCl-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 22.

Figure 22.

Photograph of the NaOCl-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 23.

Figure 23.

Photograph of the EDTA-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Figure 24.

Figure 24.

Photograph of the EDTA-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Table 1.

Irrigation solution to treat the smear layer in this study

Products Manufacturer Function & Characteristics
NaOCl
 KMC Pharmacy, Seoul, Korea
 37℃, 3%
MD-Cleanser 17% EDTA
META BIOMED Co., Okcheon, 30% ammonia solution
Chungbuk, Korea 1 – 2% acetyl pyridine chloride
Distilled water

Table 2.

Materials and instruments used in this study

Products Manufacturer Function & Characteristics
Endo-EZE® Ultradent Product Inc., 27 gauge,
South Jordan, USA Flexible irrigator tip
K3™ SybronEndo, CA, USA Rotary Ni-Ti file
K-file Maillefer, Ballaigues, Swiss Hand file
Pro-engine power unit Sae-Yang Machinery co., Daegu, Korea Micromotor & handpiece
Heating Mantle Misung Scientific co., Yangju, Korea Warmer
Temperature Controller Misung Scientific co., Yangju, Korea Keeping temperature at a fixed level
AH-26 Dentsply DeTrey, Germany Sealer
Gutta-Percha cone Diadent, Korea Canal obturation material
System B Analytic technology, USA Canal obturation unit
Buchanan Plugger Analytic technology, USA Plugger
Obtura-Ⅱ Texceed Co, USA Gutta-percha backfilling

Table 3.

Classification of experimental groups

Group n Irrigating solution Final flush
NaOCl 20 37℃ 3% NaOCl 37℃ 3% NaOCl (5㎖) 2 min
EDTA 20 37℃ 3% NaOCl 17% EDTA (5㎖) 2 min
NaOCl-6 20 37℃ 3% NaOCl 37℃ 3% NaOCl (5㎖) 2 min
EDTA-6 20 37℃ 3% NaOCl 17% EDTA (5㎖) 2 min

Table 4.

Mean leakage ratio at each level (Mean ± SD)

Group Level 1 Level 2 Level 3
NaOCl 0.46 ± 0.24 0.18 ± 0.28 0.07 ± 0.19
EDTA 0.20 ± 0.26 0.12 ± 0.25 0.07 ± 0.18
NaOCl-6 0.69 ± 0.32 0.38 ± 0.41 0.29 ± 0.37
EDTA-6 0.37 ± 0.39 0.19 ± 0.29 0.09 ± 0.14