Comparative Evaluation of Carisolv with EDTA and Sodium hypochlorite in Removing the Smear Layer on Radicular Dentine using SEM -An In Vitro Study
Bindu M. John, Shashi Rashmi Acharya, Vidya Saraswathi, Carounanidy Usha
CarisolvTM, smear layer, scanning electron microscope
Citation Information :
John BM, Acharya SR, Saraswathi V, Usha C. Comparative Evaluation of Carisolv with EDTA and Sodium hypochlorite in Removing the Smear Layer on Radicular Dentine using SEM -An In Vitro Study. 2012; 2 (2):11-18.
Background: Smear layer is a tough adherent layer on the instrumented radicular dentin composed of organic and inorganic debris. Removing this layer is imperative for disinfection and obturation of root canal. However no single irrigating solution is effective in removal of the smear layer. 5.25% Sodium hypochlorite and 17% EDTA have been proven to remove both the organic and the inorganic portion of the smear layer, when used alternatively. CarisolvTM is chemo mechanical agent in removal ofcaries which consists of0.5% of Sodium hypochlorite and amino acids. This study aims to evaluate the efficacy of CarisolvTM in removing the smear layer when compared with 17% EDTA, 5.25% Sodium hypochlorite and normal saline. Methodology: 80 roots were divided into 4 groups. All roots were prepared by step back technique and irrigated with various solutions. Roots in Group 1 was irrigated with 1 ml of CarisolvTM, in Group 2 with 1 ml of 0.5% Sodium hypochlorite, in Group 3 with 1 ml of 17% EDTA andin Group 4 with lml of saline. All the teeth were sectioned longitudinally and then horizontally to obtain middle and apical third sections. These samples were evaluated with SEM and the photomicrographs were scored according to a 5-point scale. The data was analysed by using chi square test at p< 0.01. Results: CarisolvTM was found to ineffective in removing the smear layer. 17% EDTA and 5.25% Sodium hypochlorite were effective in removal but neither of them removed the layer completely when used.
Sen BH, Wesselink PR, Türkün M. The smear layera phenomenon in root canal therapy. Int Endod J 1995;28(3): 141-48.
Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J 2010;43:2-15.
Zehnder M. Root canal irrigants. J Endod 2006;32(5):389-98.
McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975;1(7):238-42.
Yamada RS, Armas A, Goldman M, Lin PS. A scanning electron microscopic comparison of a high volume final flush with several irrigating solutions: Part3.J Endod 1983;9(4):137-42.
Goldman M, Goldman LB, Cavaleri R. The efficacy of several endodontic irrigating solutions - SEM study. J Endod 1982;8:487-92.
Goldman M, Kronman JH. A preliminary report on a chemomechanical means of removing caries. J Am Dent Assoc 1976;93:1149-53.
Elkholany NR, Abdelaziz KM, Zaghloul NM, Aboulenine N. Chemo-mechanical method: A valuable alternative for caries removal. J Minim Interv Dent 2009;2(4):248-59.
Schutzbank SG, Galaini J, Goldman M. Comparative in vitro study of GK-IO land GK-101E in caries removal. J Dent Res 1978; 57:861-65.
Hülsmann M, Hahn W. Complications during root canal irrigation--literature review and case reports. Int Endod J 2000;33(3): 186-93.
Siqueira JF Jr, Machado AG, Silveira RM, Lopes HP, de Uzeda M. Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal - An in vitro study. Int Endod J 1997;30(4):279-82.
Singhal P, Das UM, Vishwanathan D, Singhal A. Carisolv as an endodontic irrigant in deciduous teeth: an SEM study. Indian J Dent Res 2012; 23(1):120-21.
Antonio AG, Maia LC, Primo LG, Moraes RS, Cunha CB. The role of Carisolv and different auxiliary chemical substances in the removal of bovine root canal smear layer. J Oral Sci 2006; 48(3):99-103.
Rahman S, Whitworth JM, Dummer PM. Carisolv: an alternative to NaOCl in immature root canals. Int Endod J 2005; 38(7):448-55.
Al-Kilani MG, Whitworth JM, Dummer PM. Preliminary in vitro evaluation of Carisolv as a root canal irrigant. Int Endod J 2003; 36(6):433-40.
Cantatore G, Berutti E, Castellucci A. Missed anatomy: frequency and clinical impact. Endodontic Topics 2009;15:3-31.
Shahravan A, Haghdoost AA, Adl A, Rahimi H, Shadifar F. Effect of smear layer on sealing ability of canal obturation: a systematic review and meta analysis. J Endod 2007;33(2):96-105.
Lozano-Chourio MA, Zambrano O, González H, Quero M. Clinical randomized controlled trial of chemomechanical caries removal (Carisolv). Int J Paediatr Dent 2006; 16(3): 161-67.
Blank-Gonçalves LM, Nabeshima CK, Martins GH, Machado ME. Qualitative analysis of the removal of the smear layer in the apical third of curved roots: Conventional irrigation versus activation systems. J Endod 2011;37(9):1268-71.
Saghiri MA, As gar K, Lotti M, Karamifar K, Saghiri AM, Neelakantan P, Gutmann JL, Sheibaninia A. Back-scattered and secondary electron images of scanning electron microscopy in dentistry: a new method for surface analysis Acta Odontol Scand 2012;70(6):603-9.
Hülsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J 2003;36(12):810-30.
Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in Endodontics. Dent Clin N Am 2010;54: 291-312.
Abou Ross M. Effectiveness of four irrigation methods on the removal of root canal debris. Oral Sug 1982;54(3):323-8.