Comparative Evaluation Of Smear Layer Removal Using Four Different Irrigation Techniques: An In-Vitro Study

Abstract

Aim & Background: To evaluate the in vitro-study was to compare the efficacy of side vent needle, plastic files, endo activator, ultrasonic irrigator and xp-endo finisher.

Materials and Methods: Seventy-five freshly extracted single rooted teeth which do not had caries, or were extracted for orthodontic and periodontal reasons with mature apex. Samples were divided into 5 groups randomly before final irrigation as follows: Group I (n=15): Irrigation with side vent needles (Waldent., India); Group II (n=15): Irrigation with sonic irrigator (Waldent), Group III (n=15): In this activation technique, 1 ml of  NaOCl was placed into the canal); Group IV (n=15): Plastic files and Group V(n=15): xp-endo finisher irrigation Activation cycle of 30 seconds until 10 ml 3% NaOCl was used, which was activated for 90.  Teeth were split using chisel and mallets. One-half of each tooth was chosen for SEM examination to evaluate smear layer removal. 

Results: The Control Group exhibited the highest smear layer score. The Sonic Activator Group followed with a mean of 2.486 ± 0.135, suggesting a moderate to heavy smear layer. In contrast, the Passive Ultrasonic Group demonstrated the most effective smear layer removal, with the lowest mean score of 1.614 ± 0.107, closely aligned with a minimal smear layer (Score 1). Similarly, the XP-Endo Finisher Group showed improved smear layer removal with a mean of 1.771 ± 0.364, reflecting mild smear layer presence. The Plastic File Group had a mean score of 2.643 ± 0.098, indicating moderate smear layer retention.

Conclusion: The findings highlight the superiority of irrigant activation, particularly PUI, in enhancing canal cleanliness.

Clinical Significance: This study demonstrates that irrigant activation techniques, especially passive ultrasonic irrigation (PUI) and the XP-Endo Finisher, significantly enhance smear layer removal compared to conventional methods. Incorporating these activation methods in clinical practice can improve treatment outcomes by promoting cleaner canals and reducing the risk of reinfection.