Smear layer removal efficiency of Er,Cr;YSGG and Er:YAG lasers in root canals prepared with different NiTi File systems
Smear layer removal efficiency of Er,Cr;YSGG and Er:YAG lasers in root canals prepared with different NiTi File systems
Aim: Evaluation of the root canal dentinal wall by scanning electron microscopy (SEM) in order to verify the presence/absence ofsmear layer after applying different NiTi file systems and Er:YAG and Er,Cr:YSGG lasers.Material and Methods: Hundred ninety-two mandibular incisors randomly divided into four groups (n=48). Each group was preparedwith one of NiTi files: ProTaper Next, One Shape, Reciproc and Twisted file Adaptive using 5.25% NaOCl irrigation. Each group wasthen subdivided into four groups (n=12). Er,Cr:YSGG laser, Er:YAG laser and EDTA were separately applied to the first three subgroups.In the control group, no further disinfection protocol was performed. Then the roots were sectioned longitudinally and halves wereexamined under SEM.Results: Erbium laser systems removed the smear layer better than NaOCl irrigation, but not as much as EDTA/NaOCl. The greatestreduction in smear was obtained with Reciproc/EDTA and Reciproc/Er,Cr:YSGG groups. The success of irrigation protocols fromhighest to lowest was EDTA, ErCr: YSGG laser and Er:YAG laser.Conclusions: Single file NiTi instruments appeared to be more effective than multiple-file systems in leaving clean root canal walls.The reciprocating systems produced less smear layer than rotating instruments. Er:YAG and Er,Cr:YSGG laser activations appearedto be more efficient than syringe irrigation to remove the smear layer.
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- 1. Bürklein S, Hinschitza K, Dammaschke T, et al. Shaping
ability and cleaning effectiveness of two single-file systems
in severely curved root canals of extracted teeth: Reciproc
and WaveOne versus Mtwo and ProTaper. Int Endod J
2012;45:449-61.
- 2. Bürklein S, Mathey D, Schäfer E. Shaping ability of ProTaper
NEXT and BT-RaCe nickel-titanium instruments in severely
curved root canals. Int Endod J 2015;48:774-81.
- 3. Pasqualini D, Alovisi M, Cemenasco A, et al. Micro-Computed
Tomography Evaluation of ProTaper Next and BioRace
Shaping Outcomes in Maxillary First Molar Curved Canals.
J Endod 2015;41:1706-10.
- 4. Jadhav GR, Mittal P, Kulkarni A, et al. Comparative evaluation
of canal cleaning ability of various rotary endodontic files in
apical third: A scanning electron microscopic study. Dent
Res J (Isfahan) 2016;13:508-14.
- 5. Bürklein S, Benten S, Schäfer E. Shaping ability of different
single-file systems in severely curved root canals of
extracted teeth. Int Endod J 2013;46:590-7.
- 6. Dagna A, Gastaldo G, Beltrami R, et al. Debris Evaluation
after Root Canal Shaping with Rotating and Reciprocating
Single-File Systems. J Funct Biomater 2016;7:28.
- 7. Amaral P, Forner L, Llena C. Smear layer removal in canals
shaped with reciprocating rotary systems. J Clin Exp Dent
2013;5:e227-30.
- 8. Akyuz Ekim SN, Erdemir A. Comparison of different irrigation
activation techniques on smear layer removal: An in vitro
study. Microsc Res Tech 2015;78:230-9.
- 9. Takeda FH, Harashima T, Kimura Y, et al. Comparative study
about the removal of the smear layer by three types of laser
devices. J Clin Laser Med Surg 1998;16:117-22.
- 10. Matsumoto H, Yoshimine Y, Akamine A. Visualization of
Irrigant Flow and Cavitation Induced by Er:YAG Laser within
a Root Canal Model. J Endod 2011;37:839-43.
- 11. Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness
after preparation with different endodontic handpieces and
hand instruments: a comparative SEM investigation. J
Endod 1997;23:301-6.
- 12. Ruddle CJ. New directions in endodontics. Interview. Dent
Today. 2002;21:74-81.
- 13. Torabinejad M, Handysides R, Khademi AA, et al. Clinical
implications of the smear layer in endodontics: a review. Oral
Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:658-
66.
- 14. Violich DR, Chandler NP. The smear layer in endodontics - a
review. Int Endod J 2010;43:2-15.
- 15. Ahlquist M, Henningsson O, Hultenby KO. The effectiveness
of manual and rotary techniques in the cleaning of root
canals: a scanning electron microscopy study. Int Endod J
2001; 34:533-7.
- 16. Craig Baumgartner J, Mader C. A scanning electron
microscopic evaluation of four root canal irrigation
regimens. J Endod 1987;13:147-57.
- 17. Khedmat S, Shokouhinejad N. Comparison of the efficacy
of three chelating agents in smear layer removal. J Endod
2008;34:599-602.
- 18. Sasaki KM, Aoki A, Ichinose S, et al.Ultrastructural analysis
of bone tissue irradiated by Er:YAG laser. Lasers Surg Med
2002;31:322-32.
- 19. Lee B-S, Lin C-P, Hung Y-L, et al. Structural changes of
Er:YAG laser-irradiated human dentin. Photomed Laser Ther
2004;22: 330–4.
- 20. Wang Q, Zhang C, Yin X. Evaluation of the bactericidal effect
of Er, Cr: YSGG, and Nd: YAG lasers in experimentally infected
root canals. J Endod 2007;33:830-2.
- 21. Yavari HR, Rahimi S, Shahi S et al. Effect of Er,Cr:YSGG laser
irradiation on Enterococcus faecalis in infected root canals.
Photomed Laser Surg 2010;28:91-6.
- 22. Schoop U, Barylyak A, Goharkhay K, et al. The impact of an
erbium, chromium:yttrium-scandium-gallium-garnet laser
with radial-firing tips on endodontic treatment. Lasers Med
Sci 2009;24:59-65.
- 23. Kalyoncuoğlu E, Demiryürek E. A comparative scanning
electron microscopy evaluation of smear layer removal from
teeth with different irrigation solutions and lasers. Microsc
Microanal 2013;19:1465-9.
- 24. Arslan H, Aladag H, Haznerdaroglu F. Evaluation of efficiency
of laser systems on the removal of debris and smear layer in
maxillary canine root canals. J Laser Appl 2014;26:032005.
- 25. Altundasar E, Özçelik B, Cehreli ZC, et al. Ultramorphological
and Histochemical Changes After Er,Cr:YSGG Laser
Irradiation and Two Different Irrigation Regimes. J Endod
2006;32:465-8.
- 26. Guidotti R, Merigo E, Fornaini C, et al. Er:YAG 2,940-nm laser
fiber in endodontic treatment: a help in removing the smear
layer. Lasers Med Sci 2014;29: 69-75.
- 27. Kivanç BH, Ulusoy ÖİA, Görgül G. Effects of Er:YAG laser and
Nd: YAG laser treatment on the root canal dentin of human
teeth: an SEM study. Lasers Med Sci 2008;23:247-52.
- 28. Lottanti S, Gautschi H, Sener B, et al. Effects of
ethylenediaminetetraacetic, etidronic and peracetic acid
irrigation on human root dentine and the smear layer. Int
Endod J 2009;42:335-43.
- 29. Calt S, Serper A. Time-dependent effects of EDTA on dentin
structures. J Endod 2002;28:17-9.