Suman Sanghamitra, Verma Promila, Prakash-Tikku Aseem, Bains Rhythm, Kumar-Shakya Vijay
Post Graduate Student, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Clin Exp Dent. 2017 Aug 1;9(8):e981-e987. doi: 10.4317/jced.53881. eCollection 2017 Aug.
This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy.
40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test.
The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups.
None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal. EndoVac, EndoActivator, Er:YAG laser, smear layer, scanning electron microscopy.
本研究旨在通过扫描电子显微镜比较EndoActivator、EndoVac和Er:YAG激光在下颌前磨牙根管根尖、中部和冠部三分之一处去除玷污层的效果。
40颗拔除的下颌前磨牙截冠至标准化长度12mm。标本预备至ProTaper F4尺寸，在器械预备期间用37℃的5.25%次氯酸钠冲洗。根据所使用的冲洗液激活技术，将牙齿分为四组（n=10），一组为对照组（用针冲洗），三组为实验组，即超声冲洗（EndoActivator）、根尖负压冲洗（EndoVac）或激光冲洗（Er:YAG）。最终使用的冲洗液为10ml、17%乙二胺四乙酸（EDTA）和10ml、5.25%次氯酸钠。然后将根管纵向劈开，在扫描电子显微镜下观察。评估根管根尖、中部和冠部三分之一处玷污层的存在情况。通过Kruskal-Wallis检验和Mann-Whitney U检验分析得分。通过Kappa检验确定检查者内和检查者间的可靠性。
EndoVac系统在去除根尖三分之一处的碎屑方面明显比所有其他组更有效。EndoActivator在根尖三分之一处的表现优于激光冲洗。所有三个实验组（EndoVac、EndoActivator和激光冲洗）在根管中部和根尖三分之一处均优于针冲洗。在冠部三分之一处，四组之间未见显著差异。
没有一种激活系统能完全去除牙本质壁上的玷污层；然而，EndoVac在去除根管根尖三分之一处的碎屑方面明显更好。EndoVac、EndoActivator、Er:YAG激光、玷污层、扫描电子显微镜。
