This allows better flow of solution and more


This study gives the understanding of the process of
smear layer removing ability of all the solution. Removal of smear layer was
more efficient in coronal and middle third as compared to apical third. This
finding is in agreement with results of
Abbott PV, Heijkoop PS et al. study and many
studies which have proved in past that an effective cleaning action in the
coronal and middle third of the canals even with different irrigation solution,
time, and volume (15, 16). In coronal and middle third areas where a larger
canal diameter allows better flow of solution and more time to be in contact
with dentine wall which improves the efficiency of solution to remove smear
layer(3,16).

            Role
of surfactant has been discussed by many authors, in present study SmearClear,
SmearOFF and Chloroquick have surfactant in the solution. Abou-Rass and Patonai
confirmed that reduction of surface tension of endodontic solutions improved
their flow into narrow root canals (17). Therefore, addition of surfactants to
irrigation solution should improve its penetration into apical narrow part of
root canal. In present study SmearClear and SmearOFF despite having additional
surfactant doesn’t shows significant removal of smear layer in apical third
when compared to control group of 17% EDTA, which does not have a any addition
surfactant. This result is in agreement with the findings of Lui et al. (18). Also,
other studies have shown that calcium chelating ability of solution is not improved
by reducing surface tension of solution.

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            Continuous soft chelating irrigation shows significantly
better removal of smear layer then conventional irrigation protocol when 18%
HEBP was used in combination with 5.25% NaOCl (Chloroquick High). Where 9% HEBP
in combination with 3% NaOCl (Chloroquick Low) did not show any significance
difference compared to conventional irrigation protocol groups. In apical third
of the root canals Chloroquick High shows better removal of smear layer this results
can be attributed to chelating agent being more time in canal and also
chelating procedure is seen while instrumentation unlike conventional
irrigation protocol where removal of smear layer is done only once
instrumentation is completed (19). Paque et al. demonstrated that the
accumulated hard tissue debris in root canals irrigated with NaOCl + HEBP was
significantly less than when irrigation was performed with 2.5% NaOCl alone
(20). Another advantage of this combination is that it keeps the hypochlorite-
hypochlorous acid equilibrium towards hypochlorite, which has better tissue
dissolution capacity than hypochlorous acid (21). This combination is affective
on inorganic as well as organic part of smear layer.

            Result
of this study is in contrast to the recently published study by Aby
Kuruvilla et al. where 7% malic acid
was more effective in removing smear layer as compared to 17% EDTA and 18%
etidronic acid (22). This observation may be seen because 18% etidronic acid
was merely used in a final rinse irrigation protocol. 

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