THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE

Jung-Min Lee; Sang-Hyuk Park; Gi-Woon Choi

doi:10.5395/JKACD.2006.31.5.378

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Lee, Park, and Choi: THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE

Original Article

J Korean Acad Conserv Dent 2006;31(5):378-389.

Published online: 14 January 2006

DOI: https://doi.org/10.5395/JKACD.2006.31.5.378

THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE

Jung-Min Lee, Sang-Hyuk Park, Gi-Woon Choi^*

Dept. of Conservative Dentistry, Division of Dentistry, Graduate school of KyungHee University

^*Corresponding Author: Gi-Woon Choi, Dept. of Conservative Dentistry, Division of Dentistry, Graduate school of KyungHee University, 1, Hoegi Dong, Dongdaemoon Gu, Seoul, 130-702, Korea, Tel: 82-2-958-9336, E-mail: gwchoi@khu.ac.kr

Received 4 April 2006 Revised 4 September 2006 Accepted 7 September 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique.

NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0.

The mean leakage ratio was decreased cervically.
NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05).
NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05).
NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05).
EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference.
In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

Keywords: NaOCl, EDTA, Smear layer, Mean leakage, Dentinal tubule

참고문헌

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Figure 1.

Mean leakage ratio in NaOCl group and EDTA group.

Figure 2.

Mean leakage ratio in NaOCl-6 group and EDTA-6 group.

Figure 3.

Mean leakage ratio in NaOCl group and NaOCl-6 group.

Figure 4.

Mean leakage ratio in EDTA group and EDTA-6 group.

Figure 5.

Photograph of the NaOCl group Level 1 (× 120).

Figure 6.

Photograph of the NaOCl group Level 2 (× 120).

Figure 7.

Photograph of the NaOCl group Level 3 (× 120).

Figure 8.

Photograph of the EDTA group Level 1 (× 120).

Figure 9.

Photograph of the EDTA group Level 2 (× 120).

Figure 10.

Photograph of the EDTA group Level 3 (× 120).

Figure 11.

Photograph of the NaOCl-6 group Level 1 (× 120).

Figure 12.

Photograph of the NaOCl-6 group Level 2 (× 120).

Figure 13.

Photograph of the NaOCl-6 group Level 3 (× 120).

Figure 14.

Photograph of the EDTA-6 group Level 1 (× 120).

Figure 15.

Photograph of the EDTA-6 group Level 2 (× 120).

Figure 16.

Photograph of the EDTA-6 group Level 3 (× 120).

Figure 17.

Photograph of the NaOCl group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gaps between gutta-percha and the surface of root canals. Surface generally covered with smear layer. Gaps were occuring between the smear layer and the gutta-percha.

Figure 18.

Photograph of the NaOCl group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 19.

Photograph of the EDTA group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin. But, voids were occuring between the sealer and the gutta-percha.

Figure 20.

Photograph of the EDTA group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. Gap-free region was showing between the sealer and the dentinal tubules. Numerous sealer tags could be seen within the intertubular dentin.

Figure 21.

Photograph of the NaOCl-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 22.

Photograph of the NaOCl-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the gap-free region between gutta-percha and the surface of root canals. Surface generally covered with smear layer.

Figure 23.

Photograph of the EDTA-6 group Level 1 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Figure 24.

Photograph of the EDTA-6 group Level 2 (× 1000); Scanning electron micrographs of tooth sections showing the penetration of sealers to opened dentinal tubules. A few sealer tags could be seen within the intertubular dentin.

Table 1.

Irrigation solution to treat the smear layer in this study

Products	Manufacturer	Function & Characteristics
NaOCl	KMC Pharmacy, Seoul, Korea	37℃, 3%
MD-Cleanser		17% EDTA
	META BIOMED Co., Okcheon,	30% ammonia solution
	Chungbuk, Korea	1 – 2% acetyl pyridine chloride
		Distilled water

Table 2.

Materials and instruments used in this study

Products	Manufacturer	Function & Characteristics
Endo-EZE^®	Ultradent Product Inc.,	27 gauge,
Endo-EZE^®	South Jordan, USA	Flexible irrigator tip

K3^™	SybronEndo, CA, USA	Rotary Ni-Ti file

K-file	Maillefer, Ballaigues, Swiss	Hand file

Pro-engine power unit	Sae-Yang Machinery co., Daegu, Korea	Micromotor & handpiece

Heating Mantle	Misung Scientific co., Yangju, Korea	Warmer

Temperature Controller	Misung Scientific co., Yangju, Korea	Keeping temperature at a fixed level

AH-26	Dentsply DeTrey, Germany	Sealer

Gutta-Percha cone	Diadent, Korea	Canal obturation material

System B	Analytic technology, USA	Canal obturation unit

Buchanan Plugger	Analytic technology, USA	Plugger

Obtura-Ⅱ	Texceed Co, USA	Gutta-percha backfilling

Table 3.

Classification of experimental groups

Group	n	Irrigating solution	Final flush
NaOCl	20	37℃ 3% NaOCl	37℃ 3% NaOCl (5㎖)	2 min
EDTA	20	37℃ 3% NaOCl	17% EDTA (5㎖)	2 min
NaOCl-6	20	37℃ 3% NaOCl	37℃ 3% NaOCl (5㎖)	2 min
EDTA-6	20	37℃ 3% NaOCl	17% EDTA (5㎖)	2 min

Table 4.

Mean leakage ratio at each level (Mean ± SD)

Group	Level 1	Level 2	Level 3
NaOCl	0.46 ± 0.24	0.18 ± 0.28	0.07 ± 0.19
EDTA	0.20 ± 0.26	0.12 ± 0.25	0.07 ± 0.18
NaOCl-6	0.69 ± 0.32	0.38 ± 0.41	0.29 ± 0.37
EDTA-6	0.37 ± 0.39	0.19 ± 0.29	0.09 ± 0.14

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