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1- DDS, MSc, PhD student in Endodontics, Postgraduate Program in Dental Sciences, University of So Paulo, So Paulo, Brazil.
2- DDS, Center of Continued Education, Cear Dental Academy, Fortaleza, CE, Brazil.
3- DDS, MSc, School of Pharmacy, Dentistry and Nursing, Federal University of Cear, Fortaleza, CE, Brazil.
4- DDS, MSc, PhD, Post-Doctoral Researcher, Professor, Postgraduate Program in Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University
of Cear, Fortaleza, CE, Brazil.
5- DDS, MSc, PhD, Professor, Postgraduate Program in Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Cear, Fortaleza, CE, Brazil.
Corresponding address: Profa. Dra. Mnica Sampaio do Vale - Universidade Federal do Cear, Faculdade de Farmcia, Odontologia e Enfermagem "#$%&'%(#)'*+/#+067)89%+:/*)'*6;<89%+=+>?%+0%$8'@*+G&%)98H9*+I#/&*J+KLKQ+=+>*/*6T*+W#;X6*+=+G*&'%6#Y%+=+0Z+=+[&%H86+=+\Q]^_Q=_`Q+=+Ib*)#j+kqq=wq=__\\=
8425 - e-mail: monicavale@uol.com.br
H*)*(K*0P#Q7K*UW*'#XY"#Z[[\#]#^70(_)&`(7-P#^&8#[Z"#Z[X[#]#=))*f`*0P#:)`7W*'#Zh"#Z[X[
ABSTRACT
78"6'(#"9+:2"+3&/3)-"+),+'2(-+-'&50+1$-+')+"#$%&$'"+70+-6$**(*4+"%"6'/)*+.(6/)-6)30+
(SEM) the removal of smear layer from the middle and apical root thirds after use
of different irrigating solutions. Material and Methods: Forty roots of permanent human
'""'2+ 2$5+ '2"(/+ 6$*$%-+ (*-'/&."*'"5+ $*5+ 1"/"+ /$*5).%0+ $--(4*"5+ ')+ ?+ 4/)&3-+ @*BCGHI+
$66)/5(*4+')+'2"+(//(4$'(*4+-)%&'()*9+$33%"+#(*"4$/+@4/)&3+JHI+$33%"+#(*"4$/+K*(-2"5+1('2+
17% ethylenediaminetetraacetic acid (EDTA) (group B), 1% sodium hypochlorite (NaOCl)
K*(-2"5+1('2+CWX+YZ:J+@4/)&3+[H+$*5+-$%(*"+@4/)&3+Z+\+6)*'/)%H]+J,'"/+62".)."62$*(6$%+
3/"3$/$'()*I+'2"+/))'-+1"/"+6%"$#"5+%)*4('&5(*$%%0+$*5+'2"(/+.(55%"+$*5+$3(6$%+'2(/5-+1"/"+
"^$.(*"5+ 70+ _Y`+ $'+ bCIGGG+ .$4*(K6$'()*]+ :1)+ 6$%(7/$'"5+ "^$.(*"/-+ @j$33$BG]kqH+
$*$%0w"5+'2"+_Y`+.(6/)4/$32-+x&$%('$'(#"%0+$''/(7&'(*4+-6)/"-+'2$'+(*5(6$'"5+'2"+",K6$60+),+
the solutions in removing the smear layer from the surface of the dentin tubules (1 - poor,
q+\+4))5+$*5+|+\+"^6"%%"*'H]+Z$'$+,/).+'2"+6)*'/)%+$*5+"^3"/(."*'$%+4/)&3-+1"/"+$*$%0w"5+
70+'2"+}/&-j$%\~$%%(-+$*5+Z&**-+'"-'I+12(%"+'2"+~(%6)^)*+'"-'+1$-+&-"5+')+6).3$/"+'2"+
.(55%"+$*5+$3(6$%+'2(/5-+),+'2"+6$*$%-+1('2(*+'2"+-$."+4/)&3+@=0.05). Results: The middle
third presented less amount of smear layer than the apical third, regardless of the irrigant.
:2"/"+1$-+-'$'(-'(6$%%0+-(4*(K6$*'+5(,,"/"*6"+@3BG]G?GqH+$.)*4+'2"+4/)&3-+(*+'2"+.(55%"+
'2(/5]+ *+ '2"+ $3(6$%+ '2(/5I+ '2"+ $33%"+ #(*"4$/YZ:J+ 4/)&3+ -2)1"5+ '2"+ 4/"$'"-'+ /".)#$%+
),+-."$/+%$0"/+@3BG]G|W|H]+[)*6%&-()*9+J33%"+#(*"4$/+$--)6($'"5+)/+*)'+1('2+YZ:J+1$-+
",,"6'(#"+(*+/".)#(*4+-."$/+%$0"/+12"*+&-"5+$-+$*+"*5)5)*'(6+(//(4$*']
Key words: EDTA. Smear layer. Scanning electron microscopy.
INTRODUCTION
Sodium hypochlorite (NaOCl) is one of the
.)-'+ 1(5"%0+ &-"5+ "*5)5)*'(6+ (//(4$*'-+ ,)/+ '2"+
chemomechanical preparation of root canals
because of its excellent antimicrobial action
and capacity of dissolving organic materials15,
12(62+ (*6/"$-"+ 5(/"6'%0+ 1('2+ '2"+ (*6/"$-"+ ),+ '2"+
concentration 21]+ )1"#"/I+ '2"+ )3'(.$%+ )/4$*(6+
J Appl Oral Sci.
639
2011;19(6):639-43
=#)7Uf&'&`(K*#4)&--(-y#*%*)`'7-#U()'74)7f8#*K&%{&`(7-#7|#4U*&'#%&8*'#'*U7K&%#}(`~#&ff%*#K(-*y&'#&-0#470({U#~8f7)~%7'(`*#&447)(&`*0#}(`~#5<=
RESULTS
640
2011;19(6):639-43
641
2011;19(6):639-43
=#)7Uf&'&`(K*#4)&--(-y#*%*)`'7-#U()'74)7f8#*K&%{&`(7-#7|#4U*&'#%&8*'#'*U7K&%#}(`~#&ff%*#K(-*y&'#&-0#470({U#~8f7)~%7'(`*#&447)(&`*0#}(`~#5<=
DISCUSSION
The main goals of the chemomechanical
preparation are to eliminate bacteria and their
byproducts from the root canal system, remove
pulp tissue remnants and contaminated organic
and inorganic debris that are formed during
instrumentation and compacted into the dentin
tubules and produce a continuously tapered shape
(*+ '2"+ 6/)1*\$3"^+ 5(/"6'()*+ ')+ $%%)1+ ",,"6'(#"+
irrigation and three-dimensional obturation of
the canal space. Chemical endodontic irrigants
must have some important properties such as
biocompatibility, dissolution of organic tissues,
bactericidal action and capacity to remove smear
%$0"/+,/).+'2"+6$*$%+1$%%-]+Z(,,"/"*'+-)%&'()*-I+-&62+
as NaOCl at several concentrations, chlorhexidine
and more recently apple vinegar, have been used
as endodontic irrigants.
The biocompatibility of apple vinegar is attributed
to the presence in its composition of malic acid2,
12(62+2$-+'2"/$3"&'(6+3/)3"/'("-]+'+(*6/"$-"-+'2"+
organism resistance because it is one of the acids
),+ '2"+ }/"7-+ 606%"I+ 12(62+ (-+ $+ -"'+ ),+ /"$6'()*-+
responsible for production of energy in the cells. In
addition, apple vinegar has a remarkable medicinal
potential due to its high mineral content (potassium,
32)-32)/&-I+.$4*"-(&.I+-&%,&/I+6$%6(&.I+&)/(5"+
and silicon)8, and contains other elements, such
as pectin, beta-carotene, enzymes and amino
$6(5-I+ 12(62+ $''$6j+ ,/""+ /$5(6$%-+ '2$'+ $,,"6'+ '2"+
immune system8,10I+$*5+.$0+2$#"+-)."+7"*"K6($%+
role the periapical repair process. Therefore, it
may be assumed that apple vinegar has some
$*'((*$..$')/0+ $6'(#('0I+ 12(62+ (-+ $*+ (.3)/'$*'+
characteristic for an endodontic irrigating solution.
In addition to the biocompatibility, it has been
demonstrated that apple vinegar has bactericidal
activity against E. faecalis10I+ 12(62+ (-+ )*"+ ),+ '2"+
.$(*+ .(6/))/4$*(-.-+ $--)6($'"5+ 1('2+ "*5)5)*'(6+
treatment failure.
The 1% NaOCl solution has considerable
antibacterial activity and tissue-dissolving
property 1,6,16,20,21, and do not cause significant
decrease of the structural resistance of dentin4.
* + % ( * " + 1 ( ' 2 + ' 2 " + , ( * 5 ( * 4 - + ) , + 3 / " # ( ) & -+
investigations25,27, in the present study, the apical
'2(/5+1$-+.)/"+62$%%"*4(*4+,)/+-."$/+%$0"/+/".)#$%+
compared to the middle third. This can be explained
by the fact that the access of instruments and
chemical solutions to the middle third is easier and
'2"+"^3)-"5+5"*'(*+'&7&%"-+)/(K6"-+$/"+%$/4"/]
Failure to remove smear layer from the root
6$*$%+1$%%-+(-+6)*-(5"/"5+$-+)*"+),+'2"+.$(*+/"$-)*-+
of endodontic therapy failure5,11,12. Removal of the
-."$/+%$0"/+6$*+$%%)1+(*'/$6$*$%+."5(6$."*'-+')+
penetrate the dentin tubules in infected root canals
more readily and consequently cause a better
CONCLUSIONS
It may be concluded that the apple vinegar
$--)6($'"5+)/+*)'+1('2+YZ:J+1$-+.)/"+",,"6'(#"+(*+
removing smear layer from the root canals than
$[%+$--)6($'"5+1('2+YZ:J]+[%(*(6$%+(*#"-'(4$'()*-+
are needed to corroborate the use of apple vinegar
in endodontics, since it is a biocompatible substance
$*5+ 12(62+ 3/)5&6"-+ $*+ ",,"6'(#"+ "%(.(*$'()*+ ),+
smear layer in vitro, being potentially considered
as an alternative for root canal cleaning.
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2011;19(6):639-43
REFERENCES
C\+$&.4$/'*"/+[I+[&"*(*+]+Y,K6$60+),+-"#"/$%+6)*6"*'/$'()*-+
of sodium hypochlorite for root canal irrigation. J Endod.
1992;18:605-12.
q\+ [$%(4($*(+ JI+ J6x&)''(+ ZI+ $%%$+ I+ )662(+ ]+ 5"*'(K6$'()*+ $*5+
x&$*'(K6$'()*+),+'2"+.$(*+)/4$*(6+6).3)*"*'-+),+#(*"4$/-+70+2(42+
resolution 1H NMR spectroscopy. Anal Chim Act. 2007;585:110-9.
|\+$%(j$*+`}I+:/j*+`I+J%3"/+_]+J%%"/40+')+-)5(&.+203)62%)/('"+
during root canal therapy: a case report. Int Endod J.
1994;27:163-7.
4- Costa D, Dalmina F, Irala LED. The use of the vinegar as a
62".(6$%+$&^(%($/0+(*+"*5)5)*'(6-9+$+%('"/$'&/"+/"#("1]+"#+_&%\/$-+
Odontol. 2009;6:185-93.
5- De-Deus G, Gurgel-Filho ED, Ferreira CM, Coutinho-Filho T.
Intratubular penetration of root canal sealers. Pesqui Odontol
Bras. 2002;16:332-6.
6- Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman
AL. Comparative evaluation of endodontic irrigants against
Enterococcus faecalis+7()K%.-]++Y*5)5]+qGG|qIqW\|C]
7- Estrela C, Estrela CRA, Decurcio DA, Silva JA, Bammann LL.
Antimicrobial potential of ozone in an ultrasonic cleaning system
against Staphylococcus aureus. Braz Dent J. 2006;17:134-8.
8- Estrela C, Holland R, Bernab PFE, Souza V, Estrela CRA.
Antimicrobial potential of medicaments used in healing process in
5)4-+'""'2+1('2+$3(6$%+3"/()5)*'('(-]+/$w+Z"*'+]+qGG?C9CC\]
9- Estrela C, Lopes HP, Elias CN, Leles CR, Pcora JD. Cleanliness of
the surface of the root canal of apple vinegar, sodium hypochlorite,
chlorhexidine and EDTA. Rev Assoc Paul Cir Dent. 2007;61:177-82.
10- Estrela CR, Estrela C, Cruz Filho AM, Pcora JD. ESP substance:
option in endodontic therapy. J Bras Endod. 2005;5:273-9.
11- Farhad A, Elahi T. The effect of smear layer on apical seal of
endodontically treated teeth. J Res Med Sci. 2004;9:130-3.
12- Kennedy WA, Walker WA, Gough RW. Smear layer removal
effects on apical leakage. J Endod. 1986;12:21-7.
13- Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium
hypochlorite and 0.2% chlorhexidine gluconate separately and
combined as irrigants. J Endod. 1998;24:472-6.
14- Lee BS, Hsieh TT, Chi DC, Lan WH, Lin CP. The role of organic
tissue on the punch shear strength of human dentin. J Dent.
2004;32:101-7.
15- Marending M, Paqu F, Fisher J, Zehnder M. Impact of irrigant
sequence mechanical properties of human root dentin. J Endod.
2007;33:1325-8.
16- Naenni N, Thoma K, Zehnder M. Soft tissue dissolution
capacity of currently used and potential endodontic irrigants. J
Endod. 2004;30:785-7.
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2011;19(6):639-43