The present study aimed to assess the effectiveness of different final irrigation regimens (Cold Atmospheric Pressure Plasma Jet, MTAD, and EDTA) in removing the smear layer from intra-radicular dentin using a Scanning Electron Microscope (SEM). Eighty-four mandibular premolars were prepared with ProTaper Universal hand files and were equally divided into four groups i.e. Normal saline (control), EDTA, MTAD and CAP Plasma Jet. Prepared samples in the control, EDTA and MTAD groups were irrigated with 5 milliliters of the irrigant, and it was retained for 2 min. In the CAP Plasma Jet group, the plasma plume was directed towards the canal lumen for 2 min. The smear layer removal of all the groups was evaluated at the coronal, middle and apical thirds. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn\'s test. Evaluation by SEM showed that the smear layer removal ability of MTAD and EDTA were significantly better than CAP Plasma Jet (p < 0.05). While CAP Plasma Jet showed results comparable to EDTA in the coronal third. In the middle and apical third of the canal, its effect was comparable to the control group (p > 0.05). MTAD and EDTA aided in better smear layer removal than the CAP Plasma Jet in the coronal, middle, and apical third of the test samples. CAP Plasma jet performed better in the coronal third.

BACKGROUND: Innovative file systems have been recently introduced, claiming improved effectiveness and superior ability to preserve the tooth structure, still allowing an efficient preparation and disinfection up to the apical region. Regardless, few data are available on the comparative effectiveness of the most recently developed systems. Thus, this ex vivo study aimed to comparatively evaluate, for the first time, the functionality of WaveOne Gold (WOG), TruNatomy (TN), and ProTaper Ultimate (PU) file systems regarding canal shaping, dentin preservation, and smear layer removal ability.
METHODS: Human maxillary incisors were randomly divided for instrumentation with one of the assayed systems. Canal shaping ability and pericervical dentin preservation were characterized through microtomographic evaluation and morphometric assessment (n = 15). Smear layer removal ability was evaluated by scanning electron microscopy (SEM) (n = 6).
RESULTS: TN and PU presented the lowest canal volume variation upon instrumentation, found to be significantly lower than that attained with WOG (P < .05). Pericervical dentin was reduced in all groups upon instrumentation, with TN evidencing the highest preservation, quantitatively similar to PU, and significantly higher than that attained with WOG (P < .05). SEM imaging revealed the presence of scattered remnants of the smear layer and partially opened dentinal tubules at the apical portion, with no significant differences between systems.
CONCLUSIONS: TN and PU allowed for the highest tissue preservation, reporting the lowest volume variation and the highest preservation of the pericervical dentin. None of the assessed systems provided a complete removal of the smear layer in the apical region.

OBJECTIVE: This study aimed to compare the two nickel-titanium (NiTi) instruments on root dentin thickness using cone-beam computed tomography (CBCT) and ability to remove the smear layer using scanning electron microscope (SEM).
METHODS: The effect of two NiTi rotary instruments such as XP Endo shaper and ProTaper Gold (PTG) in retaining adequate dentin thickness and debridement (i.e., removal of smear layer) was evaluated in vitro using CBCT and SEM. After cleaning and shaping of the root canal with adequate irrigation, the effect of two NiTi instrument systems at 3 mm (apical), 6 mm (middle), and 9 mm (coronal) levels on buccal, lingual, mesial, and distal aspects in terms of amount of dentin removal and smear layer removal was evaluated. The data were analyzed using student\'s unpaired t-test with a significance of P ≤ 0.05.
RESULTS: Both NiTi instrument systems had no statistically significant difference in amount of dentin removal at all three levels and on all four aspects. In smear layer removal, PTG had significantly better efficacy compared to XP Endo shaper at the coronal third of root canal.
CONCLUSIONS: Instrumentation with XP Endo Shaper and PTG showed a similar amount of dentin removal. PTG has a significant effect on smear layer removal compared to XP Endo Shaper only at the coronal third of root canal.

Irrigation of the pulp space is a mandatory step to get rid of all its organic and inorganic content. Activation of the irrigants play a key role in the era of minimally invasive endodontics. The aim of this study was to assess the effectiveness of different irrigants activation methods in removing the smear layer at 1, 3, 5 and 8 mm from the apex from conservatively shaped canals.
Eighty-five human mandibular premolars were selected. Specimens were shaped to TruShape 25/.06 and divided into 5 groups (1 control and 4 test groups) according to the final activation technique (EndoActivator, EA), Ultrasonic (EndoUltra, PUI) and Laser (PIPS and SWEEPS). EDTA (Ethylenediaminetetraacetic acid) followed by NaOCl (Sodium Hypochlorite) and again EDTA were activated for each test group. Specimens were then split longitudinally and observed by Field Emission Scanning Electron Microscopy (FESEM). Blinded evaluation of the presence of smear layer was performed at 1000X magnification, according to a 5-score index system. Comparison between groups were analysed statistically using the Kruskal-Wallis non-parametric analysis of variance. Bonferroni multiple comparison tests were used.
At 1 mm only PIPS and SWEEPS performed better than the control group. At 3, 5 and 8 mm from the apex, every activation technique showed statistically significant reduction of smear layer when compared to the control group. PIPS and SWEEPS obtained better cleanliness result compared to EA, while only PIPS was superior to PUI in terms of cleanliness.
PIPS and SWEEPS showed the best results in conservative canal preparations. Nowadays, contemporary rotary instruments allow fast and minimally invasive shaping of the endodontic space. In this scenario irrigants\' activation may be regarded as a mandatory step to a favourable clinical outcome.

UNASSIGNED: Healing potential of plants is an age-old idea that has recently attained renewed interest. Considering the ineffectiveness, potentially harmful effects, and safety concerns of commonly used synthetic irrigants, the herbal alternatives for endodontic usage might prove to be advantageous.
UNASSIGNED: The aim of this study was to evaluate the adequacy of smear layer removal and cytotoxicity potential of triphala in comparison to sodium hypochlorite.
UNASSIGNED: The study was conducted in two parts: the first part of the study was cytotoxicity assessment studied using Alamar blue assay. L929 mouse fibroblasts were seeded in 96-well plates at a density of 5000 cells/well and treated with different concentrations of triphala and NaOCl for a period of 24 and 48 h. The percentage of cell viability was then quantified using an Alamar blue assay. The optical density was measured at 570 nm and compared with 620 nm, which was considered as a reference wavelength. The second part of the study was smear layer assessment at the coronal, middle, and apical third of twenty human premolar teeth using scanning electron microscope.
UNASSIGNED: The Alamar blue reagent cytotoxicity study suggested that triphala showed no cytotoxic properties against the normal mouse fibroblast cells whereas sodium hypochlorite showed a significant cytotoxic effect against the L929 cell lines with the IC50 concentration at 1.8%, respectively, after the treatment of 24 h of incubation at 37°C temperature. Triphala was as effective as sodium hypochlorite in smear layer removal in the coronal and middle third of the root, but sodium hypochlorite showed better smear layer removal in the apical third.
UNASSIGNED: Triphala can be considered as a superior irrigant with good antibacterial efficacy and least cytotoxicity potential compared to conventional hypochlorite irrigating agent and provide adequate clearing of smear layer in the coronal and middle third, and further studies are warranted to alter the properties of liquid to make it more cleansable in the apical third of the root.

UNASSIGNED: The presence of smear layer and debris can prevent the irrigant and sealer from penetrating the dentinal tubules thereby compromising the seal of the root canal filling.
UNASSIGNED: This study aims to evaluate the efficacy of XP-endo Finisher with ProTaper Next and HyFlex in smear layer and debris removal.
UNASSIGNED: : Thirty-two extracted mandibular premolar teeth were selected and sectioned at the cementoenamel junction. The roots were then randomly divided into 4 groups. In group 1 and 2, canals were instrumented with X2 ProTaper Next (25 0.06 taper). In group 3 and 4, canals were instrumented with HyFlex system (25 0.06 taper). The canals in group 2 and 4 were further finished with XP-endo Finisher. Irrigation was carried out using 3% sodium hypochlorite during instrumentation, and 17% ethylenediaminetetraacetic acid was used as the final rinse. The roots were then split longitudinally. The canal wall was observed under the scanning electron microscope in coronal, middle, and apical thirds at a magnification of ×400 and ×1000 for evaluation of debris and smear layer, respectively. Photomicrographs were taken, and qualitative assessment for debris and smear layer removal was done.
UNASSIGNED: The results were analyzed using Kruskal-Wallis test and Mann-Whitney U-test.
UNASSIGNED: Lower debris and smear layer scores were seen in canal thirds instrumented with ProTaper Next and XP-endo Finisher (P < 0.01).
UNASSIGNED: The use of XP-endo Finisher as an adjuvant during shaping and cleaning produced cleaner root canal walls.

UNASSIGNED: The aim of this study was to evaluate the ability of pressurized water irrigation technique (AquaPick Device) as an intra-canal irrigation technique and compare it with sonic irrigation device (Endoactivator) for their ability to remove smear layer from canals.
UNASSIGNED: Total number of 80 single rooted teeth (premolars) were prepared, divided into eight main groups, Group 1: Aquapick with apically vented needle/18 mm depth, Group 2: Aquapick with apically vented needle/15 mm depth, Group 3: Endoactivator device/18 mm depth, Group 4: Endoactivator device/15 mm depth, Group5: Aquapick with 2 side vented needle/18 mm depth, Group 6: Aquapick with 2 side vented needle/15 mm depth and two control groups. Then all samples were tested by SEM in 3, 6 and 9-mm distances from the apical foramen. The data were statistically analyzed using Kruskal Wallis and Mann-Whitney U tests.
UNASSIGNED: There was a high significant difference among the tested groups with the best removal of smear layer by the use of pressurized water irrigation device with apical vented needle especially at the 3 mm area.
UNASSIGNED: Pressurized water irrigation technique could be used as intra-canal irrigation technique with good results.

OBJECTIVE: The purpose of this study was to compare the efficacy of smear layer removal by 5% chlorine dioxide and 15% Ethylenediamine Tetra-Acetic Acid plus Cetavlon (EDTAC) from the human root canal dentin.
METHODS: Fifty single rooted human mandibular anterior teeth were divided into two groups of 20 teeth each and control group of 10 teeth. The root canals were prepared till F3 protaper and initially irrigated with 2% Sodium hypochlorite followed by 1 min irrigation with 15% EDTAC or 5% Chlorine dioxide respectively. The control group was irrigated with saline. The teeth were longitudinally split and observed under Scanning electron microscope SEM (×2000).
METHODS: The statistical analysis was done using General Linear Mixed Model.
RESULTS: At the coronal thirds, no statistically significant difference was found between 15% EDTAC and 5% Chlorine dioxide in removing smear layer. In the middle and apical third region 15% EDTAC showed better smear layer removal ability than 5% Chlorine dioxide.
CONCLUSIONS: Final irrigation with 15% EDTAC is superior to 5% chlorine dioxide in removing smear layer in the middle and apical third of radicular dentin.