Effect of endodontic irrigation, with and without the use of ultrasound, on removal of smear layer and biofilm

Kathrein Tapia da Silva, Nathiele Boeno, Sílvia Dias de Oliveira, Renata Grazziotin-Soares, José Antonio Poli de Figueiredo

Introduction: This study investigated the effect of different endodontic irrigation protocols, with or without ultrasonic activation, on cleaning and decontamination of the three thirds of the root canal. Methods: Teeth were inoculated with E. faecalis and remained in culture for 50 days for biofilm formation. The teeth were divided into eight groups according to the endodontic irrigant used and the use of ultrasonic activation: G1 = 2.5% NaOCl + ultrasound; G2 = 2% chlorhexidine solution + ultrasound; G3 = 2% chlorhexidine gel + ultrasound; G4 = H2O + ultrasound; G5 = 2.5% NaOCl; G6 = 2% chlorhexidine solution; G7 = 2% chlorhexidine gel and G8 = H2O. The roots were divided into two slices and analyzed by scanning electron microscopy (SEM). The images were classified according to the level of cleanness (presence of smear layer, 2000x) and decontamination (presence of bacteria, 10000x) on the coronal, middle and apical thirds. Results: Ultrasound improved the cleaning and decontamination ability of all endodontic irrigants tested, mainly of sodium hypochlorite and chlorhexidine solution. Chlorhexidine gel without ultrasound had the lowest values of cleaning; however, when combined with ultrasound, it provided a cleaning ability similar to 2.5% NaOCl. As for decontamination in the apical third, chlorhexidine solution without ultrasound presented better decontamination ability than chlorhexidine gel with ultrasound. Conclusion: It was concluded that ultrasound improved the cleaning ability on the three root canal thirds by bringing the endodontic irrigant in contact with microorganisms and dentin debris within the canal system, thus optimizing their removal.

Keywords: Endodontics. Enterococcus faecalis. Chlorhexidine. Scanning electron microscopy. Sodium hypochlorite.

How to cite: Silva KT, Boeno N, Oliveira SD, Grazziotin-Soares R, Figueiredo JAP. Effect of endodontic irrigation, with and without the use of ultrasound, on removal of smear layer and biofilm. Dental Press Endod. 2015 May-Aug;5(2):12-9. DOI: http://dx.doi.org/10.14436/2358-2545.5.2.012-019.oar

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