Effect of MTAD as a final rinse on removal of smear layer in ten-minute preparation time.

Introduction: The aim of this study was to evaluate the effect of MTAD as final rinse on removal of the smear layer subsequent to primary irrigation with 1.3% sodium hypochlorite (NaOCl) during 10-minute instrumentation periods.

Methods: Forty teeth were divided into 2 experimental groups, each containing 15 teeth, and 1 positive control group of 10 teeth. The canals were prepared with hand and rotary instruments. In the MTAD group, the root canals were flushed with 1.3% NaOCl solution during 10-minute instrumentation, and MTAD was used as the final rinse. In other experimental group, 5.25% NaOCl was used during instrumentation, and 17% ethylenediaminetetraacetic acid (EDTA) was used as the final rinse. In the positive control group, sterile distilled water was used for irrigation. The overall instrumentation period for each canal was 10 minutes. The amount of the smear layer and degree of erosion qualified according to the study by Torabinejad et al by using a scanning electron microscope. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests. All statistical analyses were set with a significance level of α = 0.05.

Results: In the positive control group, debris and heavy smear layer covered the root canal surface and the tubules. In MTAD group, moderate smear layer covered the root canal surface and the tubules. In EDTA group, there was no smear layer on surface of canals. There were significant differences between groups (α < 0.0001). Mann-Whitney test showed significant difference between experimental groups (α = 0.01).

Conclusions: In 10-minute instrumentation period, the use of 5.25% NaOCl during instrumentation and 17% EDTA as the final rinse is more effective than using 1.3% NaOCl as primary irrigation and MTAD as final rinse on removal of the smear layer.