Can Irrigant Agitation Lead to the Formation of a Smear Layer?

Introduction: This study aimed to assess whether ultrasonic activation (UA) or the EasyClean (EC; BassiEndo, Belo Horizonte, BH, Brazil) or EDDY (ED; VDW, Munich, Germany) systems used to promote agitation of the irrigating solutions during the final irrigation step can lead to smear layer formation in the apical third of the root canal.

Methods: Thirteen premolars were instrumented with the Reciproc R40 file (VDW) and embedded in silicone, forming a closed irrigation/aspiration system. The teeth were cleaved, and 4 indentations were made on the inner buccal wall of the canal to standardize the observation sites. All the specimens were cleaned in an ultrasonic bath and evaluated under environmental scanning electron microscopy, thus constituting the control group. The same specimens were reassembled, submitted to final irrigation using UA or the ED or EC systems, and classified using a 4-level scoring system. The data were analyzed using the kappa, Pearson, and Kruskal-Wallis tests (P < .05).

Results: Smear layer formation occurred in all of the experimental groups and at all apical levels. At 3 and 4 mm, all of the experimental groups had significantly higher levels of smear layer formation than the control group. At 2 mm, the level of smear layer formation in the UA group was significantly higher than that of the control group, and there were no significant differences among the EC, ED, and control groups. At 1 mm, there were no significant differences between the ED and control groups, and the levels of smear layer formation in the EC and UA groups were significantly higher than that of the control group. There were no significant differences between the ED and EC groups at any of the apical levels.

Conclusions: The smear layer formation occurred in all of the specimens submitted to final irrigation, irrespective of the technique used.