Effect of Combined Use of Photon-Initiated Photoacoustic Streaming and Chitosan on Smear Layer Removal

Abstract

Objective: Ethylene diamine tetraacetic acid (EDTA) is an appropriate irrigant for smear removal. This study aims to compare the smear-removing capacity of chitosan in combination with photon-initiated photoacoustic streaming (PIPS) to that of EDTA.

Methods: Forty-five human mandibular premolar teeth were included. Root canals were prepared with OneShape files. The samples were randomly divided into three equal groups. The final rinsing was done as follows. Group 1: 0.2% chitosan irrigation with PIPS irradiation; Group 2: 0.2% chitosan alone; and Group 3: 17% EDTA. All the roots were longitudinally split into two halves and examined under SEM to assess the remaining smear. A statistical analysis was performed using the Kruskal-Wallis test.

Results: In the overall evaluation, the remaining smear was significantly less for group 1 as compared to the other groups (p<0.05). In groups 2 and 3, the remaining smear significantly increased in the apical one-thirds, while in Group 1, the remaining smear was significantly less than the apical one-thirds of the other groups (p<0.05).

Conclusion: Photon-initiated photoacoustic streaming combined with 0.2% chitosan improved the removal of smear layers.