The Impact of Different Endodontic Irrigant Solutions on Smear Layer Removal Activated by Diode Laser, Sonic, and Ultrasonic Waves: An in-Vitro study
Abstract
https://doi.org/10.31386/dmj.2026.20.2.9
Background and Objective: To evaluate and compare the effectiveness of (ethylenediaminetetraacetic acid EDTA, Triton and QMix) with three different activation techniques (Sonic, Ultrasonic, Diode laser) on smear layer removal.
Materials and Methods: Ninety single-rooted extracted mandibular premolars were decoronated to a length of 12 mm instrumented biomechanically with Protaper Next up to size X3. The roots were then randomly divided into three groups according to final irrigation (17%EDTA, Triton, QMix) (number=30) each group subdivided into subgroup according to activation method (Sonic, Ultrasonic, Diode laser) (number=10). The samples were sectioned longitudinally and analyzed using a four-level scoring system in the coronal, middle, and apical thirds under a scanning electron microscope at 3000x magnification.
Result: Triton activated by diode laser was the most effective method on smear layer removal in apical third with a significant difference when compared to Sonic, Triton with diode laser being more effective on smear layer removal than in QMix group with significant differences, and no significant different in activation method between other group. The removal of the smear layer was more successful in the middle and coronal thirds than in the apical third with significantly observed in most group.
Conclusion: Diode laser activation, especially when used with Triton irrigant optimizes smear layer removal in apical area outperforming Sonic methods and combination of Triton with Diode laser enhanced cleaning performance compared with other groups. The removal of the smear layer was more successful in the middle and coronal thirds than in the apical third.
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References
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