Influence of Smear Layer on the Antimicrobial Activity of a Sodium Hypochlorite/Etidronic Acid Irrigating Solution in Infected Dentin

Ana Morago, Ronald Ordinola-Zapata, Carmen María Ferrer-Luque, Pilar Baca, Matilde Ruiz-Linares, María Teresa Arias-Moliz

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Introduction The aim of this study was to evaluate the influence of the smear layer on the antimicrobial activity of a 2.5% sodium hypochlorite (NaOCl)/9% etidronic acid (HEBP) irrigating solution against bacteria growing inside dentin tubules. Methods Dentin tubules were infected with Enterococcus faecalis by centrifugation. After 5 days of incubation, the smear layer had formed in half of the samples, which were then treated with 2.5% NaOCl either alone or combined with 9% HEBP for 3 minutes. The percentage of dead cells in infected dentinal tubules was measured using confocal laser scanning microscopy and the live/dead technique. The smear layer on the surface of the root canal wall was also observed by scanning electron microscopy. Results of the percentage of dead cells were compared using parametric tests after subjecting data to the normalized Anscombe transformation. The level of significance was P < .05. Results In the absence of the smear layer, 2.5% NaOCl alone and combined with 9% HEBP showed high antimicrobial activity without significant differences between the 2. The smear layer reduced the antimicrobial activity of 2.5% NaOCl significantly, whereas the solution with HEBP was not affected. No dentin tubules free of the smear layer were obtained in the 2.5% NaOCl group. In the case of 2.5% NaOCl/9% HEBP, 95.40% ± 3.63% of dentin tubules were cleaned. Conclusions The presence of the smear layer reduced the antimicrobial activity of 2.5% NaOCl. The combination of 2.5% NaOCl/9% HEBP exerted antimicrobial activity that was not reduced by the smear layer.

Original languageEnglish (US)
Pages (from-to)1647-1650
Number of pages4
JournalJournal of Endodontics
Volume42
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Bibliographical note

Funding Information:
Supported by the Research Group CTS -167 (Junta de Andalucía, Spain).

Keywords

  • Antimicrobial activity
  • etidronic acid
  • infected dentin
  • root canal irrigants
  • smear layer
  • sodium hypochlorite

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