Scanning electron microscopic evaluation of smear layer removal at the apical third of root canals using diode laser, endoActivator, and ultrasonics with chitosan: An in vitro study

Abstract

<b>Aim</b>: The aim of this study was to compare the effect of diode laser, endoActivator, and passive ultrasonics for smear layer removal at the apical third from root canals with 0.2% chitosan.<br><b>Materials and Methods</b>: A total of 40 mandibular premolars were decoronated to establish a working length of 12 mm and shaped with ProTaper rotary files up to size F3. In Group A, canals were irrigated with 1 ml of 0.2% chitosan. In Group B, canals were initially irrigated with 0.8 ml of 0.2% chitosan and the remaining 0.2 ml was activated with diode laser. In Group C, canals were irrigated with 1 ml of 0.2% chitosan which was activated with endoActivator. In Group D, canals were irrigated with 0.2% chitosan and activated with passive ultrasonics. All samples were finally flushed with 3 ml of distilled water. The percentage of smear layer removal was analyzed with a scanning electron microscope examination at ×1000 and ×3000. Data were analyzed using Statistical Package for the Social Sciences version 16.0 (SPSS Inc., Chicago, IL, USA) at a significance level of <i>P</i> < 0.05.<br><b>Results</b>: The mean value for Group B when compared to Group C for the removal of smear layer was higher, but there was no statistically significant difference between the two groups (<i>P</i> < 0.068 and <i>P</i> < 0.295). Both Group B and Group C showed a statistically significant difference (<i>P</i> < 0.001) when compared to Group A and Group D for the removal of smear layer.<br><b>Conclusion</b>: Diode laser and endoActivator with 0.2% chitosan proved better in the removal of the smear layer when compared to passive ultrasonic irrigation.