Effectiveness of Ultrasonic, F-File, and NaviTip FX Needle Agitation Techniques on Removal of Root Canal Debris and Smear Layer Using Two Different Irrigants: A Scanning Electron Microscopy Study

Introduction: For successful endodontics, there should be proper cleaning and shaping of the canal before the obturation. Various agitation techniques help in the removal of the debris and smear layer. With the removal of this debris and smear layer, there will be a better opening of dentinal tubules and penetration of sealer in the tubule. Aim: To evaluate the effectiveness of removal of debris and smear layer from prepared root canals by comparing ultrasonic agitation, F-file agitation, and NaviTip FX needle agitation using Sodium hypochlorite (NaOCl) and SmearClear as irrigants. Materials and Methods: The present in-vitro study included 60 bilaterally matched pairs of extracted human premolar teeth with single canal and mature apices, were collected. All teeth were decoronated at the cementoenamel junction. The teeth were grooved longitudinally on the buccal and lingual surfaces. Instrumentation was done using K3 rotary files up to #40 and irrigation was carried out using 2 mL syringes mounted with Max-i-probe needles. Agitation procedure (n=10 for each group) was done as follows. Group 1: Ultrasonic agitation of 2.5% NaOCl for 30 seconds. Group 2: F-file agitation of 2.5% NaOCl for 30 seconds Group 3: NaviTip FX agitation of 2.5% NaOCl for one minute continuously. Group 4: Ultrasonic agitation of SmearClear for 30 seconds. Group 5: F-file agitation of SmearClear for 30 seconds. Group 6: NaviTip FX agitation of SmearClear for one minute continuously. The roots were split into two halves using a chisel and mallet. The amount of debris and smear layer was assessed using SEM at 1000X magnification at each root canal’s coronal, middle, and apical areas. Statistical analysis was done using Kruskal-Wallis and Mann-Whitney U test. Results: Statistically significant difference was obtained in the reduction of debris and smear layer between 2.5% NaOCl and SmearClear. Ultrasonic agitation of SmearClear was better than F-file agitation and NaviTip FX. In both debris and smear layer removal (p-value <0.05). Conclusion: Ultrasonic agitation of SmearClear was better than F-file agitation and NaviTip FX agitation. SmearClear produced better removal of debris and smear layer than 2.5% NaOCl.