Comparative evaluation of the efficacy of different irrigants including MTAD under SEM

CONTEXT: During biomechanical preparation, a smear layer is formed which occludes the openings of dentinal tubules and disfavors the penetration of irrigants. Hence, such layers should be removed. It becomes more challenging when we approach the apical third of the root canal. AIM: The aim was to compare the efficacy of different irrigants including ethylenediaminetetraacetic acid (EDTA), EDTA along with ultrasonication, citric acid, and mixture of tetracycline isomer, an acid, and a detergent (MTAD) as final irrigants where sodium hypochlorite (NaOCl) was used in each experimental group during root canal preparation with special emphasis on the apical third. SETTINGS AND DESIGN: Forty-five human upper anterior teeth were selected and divided into one control group (group 1) and four experimental groups (group 2 to group 5), each containing nine teeth. All the four experimental groups were irrigated with 5.25% NaOCl solution during preparation, whereas test irrigants (5 mL) as the final solution used in each experimental group were 17% EDTA, 17% EDTA along with ultrasonication, 25% citric acid, and MTAD, respectively. The samples were prepared and observed under a scanning electron microscope (SEM). The photomicrographs were recorded and evaluated with a scoring system. STATISTICAL ANALYSIS USED: Data were analyzed using Kruskal-Wallis test and Dunn's test (P = 0.05). RESULTS: None of the combined irrigants was found completely effective. All the test irrigants including MTAD worked well in the middle and cervical third, whereas MTAD showed excellent results in the apical third as compared to the other groups.