Cleanliness in the Root Canal System: An Scanning Electron Microscopic Evaluation of Manual and Automated Instrumentation using 4% Sodium Hypochlorite and EDTA (Glyde File Prep)―An in vitro Study

Aim : To assess the cleaning efficacy of manual and automated instrumentation using 4% sodium hypochlorite singly and in combination with Glyde file Prep as root canal irrigant. Methodology : The study utilized 40 extracted human permanent premolars with single, straight and fully formed root. The teeth were then divided into four groups of ten each, Group I and II were prepared by manual instruments with 4% sodium hypochlorite used as irrigant singly [Group I] or in combination with Glyde file prep. Group III and IV were prepared by automated instruments at 250 rpm with 4% sodium hypochlorite as irrigant singly [Group III] and in combination with glyde file prep [Group IV] automated instrumentation. After completion of the root canal preparation the canal, teeth were prepared for SEM examination. These photomicrographs were qualitatively evaluated using criteria. Overall cleanliness, presence or absence of the smear layer, presence or absence of the debris, patency of the opening of dentinal tubules. Results : When comparing the cleansing efficacy of manual and automated instrumentation using 4% sodium hypochlorite better cleansing was there with manual instrumentation. When comparing the cleansing efficacy of manual and automated instrumentation using combination regime cleansing is better with automated instrumentation. When comparing the cleansing efficacy of manual instrumentation using 4% sodium hypochlorite singly and in combination with EDTA, the combination regime led to better cleansing. When comparing the cleansing efficacy of automated instrumentation using 4% sodium hypochlorite singly and in combination regime lead to better cleansing. Conclusion : Neither of instrumentation technique, nor irrigating regimes were capable of providing a completely clean canal. Automated instrumentation with a combination of sodium hypochlorite & EDTA resulted the best cleansing efficacy.