Effectiveness of different irrigation techniques on smear layer removal in apical thirds of mesial root canals of permanent mandibular first molar: A scanning electron microscopic study.

AIM: The aim of this study was to compare smear layer removal after final irrigant activation with sonic irrigation (SI), manual dynamic agitation (MDA), passive ultrasonic irrigation (PUI), and conventional syringe irrigation (CI). MATERIALS AND METHODS: Forty mesial canals of mandibular first molars (mesial roots) were cleaned and shaped by using ProTaper system to size F1 and sodium hypochlorite 3% and 17% ethylenediaminetetraacetic acid. The specimens were divided into 4 equal groups (n = 10) according to the final irrigation activation technique: Group 1, PUI; group 2, manual dynamic activation (MDA); group 3, SI; and group 4, control group (simple irrigation). Samples were split longitudinally and examined under scanning electron microscope for smear layer presence. RESULTS: Control groups had the highest smear scores, which showed the statistically significant highest mean score at P < 0.05. This was followed by ultrasonic, MDA, and finally sonic, with no significant differences between them. CONCLUSIONS: Final irrigant activation with sonic and MDA resulted in the better removal of the smear layer than with CI.