Comparative Evaluation of a New Endodontic Irrigant - Mixture of a Tetracycline Isomer, an Acid, and a Detergent to Remove the Intracanal Smear Layer: A Scanning Electron Microscopic Study

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Abstract
The most important and demanding aspect of endodontic therapy is considered to be cleaning and shaping. Irrigation is considered a vital adjunct to instrumentation of the root canal for canal debridement. Until date, there is no single solution that simultaneously removes the smear layer and disinfects the entire root canal system. Thus, this in vitro study was designed to evaluate the efficiency of a new irrigation solution mixture of a tetracycline isomer, an acid, and a detergent (MTAD) (BioPure, Dentsply) containing a mixture of tetracycline (doxycycline hydrochloride), an acid (citric acid) and a detergent (Tween 80) in comparison with normal saline, 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) to remove intracanal smear layer. A total of 60 single rooted teeth were irrigated with Saline (Group A), 5% NaOCl (Group B), 17% EDTA (Group C) and MTDA (Group D). The extent of removal of smear layer and erosion was assessed using scanning electron microscope. Irrigation with 5% NaOCl and MTAD as a final flush produced the cleanest surface with all the dentinal tubules open. No conjugation or erosion of dentinal tubules was noted (P > 0.05). MTAD flush was the most effective debridement regimen in all the three thirds of the canal showing its ability to reach the apex with no conjugation and erosion of dentinal tubules.

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