Efficacy of Glycolic Acid on Debris and Smear Removal as a Final Rinse Solution in Curved Canals: A Scanning Electron Microscope Study.

AIM: This study aims to compare intraradicular smear layer removal efficacy of different concentrations of glycolic acid (GA), 17% ethylenediaminetetraacetic acid (EDTA), and 10% citric acid (CA) as final rinses in the canals of curved mesial root of mandibular first molars using the specific irrigant protocols. MATERIALS AND METHODS: Fifty-eight mandibular first permanent molars with 15°-30° of curvature of the mesial roots were selected, standardized, mesiobuccal canal prepared using the rotary instrumentation. Sodium hypochlorite was used as initial rinse solution (8 ml). The samples were divided into control (n = 5) (I - Normal saline and II - 17% EDTA) and experimental groups (n = 8) (Groups III, IV, V, VI, VII, and VIII) based on the type of final rinse solution (5 ml) used, i.e. 2.5% GA, 5% GA, 10% GA, 17% GA, 37% GA, and 10% CA. Samples were split buccolingually, dehydrated, splutter coated, and examined under a scanning electron microscope. RESULTS: Group IV presented the least amounts of smear among the GA experimental groups at the apical, middle, and coronal one-thirds of the root canal with a mean value of 2.6 ± 1.012, and on comparison with Group II, the results were comparable, and no significant difference found statistically (P > 0.05). CONCLUSION: The use of GA as final rinse solution for biomechanical preparation during endodontic therapy seems promising. Further evaluation in a clinical setting is recommended.

Successful Nonsurgical Management of Periapical Lesions of Endodontic Origin: A Conservative Orthograde Approach.

Periapical lesions of endodontic origin are common pathological conditions affecting periradicular tissues. Microbial infection of pulpal tissues is primarily responsible for initiation and progression of apical periodontitis. The primary objective of endodontic therapy should be to restore involved teeth to a state of normalcy nonsurgically. Different nonsurgical management techniques, namely, conservative root canal therapy, decompression technique, method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and tissue repair therapy, active nonsurgical decompression technique, and the apexum procedure have been advocated. New techniques which use drug-loaded injectable scaffolds, simvastatin, and epigallocatechin-3-gallate have been tried. Surgical option should be considered when intra- or extra-radicular infections are persistent. Incidence of nonendodontic periapical lesions has also been reported. An accurate diagnosis of the periapical lesion whether it is of endodontic or nonendodontic origin has to be made. Surgical methods have many disadvantages, and hence should be considered as an option only in the case of failure of nonsurgical techniques. Assessment of healing of periapical lesions has to be done periodically which necessitates a long-term follow-up. Even large periapical lesions and retreatment cases where the lesion is of endodontic origin have been successfully managed nonsurgically with orthograde endodontic therapy.